Determinants of sit-to-stand tasks in individuals with hemiparesis post stroke: A review

The ability to rise from a chair to reach a standing position is impaired after stroke. This paper aims to review for the first time the factors that impact the ability to rise from a chair and identify recommendations for post-stroke rehabilitation.

In order to analyse relevant scientific publications (French and English), the search terms "stroke", "rehabilitation" and "sit-to-stand" (STS and its variations) were used. The initial literature search identified 122 titles and abstracts for full review and 46 were retained because both the junior and senior researchers agreed that they were aligned with the objectives of this review.

During STS, most individuals with hemiparesis able to stand independently presented several changes such as lateral deviation of the trunk towards the unaffected side (ipsilesional side), asymmetrical weight bearing (WB) and asymmetry of knee moment forces. Interestingly, the WB asymmetry was observed even before seat-off, when subjects with hemiparesis still had their thighs in contact with the chair suggesting a planned strategy. Among other interesting results, the time to execute the STS was longer than in controls and influenced by the sensorimotor deficits. A greater risk of falling was observed with a need for more time to stabilize the body during STS and especially during the extension phase. Some rehabilitation interventions may be effective in improving STS duration, WB symmetry and the ability to stand independently with repeated practice (mentally or physically) of STS tasks. However, more research is essential to further investigate effects of specific training protocols and pursue better understanding of this complex and demanding task, particularly for stroke patients who need assistance during this transfer.