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Updated: Jul 7, 2026
Sit-to-stand-and-walk from 120% Knee Height: A Novel Approach to Assess Dynamic Postural Control Independent of Lead-limb
Published on: August 30, 2016
Persistence of altered movement patterns during a sit-to-stand task 1 year following unilateral total knee
Sara J Farquhar1, Darcy S Reisman, Lynn Snyder-Mackler
1Department of Physical Therapy, University of Delaware, Newark, DE 19716, USA.
Background And Purpose:
Following total knee arthroplasty (TKA), quadriceps femoris muscle strength (force-generating capacity) and functional test scores improve but continue to be lower than those in people without injury. Analysis of the sit-to-stand (STS) task demonstrated side-to-side differences in subjects with TKA, as well as differences between subjects with TKA and control subjects. It was hypothesized that, when using a self-selected starting position, subjects 1 year following TKA would show improvements in strength and movement patterns but would continue to show asymmetries of angles and moments at the hips and knees.
Subjects And Methods:
Twenty-four subjects (12 subjects with unilateral TKA and 12 control subjects) were recruited; those with TKA were tested 3 months and 1 year following surgery. Motion analysis of an STS task was synchronized with 2 force platforms and electromyography. Outcome measures included joint angles and moments, electromyography, vertical ground reaction forces, muscle strength, and functional performance tests.
Results:
Subjects with TKA showed improvements in symmetry of motion, strength, and functional performance from 3 months to 1 year following TKA. Compared with control subjects, subjects with TKA relied on increased hip flexion and a larger hip extensor moment to perform the STS task.
Discussion And Conclusion:
The increased hip extensor moment demonstrated that subjects adopted a strategy to avoid the use of the quadriceps femoris muscle, yet this strategy persisted as quadriceps femoris muscle strength improved. This pattern may be a learned movement pattern that may not resolve without retraining.
