Multi-parametric evaluation of sit-to-stand and stand-to-sit transitions in elderly people

The aim of this study was to extract multi-parametric measures characterizing different features of sit-to-stand (Si-St) and stand-to-sit (St-Si) transitions in older persons, using a single inertial sensor attached to the chest. Investigated parameters were transition's duration, range of trunk tilt, smoothness of transition pattern assessed by its fractal dimension, and trunk movement's dynamic described by local wavelet energy. A measurement protocol with a Si-St followed by a St-Si postural transition was performed by two groups of participants: the first group (N = 79) included Frail Elderly subjects admitted to a post-acute rehabilitation facility and the second group (N = 27) were healthy community-dwelling elderly persons. Subjects were also evaluated with Tinetti's POMA scale. Compared to Healthy Elderly persons, frail group at baseline had significantly longer Si-St (3.85 ± 1.04 vs. 2.60 ± 0.32, p = 0.001) and St-Si (4.08 ± 1.21 vs. 2.81 ± 0.36, p = 0.001) transition's duration. Frail older persons also had significantly decreased smoothness of Si-St transition pattern (1.36 ± 0.07 vs. 1.21 ± 0.05, p = 0.001) and dynamic of trunk movement. Measurements after three weeks of rehabilitation in frail older persons showed that smoothness of transition pattern had the highest improvement effect size (0.4) and discriminative performance. These results demonstrate the potential interest of such parameters to distinguish older subjects with different functional and health conditions.