Effects of different initial foot positions on kinematics, muscle activation patterns, and postural control during a sit-to-stand in younger and older adults

Background: Performing a sit-to-stand (STS) can be a challenging task for older adults because of age-related declines in neuromuscular strength and coordination. We investigated the effects of different initial foot positions (IFPs) on kinematics, muscle activation patterns, and balance control during a STS in younger and older adults.

Methods: Ten younger and ten older healthy adults participated in this study. Four symmetric IFPs were studied: (1) reference (REF), (2) toes-out with heels together (TOHT), (3) toes-out (TO), and (4) Wide. Lower-extremity muscle activation patterns and kinetic and kinematic data in the sagittal and frontal planes were measured.

Results: The trunk forward-tilt angle and hip extension torque during uprising were smaller in TO and Wide for both age groups. Postural sway and center of pressure sway area were smallest in TO after completion of uprising with no difference between age groups. Adductor longus and gluteus medius activity was greater in TO than in the other IFPs, and older adults activated these muscles to a greater degree than younger adults.

Conclusion: Smaller trunk flexion angles with greater activation of the hip abductor and adductor muscles in TO contributed to improving postural stability during the STS.

Significance: STS training with a toes-out foot position could be an effective rehabilitation strategy for older adults to strengthen hip muscles that control medio-lateral balance required for balance during a STS.