Analysis of the starting position of the non-paretic upper limb in hemiplegic patients after stroke who have insufficient rising ability

Abstract

Objective: Improving the ability patients with stroke to get out of bed to avoid long bedridden periods is an important public health problem. However, few studies have examined the various methods for rising from bed in individuals with stroke. The aim of this study was to clarify differences in movement duration and trunk angle amplitude during supine-to-sit motion according to the abduction angle of the non-paretic upper limb in individuals after stroke.

Method: Thirteen poststroke patients were instructed to rise from bed under three conditions for abduction of the non-paretic upper limb (30, 60, and 90 degrees), and the duration and amplitude of the trunk angle were analyzed by three-dimensional motion analysis. The movement task was divided into Phase 1 (from the start of center of mass movement to On Elbow) and Phase 2 (from On Elbow to the maximum vertical center of mass position in a sitting posture). Main effects were tested by repeated-measures analysis of variance or the Friedman test in data for three conditions, and if the main effect was observed, the paired t-test with correction for multiple comparisons or the Wilcoxon signed rank test was performed. The significance level of multiple comparisons with Bonferroni correction was p < 0.0167.

Results: The movement duration was significantly shorter in the 90 degree task than in the 30 degree task. In terms of trunk angle, lateral flexion during phase 2 was significantly less in the 60 and 90 degree conditions than in the 30 degree condition (p < 0.0167).

Conclusion: As the movement duration was shorter and lateral bending was less when the non-paretic upper limb was abducted by 60 or 90 degrees than 30 degrees, individuals with stroke are recommended to abduct their upper limb on the non-paretic side at least 60 degrees when they rise from bed.