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Design Rising From A Chair: Influence of Age and Chair: Phys Ther
Design Rising From A Chair: Influence of Age and Chair: Phys Ther
Design
Joyce Wheeler, Carol Woodward, Rae Lynn Ucovich,
Jacquelin Perry and Joan M Walker
PHYS THER. 1985; 65:22-26.
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No evidence exists that the act of rising from a chair has been considered in
reported studies of chair design although
older adults compared with younger
adults often have difficulty rising from
chairs. Suggested dimensions and specifications for chair design have been
based on anthropometric measurements1 and studies that determined the
optimal position to reduce stress on the
lumbosacral spine.2, 3
Ms. Wheeler is Staff Physical Therapist, Good
Samaritan Hospital and Medical Center, 1015 NW
22nd Ave, Portland, OR 97210.
Ms. Woodward is Staff Physical Therapist, San
Jose Hospital, 675 E Santa Clara St, San Jose, CA
95112.
Mrs. Ucovich is Staff Physical Therapist, Mills
Memorial Hospital, 100 S San Mateo Dr, San Mateo, CA 94401.
Dr. Perry is Director, Pathokinesiology Service,
Rancho Los Amigos Medical Center, 7601 E Imperial Hwy, Downey, CA 90242, and Professor of
Orthopaedic Surgery, University of Southern California.
Dr. Walker is Associate Professor, Department
of Physical Therapy and Department of Anatomy
and Cell Biology, University of Southern California,
12933 Erickson Ave, Bldg 30, Downey, CA 90242
(USA).
Address correspondence to Dr. Walker.
Ms. Wheeler, Ms. Woodward, and Mrs. Ucovich
completed this study in partial fulfillment of the
Master of Science degree in the Department of
Physical Therapy, University of Southern California.
This research was funded by the National Institute for Handicapped Research.
This article was submitted February 13, 1984;
was with the authors for revision 10 weeks; and was
accepted July 11, 1984.
and in the proportion of the total population formed by elderly people make
it vital to ensure independence of the
aged. Appropriate chair design is one
factor that will facilitate independence.
The objectives of this descriptive study
were 1) to determine, with electrogoniometry, EMG, and videotape analysis,
if a difference exists in the act of rising
from a standard armchair between
younger and older subjects and 2) to
determine only in the older group, if
differences exist in the same act when
using an armchair specially designed for
the elderly.
This study reports for the first time a
comparison of groupsrisingfrom a standard chair and, thus, contributes to
knowledge of differences between
younger and older people and describes
differences in this activity for older people rising from a standard chair and
rising from a chair specially designed for
the elderly.
METHOD
We studied two age groups (each, n =
10) of adult women volunteers. Younger
subjects had a mean age of 24 years
(range, 22-28 years); the mean age for
older subjects was 75 years (range, 6781 years). The younger group was taller
( =167.1 cm; range, 156.2-179.7 cm)
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PHYSICAL THERAPY
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RESEARCH
than the older group ( = 160.9 cm;
range, 144.0-170.2 cm) (t = 2.01, p =
NS) and had a significantly lower mean
body weight ( =58.1 kg; range, 48.877.6 kg and = 69.1 kg; range, 59.487.5 kg, respectively) (t = 2.41, p < .05).
Subjects were excluded if they had conditions that caused strength or range-ofmotion (ROM) limitation that produced abnormal patterns of rising from
a chair (eg, severe arthritis).
We recorded each subject's height,
weight, and limb dominance (writing
hand and foot used to kick a ball). Skin
markers (4-cm diameter circles with 2cm white centers) were taped bilaterally
on the following bony landmarks: 3 cm
anterior to the posterior edge of the
greater trochanter, 2 cm anterior to the
posterior edge of the acromion process,
and the lateral femoral epicondyle. We
measured femoral shaft length (greater
trochanter to lateral epicondyle).
Procedure
Each subject was instructed to sit back
against the chair backrest and then to
rise on the verbal request: "Please stand
Equipment
We used 50-m dual wire electrodes
to record the activities of the vastus
lateralis (VL) and the medial head of
triceps brachii (MT) muscles. We used
indwelling electrodes instead of surface
electrodes to eliminate the action of the
rectus femoris muscle, which also functions as a hip flexor and may show
activity during trunk forward lean in the
initial stage of rising from a chair. Burke
et al showed in the cat that the same
motor units span the bulk of the muscle;
thus, a sample of any spot is representative of the entire muscle.13 We used the
insertion technique described by Basmajian with the electrode placement
confirmed by electrical stimulation.14
Myoelectric signals were relayed by an
FM-FM telemetry system. Maximal isometric strength using standard manual
muscle testing techniques for VL and
MT muscles was recorded with EMG.
We recorded joint motion by a double
parallelogram electrogoniometer (mean
error for 0 to 90 of knee flexion was
<7).15 Electrogoniometers were set at
zero with the subject standing. Knee
extension was confirmed by alignment
of a straight edge with the greater trochanter (3 cm anterior to posterior
edge), the lateral femoral epicondyle,
and the lateral malleolus. The elbow
goniometer was set similarly at zero with
alignment of bony landmarks. For subjects with elbow flexion contractures (n
= 2, maximum limitation 15), the gon-
Fig. 2. Lateral and oblique view of a representative chair with arms showing dimensions
measured (values for standard and special chairs used, but not shown, are given, respectively):
A, seat height (44.0 cm,'44.4 cm); B, seat width (45.1 cm, 45.0 cm); C, width between armrests
(44.4 cm, 45.0 cm); D, seat depth (47.3 cm, 45.0 cm); E, posterior slant (1.5 cm, 7.1 cm); F,
height of armrests (24.0 cm, 13.6 cm); G, backrest incline (15, 20); H, clearance under front
of chair (34.5 cm, 29.5 cm).
