-
International Journal of Environmental... May 2024Children functioning at Gross Motor Function Classification System (GMFCS) levels IV-V cannot maintain an aligned standing position or take steps without support....
Children functioning at Gross Motor Function Classification System (GMFCS) levels IV-V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and emotional well-being. Standers and supported stepping devices facilitate opportunities for biomechanical loading, potentially helping to build and maintain muscle and bone integrity, and they promote physical development. However, families are often required to choose between these two devices for their young child. This study aims to synthesize evidence for use and benefits of both supported standing and stepping devices through the lens of two contemporary theoretical frameworks to support clinical reasoning and implementation. The F-words for childhood development (functioning, family, fitness, fun, friends, future) and the interdependence-Human Activity Assistive Technology (iHAAT) models were combined to illustrate the complex interactions between the child, family, caregivers, peers and contextual factors when implementing standing and stepping devices with children at GMFCS levels IV and V. Supported standing and stepping devices provide complementary benefits, and both may be necessary starting at 9-15 months. We propose they both be included ON-Time, along with other age-appropriate positioning and mobility devices, to promote more equitable developmental opportunities for children with non-ambulant cerebral palsy.
Topics: Child; Child, Preschool; Humans; Cerebral Palsy; Self-Help Devices; Standing Position
PubMed: 38928915
DOI: 10.3390/ijerph21060669 -
Disability and Rehabilitation.... Nov 2023There are no manually propelled wheelchairs on the market that are mobile in both seated and standing positions. In response to this product gap, our group formerly...
PURPOSE
There are no manually propelled wheelchairs on the market that are mobile in both seated and standing positions. In response to this product gap, our group formerly designed a mobile manual standing wheelchair (MMSW) and gathered stakeholder feedback. The purpose of this study was to refine the MMSW based on feedback, including weight and width reduction, and evaluate its performance.
MATERIALS AND METHODS
The MMSW was subjected to ANSI/RESNA stability testing, and three male participants completed a subset of the wheelchair skills test, including a 100-m roll test in the MMSW (seated and standing) and in their ultralight wheelchair.
RESULTS
The MMSW met ANSI/RESNA stability safety standards. During the 100-m roll test, participants reached speeds with the MMSW in both the standing and sitting postures similar or greater than those typical of moving in the home environment (1.11 m/s seated; 0.79 m/s standing). Mobility speeds in the MMSW in the standing position were about three times faster than average walking speeds in exoskeletons (0.26 m/s exoskeletons). With the addition of chain drive bracing to the MMSW, one user was able to reach speeds in the standing position similar to average neurotypical walking speeds indicating the possibility for wheelchair users to be able to move in pace with family and friends.
CONCLUSION
All participants expressed interest in the MMSW to facilitate improved quality of life. Further work is needed to test the utility of the MMSW in home and community settings, and its potential effects on standing time and health outcomes.Implications for rehabilitationManual standing wheelchairs with standing mobility may increase functional utility and length of standing time for manual wheelchair usersIncreased standing time may lead to several health benefits for manual wheelchair users.
Topics: Humans; Male; Standing Position; Quality of Life; Equipment Design; Wheelchairs; Braces
PubMed: 35196472
DOI: 10.1080/17483107.2022.2041737 -
Acta of Bioengineering and Biomechanics 2018The aim of this study was to compare and analyse of relationships between stability indices registered in two positions: standing and handstand in athletes practicing...
PURPOSE
The aim of this study was to compare and analyse of relationships between stability indices registered in two positions: standing and handstand in athletes practicing gymnastics at various levels of advancement.
METHODS
The study included 46 athletes practicing gymnastics. The research tool was posturograph CQ-Stab 2P.
RESULTS
In both standing position and handstand in the seniors there were statistically significantly lower values of such indicators as: sway area delimited by the center of pressure ( p = 0.004, p = 0.014), mean amplitude of COP ( p = 0.021, p = 0.017), mean displacement of the center of feet/hands pressure in medio-lateral direction ( p = 0.011, p = 0.003) and maximal displacement of the center of feet/hands pressure in mediolateral direction ( p = 0.036, p = 0.036). In the standing position, seniors also had statistically significantly lower values of the statokinesiogram path length, both total ( p = 0.000) as well as in anteroposterior ( p = 0.001) and mediolateral ( p = 0.002) directions. In the seniors group there were statistically significant correlations between variables obtained in standing position and handstand.
CONCLUSIONS
The level of sport advancement significantly differentiates the stability of a body in standing position and handstand. The seniors practicing gymnastics, compared to juniors, are characterized by a better ability to control the position of the body in both positions. The lack of relationships between stability indices registered in standing and handstand in juniors suggests that the analysis of the values of stability indices obtained in a standing position does not provide the possibility of predicting the ability to maintain balance in the handstand during the recruitment of candidates for gymnastics.
Topics: Adolescent; Athletes; Gymnastics; Humans; Postural Balance; Regression Analysis; Standing Position; Young Adult
PubMed: 30220715
DOI: No ID Found -
PloS One 2022Sit-to-stand can be defined as a set of movements that allow humans to rise from a sitting position to a bipedal standing pose. These movements, often categorized as...
