Biomechanical analysis of failed sit-to-stand.

Background sit-to-stand (STS) failure is a transient loss of balance that can engender falls among elders. The purpose of this paper is to describe the mechanisms whereby failed STS differs from successful STS. The authors compared successful STS from 11 normal elders to 20 "sitback" and 20 "step" type failed STS's in 13 subjects. Kinematic and kinetic data were incorporated into our 11-segment whole body model to estimate the net joint forces and torques and body segment momenta. Significant between group differences in the magnitude and timing of momentum generation and dissipation, knee extensor torques and the magnitude of the vertical ground reaction force were identified. Both types of failed sit-to-stand maneuvers are less energetic than successful rises. STS failures might result from either weakness or balance control and coordination impairment, or both, resulting in an insufficiently energetic effort. Further research is required to differentiate between these two possible sources of impairment. Determining the root cause of functional limitations is necessary to develop effective interventions.