ISSN: 2640-2734
Authors: Hiroki Takeda, Yuji Takeda, Naoko Matsuda, Kaori Ito, Hiroshi Sasahara, Sunao Takemura, Yuki Saito, Noboru Chiba, Hiromi Fujii*
Introduction: Studies of independent toileting in hemiplegic stroke patients have examined patients’ ability to perform sit-tostand (STS) motion from a Western-style toilet; however, the characteristics of the STS motion performed in conjunction with pulling up of pants (toileting) remain unclear. This study elucidated the characteristics of toileting based on the differences in the center of pressure (COP), force on the foot sole (foot force), and trunk acceleration during toileting in hemiplegic patients under conditions similar to those of daily life. Methods: Ten male hemiplegic patients participated in this study. Measurements were taken using a foot pressure distribution analysis tool and portable three-dimensional motion analysis tool. Based on video recordings, STS and toileting tasks were divided into four phases (P1–P4), and each phase was analyzed. STS and toileting tasks were evaluated and compared. Results: Eight participants exhibited “Pattern A,” which involved increased displacement of the COP toward the paretic side during toileting compared to that during STS. Two participant exhibited "Pattern B", which involved decreased displacement of the COP toward the paretic side during toileting compared to that during STS. Comparisons between STS and toileting showed that the phase from maximum dorsiflexion to full hip extension (P3) was significantly different for maximum displacement of the COP in the paretic side direction (STS, -4.7 ± 9.17; toileting, 8.6 ± 14.12; p <.05) and the maximum foot force on the paretic side direction (STS, 42.6 ± 6.03; toileting, 53.4 ± 11.25; p <.05). Furthermore, the maximum trunk acceleration, which reflects the magnitude of the force applied to the body, was significantly different in the paretic side direction (STS, 0.04 ± 0.01; toileting, 0.09 ± 0.03; p <.01) and non-paretic side direction (STS, 0.04 ± 0.01; toileting, 0.09 ± 0.03; p <.01). Conclusion: Our findings suggest that the characteristics of toileting and STS differ in hemiplegic stroke patients. Occupational therapists and physiotherapists need to provide independent toileting. Activity instructions to hemiplegic stroke patients that cover the actual toileting motion in addition to the STS motion.
Keywords: Activity Of Daily Living; Occupational Therapy; Center Of Pressure; Motion Analysis; Rehabilitation; Stroke; Toileting