Sit-to-stand can be defined as a set of movements that allow humans to rise from a sitting position to a bipedal standing pose. These movements, often categorized as four distinct kinematic phases, must be coordinated for assuring personal autonomy and can be compromised by ageing or physical impairments. To solve this, rehabilitation techniques and assistive devices demand proper description of the principles that lead to the correct completion of this motor task. While the muscular dynamics of the sit-to-stand task have been analysed, the underlying neural activity remains unknown and largely inaccessible for conventional measurement systems. Predictive simulations can propose motor controllers whose plausibility is evaluated through the comparison between simulated and experimental kinematics. In the present work, we modelled an array of reflexes that originate muscle activations as a function of proprioceptive and vestibular feedback. This feedback encodes torso position, displacement velocity and acceleration of a modelled human body with 7 segments, 9 degrees of freedom, and 50 actuators. We implemented two controllers: a four-phases controller where the reflex gains and composition vary depending on the kinematic phase, and a simpler two-phases controller, where three of the kinematic phases share the same reflex gains. Gains were optimized using Covariance Matrix Adaptation. The results of the simulations reveal, for both controllers, human-like sit-to-stand movement, with joint angles and muscular activity comparable to experimental data. The results obtained with the simplified two-phases controller indicate that a simple set of reflexes could be sufficient to drive this motor task.
Topics: Humans; Movement; Torso; Sitting Position; Standing Position; Muscles; Biomechanical Phenomena
PubMed: 36584117
DOI: 10.1371/journal.pone.0279300 -
Journal of Biomechanics Dec 2021With marathon-running grew in popularity, the effect of long-distance running on plantar pressure has been more attractive. It has been proposed that long-distance...
With marathon-running grew in popularity, the effect of long-distance running on plantar pressure has been more attractive. It has been proposed that long-distance running influences the deviation in the center of pressure (COP) during standing and the changes to plantar pressure during walking. The objective of this study was to observe the effects on the COP motion amplitude of static standing and the plantar pressure distribution of walking after long-distance running. The influence of a 10-km run on changes to plantar pressure was assessed during standing and walking. Plantar pressure was measured before and immediately after running. In the study, seven males and five females participated in barefoot tests of static standing and dynamic walking. In the static standing tests, COP was measured under the following four ordered conditions: (1) bipedal, eyes open, standing; (2) bipedal, eyes closed, standing; (3) unipedal, eyes open, standing and (4) unipedal, eyes closed, standing. Under each condition, the data was collected while a stable standing posture for 10 s. In the dynamic walking tests, the contact duration and plantar pressure were recorded. The standing tests results revealed no significant differences between males and females while slight differences before vs. after running. Running for a single time had no effect on COP deviation during standing. The walking tests results revealed an initial landing on the lateral heel. After landing on the lateral heel, the females quickly transferred to the medial heel. The movement of the pressure to the medial heel was slower in males than females. After running, the pressure of females was more inward, while that of males was more outward under the metatarsal zones in the propulsion phase.
Topics: Female; Foot; Heel; Humans; Male; Metatarsal Bones; Standing Position; Walking
PubMed: 34607282
DOI: 10.1016/j.jbiomech.2021.110779 -
Pacing and Clinical Electrophysiology :... Mar 2022The displacement of cardiac implantable electronic devices (CIEDs) toward the caudal side during standing after CIED implantation could cause lead dislodgement. This...
BACKGROUND
The displacement of cardiac implantable electronic devices (CIEDs) toward the caudal side during standing after CIED implantation could cause lead dislodgement. This study investigated the relationship between supine pocket position and standing CIEDs' displacement distance after the implantation.
METHODS
After CIED surgeries performed at 2 hospitals between 2012 and 2020, 134 patients underwent postoperative chest x-rays in the supine and standing positions during hospitalization. To measure the displacement distance of CIEDs from the supine to the standing position, we identified the first thoracic vertebrae (Th1) in the supine position using the first rib as an index, drew a horizontal line at the lower edge of the Th1, and calculated the distance from that point to the upper edge of the CIED. The difference between measures for the two positions was compared. At the position of the pocket in the thorax in the supine position, the ratio of the distance between the thorax and the device is defined as the device thorax ratio (DTR). We examined the relationship between DTR and CIED displacement distance.
RESULTS
In this study, we included 134 patients (53% men; median age, 79 years, body mass index, 22.3 ± 3.4; pacemaker 93%, left implantation 96%). We found that the more lateral the position of the CIED pocket, the more the CIED fell when standing (confidence interval = 0.34-0.60, P < .001).
CONCLUSIONS
The farther the CIED was implanted outside the thorax in the supine position, the more significantly the CIED was displaced in the standing position.
Topics: Aged; Defibrillators, Implantable; Female; Humans; Male; Pacemaker, Artificial; Retrospective Studies; Standing Position; Thorax
PubMed: 35172014
DOI: 10.1111/pace.14464 -
Drug and Therapeutics Bulletin Aug 2018
Topics: Female; Humans; Parturition; Pregnancy; Pregnancy Outcome; Standing Position
PubMed: 30135056
DOI: 10.1136/dtb.2018.8.0649 -
Gait & Posture Jun 2023A method has been developed to assess toe pressure strength in the standing position, taking into account concerns about toe grip strength.
