Sit-to-stand performance in people with stroke and the effect of constraint-induced movement strategies on sit-to-stand performance

Abstract

Asymmetry of weight-bearing and impaired ability to maintain centre of pressure in midline contribute to an increased fall risk during sit-to-stand in people with stroke. The main objective of this thesis was to investigate the effect of constraint-induced movement strategies on affected limb weight-bearing and measures of balance in people with stroke. Four studies were conducted to achieve this objective. Study one and two investigated the methodology for describing sit-to-stand performance in people with stroke and reliability of measures of sit-to-stand performance. Findings from study one demonstrated that methods for describing sit-to-stand performance in healthy adults are not feasible in people with stroke and established a method for describing sit-to-stand performance in subsequent studies. Findings from the second study demonstrated within and between day reliability of temporal, weight-bearing and displacement measures of sit-to-stand performance in both groups. The third study of this thesis described impairments of sit-to-stand performance in people with stroke when compared with healthy age and sex matched adults. The findings confirmed results from previous studies and further described sit-to-stand performance by demonstrating a shift in the frontal plane centre of pressure and centre of mass position toward the unaffected limb at seat-off in people with stroke. The final study investigated the effect of three constraint-induced movement strategies on sit-to-stand performance in people with stroke. The results demonstrated increased affected limb weight-bearing and a shift of the centre of pressure and centre of mass toward midline with all of the strategies. Only two of the strategies altered centre of pressure and centre of mass displacement in the sagittal plane. Findings from this body of research provide new information regarding the methodology of describing sit-to-stand performance in people with stroke and the reliability of measures of sit-to-stand performance. The results also provide an advanced understanding of sit-to-stand performance in people with stroke and the effect of constraint-induced movement strategies on sit-to-stand performance. Additional research using constraint-induced movement strategies in a randomized controlled trial will inform clinical practice and may reduce the fall risk in people with stroke.