23
TABLE 1
Videotape and Goniometric Analysis of the Activity of Rising from the Standard Chair,
with Body Weight as a Covariate
RESULTS
Younger
Group
(n = 10)
Variable
Older Group
(n = 10)
s
75.0
6.0
-0.4
4.90
2.11
2.67
78.1
5.9
-4.6
5.65
1.45
2.01
5.64a
0.69
4.43a
74.3
75.5
81.6
5.95
3.66
5.27
76.2
72.8
76.7
6.88
5.63
7.50
3.45
2.02
0.44
p.05
Data Analysis
We calculated means and standard
deviations for all quantitative data. The
t test for paired observations was used
to examine differences in mean values
between sides of the body and between
chairs in the older group. For clarity of
results, data from both sides of the body
were combined because analyses
showed minimal differences. Differ
ences between groups rising from the
standard chair were analyzed with an
analysis of covariance, with body weight
as a covariate, using the General Linear
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RESEARCH
between the two chairs despite the increased trunk forward lean in the special
chair.
The older subjects showed significantly greater VL muscle activity when
rising from the special chair than from
the standard chair (differences: peak =
16.6%, p < .05; average = 13.3%, p <
.01). When subjects rose from the special chair, MT muscle activity occurred
earlier than that of VL muscle (differences: onset = 8.0%, p < .05; peak =
12.7%, p < .05; end = 9.9%, p < .01).
With the exception of trial one (optional
arm use), subjects started with their
hands on the arms of the chair, and they
used their arms to initiate rising from
both chairs. Table 4 and Figure 4 show
that MT muscle activity ceased as the
hands left the armrests, and this event
occurred earlier in the special chair (difference: 2.3% of cycle, p < .01).
TABLE 2
Values for Integrated EMG Muscle Activity While Rising from the Standard Chair with
Body Weight as a Covariate
DISCUSSION
Based on observations, we anticipated
that older subjects would rise from a
standard armchair differently than
younger subjects and would rise differently from a chair specially designed for
their age group than from a standard
armchair. In the small sample studied,
the special chair did not facilitate the act
of rising from a chair. To the contrary,
rising from this chair was a more difficult task for subjects.
Because the older subjects performed
twice as many trials as the younger subjects, a fatigue effect cannot be ruled
out; however, rest periods were given
and the starting chairstandard or specialwas randomized.
The standard chair had a 5-cm greater
foot clearance than the special chair,
which allowed the subjects to place their
feet farther back. Open space below the
chair seat should facilitate movement of
the center of gravity over the feet during
rising if the person is sitting back in the
chair and does not move forward before
rising.3 None of the subjects in this study
moved forward in either chair before
rising.
Triceps brachii muscle activity reflects use of the arms to lift and propel
the center of gravity forward. In the
special chair, MT muscle activity commenced and peaked later but ended
sooner than when subjects rose from the
standard chair. Potential assistance from
the abdominal or hip flexor muscles in
the act of rising was not assessed. The
Muscle
Variable
Older Group
(n = 10)
Younger Group
(n = 10)
s
1.5
0.16
1.9
0.68
0.51
13.9
49.9
97.0
46.5
19.4
6.37
12.58
5.56
25.48
11.30
10.8
46.2
99.4
89.7
40.7
6.05
11.23
1.58
33.72
11.86
0.87
0.25
0.84
7.17c
8.72c
3.4
31.1
88.8
80.0
28.0
10.75
10.07
11.37
38.38
16.65
2.7
34.2
91.5
102.2
39.8
4.81
8.11
9.41
50.77
24.91
0.00
0.65
0.17
1.07
2.01
Expressed as % of cycle.
Expressed as % of maximum.
c
p<.01.
b
TABLE 3
Videotape and Goniometric Analysis of the Activity of Rising from the Standard and
Special Chairs in the Elderly Group (n = 10)
Variable
Standard
Chair
Special Chair
s
78.1
5.9
-4.6
76.2
72.8
76.7
5.65
1.45
2.01
6.88
5.63
7.50
66.7
5.4
-1.9
72.0
78.5
71.7
4.79
2.07
1.66
7.56
5.66
11.22
13.69a
0.68
-6.38 a
4.36b
-10.58a
2.24
p<.001.
p<.01.
25
TABLE 4
Values for Integrated EMG Muscle Activity in the Older Group (n = 10) While Rising from
the Standard and Special Chairs
Muscle
Variable
Cycle duration
Vastus lateralis
Begin timea
Peak timea
End timea
Peak activityb
Average activityb
Medial triceps brachii
Begin timea
Peak timea
End timea
Peak activityb
Average activityb
a
b
Standard Chair
Special Chair
1.9
0.68
2.2
1.06
-1.96
10.8
46.2
99.4
89.7
40.7
6.05
11.23
1.58
33.72
11.86
9.2
44.2
98.7
106.3
54.0
4.61
11.87
3.77
35.88
15.75
-1.11
-0.76
-1.00
2.74c
4.15d
2.7
34.2
91.5
102.2
39.8
4.81
8.11
9.41
50.77
24.91
1.2
31.5
88.8
115.5
44.9
2.30
11.14
10.28
49.02
21.86
-0.99
-0.80
-2.83 e
1.78
1.57
Expressed a s % of cycle.
Expressed as % of maximum.
p<.05.
p<.01.
e
p<.02.
d
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