BACKGROUND
A method has been developed to assess toe pressure strength in the standing position, taking into account concerns about toe grip strength.
RESEARCH QUESTION
Which is more associated to postural control capability, the conventional toe grip strength or the newly devised toe pressure strength in the standing position, which is close to the actual movement?
METHODS
This study is a cross-sectional study. This study included 67 healthy adults (mean age, 19 ± 1 years; 64% male). The postural control capability was measured using the center-of-pressure shift distance in the anterior-posterior axis. Toe pressure strength in the standing position was assessed using a toe pressure measuring device to evaluate the force of pressure on the floor surface by all toes. During measurement, care is taken to ensure that the toes do not flex. However, toe grip strength in the sitting position was measured using muscle strength for toe flexion in a conventional manner. Statistical analysis was conducted by performing a correlation analysis between each of the measured items. Additionally, multiple regression analysis was used to examine the functions associated with postural control capability.
RESULT
Pearson's correlation analysis revealed that the postural control capability was correlated with toe pressure strength in the standing position (r = 0.36, p = 0.003). Multiple regression analysis demonstrated that only toe pressure strength in the standing position was significantly associated with the postural control capability, even after adjusting for covariates (standard regression coefficient: 0.42, p = 0.005).
SIGNIFICANCE
The results of this study indicated that toe pressure strength in the standing position was more strongly associated with the postural control capability in healthy adults than toe grip strength in the sitting position. It has been suggested that a rehabilitation program for toe pressure strength in the standing position would help improve postural control capability.
Topics: Humans; Male; Adult; Adolescent; Young Adult; Female; Standing Position; Cross-Sectional Studies; Toes; Lower Extremity; Postural Balance
PubMed: 37141835
DOI: 10.1016/j.gaitpost.2023.04.015 -
Experimental Brain Research Jan 2023The literature on postural control highlights that task performance should be worse in challenging dual tasks than in a single task, because the brain has limited...
The literature on postural control highlights that task performance should be worse in challenging dual tasks than in a single task, because the brain has limited attentional resources. Instead, in the context of visual tasks, we assumed that (i) performance in a visual search task should be better when standing than when sitting and (ii) when standing, postural control should be better when searching than performing the control task. 32 and 16 young adults participated in studies 1 and 2, respectively. They performed three visual tasks (searching to locate targets, free-viewing and fixating a stationary cross) displayed in small images (visual angle: 22°) either when standing or when sitting. Task performance, eye, head, upper back, lower back and center of pressure displacements were recorded. In both studies, task performance in searching was as good (and clearly not worse) when standing as when sitting. Sway magnitude was smaller during the search task (vs. other tasks) when standing but not when sitting. Hence, only when standing, postural control was adapted to perform the challenging search task. When exploring images, and especially so in the search task, participants rotated their head instead of their eyes as if they used an eye-centered strategy. Remarkably in Study 2, head rotation was greater when sitting than when standing. Overall, we consider that variability in postural control was not detrimental but instead useful to facilitate visual task performance. When sitting, this variability may be lacking, thus requiring compensatory movements.
Topics: Young Adult; Humans; Standing Position; Posture; Movement; Task Performance and Analysis; Sitting Position; Postural Balance
PubMed: 36416923
DOI: 10.1007/s00221-022-06512-6 -
Experimental Brain Research Jul 2023Older adults adapt the execution of complex motor tasks to use compensatory strategies in the reaching-to-grasping (i.e., prehension) movement. The presence of postural...
Older adults adapt the execution of complex motor tasks to use compensatory strategies in the reaching-to-grasping (i.e., prehension) movement. The presence of postural constraints may exacerbate these compensatory strategies. Therefore, we investigated the reach-to-grasp action with different postural constraints (sitting, standing, and walking) in younger and older people and evaluated the postural stability during the reach-to-grasp action. Thirty individuals (15 younger and 15 older adults) performed the prehension under three postural tasks: sitting, standing, and walking. The reaching movement was slower in the walking task than in the other two postural tasks; however, there was no difference between the age groups. For the grasping action, the older adults presented a larger grip aperture, and the peak grip aperture occurred earlier during hand transportation in sitting and standing tasks. In the standing task, the margin of stability was smaller for older adults. In the walking task, there was no difference between the groups for the margin of stability. Also, prehension during sitting and standing tasks were similar, and both differed from walking across age groups. Finally, older adults reduced their margin of stability compared to younger adults, but only in the standing task. The margin of stability was similar between age groups during the walking task. We concluded that age affected grasping (distal component) but not reaching (proximal component), suggesting that healthy older adults have more difficulty controlling distal than proximal body segments.
Topics: Humans; Aged; Walking; Hand; Movement; Standing Position; Sitting Position; Postural Balance
PubMed: 37256337
DOI: 10.1007/s00221-023-06647-0