Quantitative assessment of bed rise difficulty in young and elderly women.

OBJECTIVE: To describe the motions which occur during rising from bed, specifically the motions that appeared to characterize difficulty in rising from a bed in older adults. DESIGN: Development of a Mobility assessment tool. SETTING: Retirement center and two university laboratories. PARTICIPANTS: Three groups of female volunteers: young controls (n = 17, mean age 24), community-dwelling older adults (n = 12, mean age 71), and retirement center-dwelling older adults who admitted to difficulty in rising from a bed (n = 15, mean age 86). INTERVENTION: Videotaping of motions occurring during controlled rises from a supine to sitting position. MAIN OUTCOME MEASURES: These motions were rated on the specially developed Bed Rise Difficulty (BRD) scale, a scale designed to measure movements that characterize difficulty in rising from a bed in older adults. Subject groups were compared in total BRD score, individual BRD item score, and total time to rise. Item relationships and scale reliability were also assessed. RESULTS: Older adults with no apparent difficulty in rising based on total time to rise or on the BRD score nevertheless showed differences in upper extremity use when compared to young controls. Older adult subjects with difficulty in rising from a bed, when compared to other older adults with no apparent difficulty, differed more often in their upper extremity and leg use to facilitate the rise. Five BRD scale items, including use of extremity pushes, discontinuity of trunk and leg motion, multiple shoulder/pelvic adjustments, multiple leg adjustments, and poor vertical heel clearance may have best indicated true bed rise difficulty. CONCLUSIONS: These data provide a reliable and valid method to characterize difficulty in rising from a bed and provide the basis for biomechanical analyses of the strength and joint ranges of motion required to rise from a bed.

Healthy young and old women differ in their trunk elevation and hip pivot motions when rising from supine to sitting.

OBJECTIVE: To describe the differences between healthy young and older women in regards to trunk elevation and hip pivot motions when rising from a supine to a seated position. DESIGN: Cross-sectional comparison. SETTING: University laboratory. PARTICIPANTS: Two groups of healthy female volunteers: young adult female controls (n = 22, mean age 23.5 years) and community-dwelling older female adults (n = 17, mean age 73.8 years). MEASUREMENTS: Subjects were videotaped as they performed three controlled bed mobility tasks, starting from a supine position: (1) rising to a seated position at the edge of a firm plinth surface (SS); and rising to a seated position without moving to the edge of the bed while either (2) using hands (SUH) or (3) not using hands (SUNH). A series of movements involving the trunk were identified as subjects performed the SS task. RESULTS: The older women were more likely to rotate and laterally flex their trunks, particularly in the later phases of the SS task. In addition, during the SS task, the older group was more likely to bear weight on their hip/gluteal area, particularly in the later phases, and more likely to use a broad pivot base, consisting of the hip and the elbow. While all young and old performed the SUH task, less than half of the older group could complete the SUNH task. Moreover, the subgroup of older adults who could not complete the SUNH task may have accounted for much of the differences between the young and the old on the SS task. CONCLUSION: Healthy young and older women differ in their ability to rise from a supine to sitting position, primarily in the strategies used to elevate the trunk and facilitate a pivot. Trunk flexion ability likely contributes to the age group differences noted in rising. These data provide the basis for a biomechanical analysis of the critical body segment motions and the strengths required to perform bed mobility tasks.