First published on February 18, 2010

Physical Therapy 2010;90:561.

Physical Therapy
DOI: 10.2522/ptj.20090093
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Research Reports

Kinematics of Rising From a Chair: Image-Based Analysis of the Sagittal Hip-Spine Movement Pattern in Elderly People Who Are Healthy

Mohammad R. Fotoohabadi, Elizabeth A. Tully and Mary P. Galea

M.R. Fotoohabadi, PT, MScMedEd, PhD, is Assistant Professor and Senior Lecturer, and Head, Education Development Office, Faculty of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.
E.A. Tully, BAppSci (Physio), PhD, is Senior Lecturer, School of Physiotherapy, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, 200 Berkeley St, Carlton, Victoria 3010, Australia.
M.P. Galea, BAppSci (Physio), BA, PhD, is Professor of Clinical Physiotherapy and Director, Rehabilitation Sciences Research Centre, University of Melbourne, and Austin Health, Parkville, Victoria, Australia.

e.tully{at}unimelb.edu.au

Background: Rehabilitation of elderly patients with sit-to-stand (STS) dysfunction includes retraining coordinated movement among participating body segments. Although trunk position is considered important, spinal movement has not been measured.

Objective: The aim of this study was to describe the sagittal thoracolumbar kinematics and hip-lumbar interaction during the STS task in elderly people who were healthy in order to guide physical therapists in developing treatment strategies.

Design: This was an observational study.

Methods: Ten retroreflective markers were attached to the midline thoracolumbar spine, pelvis, and right lower limb of 41 elderly people who were healthy. A 2-dimensional video analysis system was used to measure sagittal thoracic, lumbar, hip, and knee joint angles during the STS task. Maximal available flexion-extension angles in these joints and regions also were determined.

Results: Prior to buttocks lift-off, forward trunk lean comprised concurrent hip and lumbar flexion and thoracic extension. Hip flexion dominated, with a hip/lumbar ratio of 4.7:1 and a thoracic/lumbar ratio of 1.7:1. The hip and lumbar spine contributed 90% and 23% of their maximal available flexion angle, respectively, and the thoracic spine contributed 86% of its maximal extension range of movement. After lift-off, the hips and lumbar spine extended (ratio of 5.2:1), and the thoracic spine flexed (thoracic/lumbar ratio of 0.4:1). At lift-off, the hips and knees were similarly flexed (96°) and then locked together in a linear pattern of extension. Following lift-off, there was a brief transition phase (5% of STS duration) in which, although the hips, knees, and lumbar spine were extending, the trunk continued to flex forward a few degrees.

Limitations: Results may differ in elderly people who are less active.

Conclusions: The revised model for image-based analysis demonstrated concurrent hip and thoracolumbar movement during the STS task. Close to full available hip flexion and thoracic extension were needed for optimal STS performance.


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