Joint torques during sit-to-stand in healthy subjects and people with Parkinson's disease

Objectives. To compare lower limb joint torques during sit-to-stand in normal elderly subjects and people with Parkinson's disease, using a developed biomechanical model simulating all phases of sit-to-stand. Design. A cross-sectional study utilizing a Parkinsonian and a control group. Background. Subjects with Parkinson's disease were observed to experience difficulty in performing sit-to-stand. The developed model was used to calculate the lower limb joint torques in normal elderly subjects and subjects with Parkinson's disease, to delineate possible causes underlying difficulties in initiating sit-to-stand task. Methods. Six normal elderly subjects and seven age-matched subjects with Parkinson's disease performed five sit-to-stand trials at their self-selected speed. Anthropometric data, two-dimensional kinematic and foot-ground and thigh-chair reactive forces were used to calculate, via inverse dynamics, the joint torques during sit-to-stand in both before and after seat-off phases. The difference between the control and Parkinson's disease group was analysed using independent t-tests. Results. Both control and Parkinson's disease groups had a similar joint kinematic pattern, although the Parkinson's disease group demonstrated a slower angular displacement. The latter subjects produced significantly smaller normalized hip flexion torque and presented a slower torque build-up rate than the able-bodied subjects (P<0.05). Conclusion. Slowness of sit-to-stand in people with Parkinson's disease could be due to a reduced hip flexion joint torque and a prolonged rate of torque production.