Evidence - WTT - Reaching in sitting

Question 1

What did Chari and Kirby, 1986 suggest in their study

Answer 1

• compared reaching distance with both feet on floor, one foot on floor, both feet off floor - stroke
• furthest reach achieved with both feet on floor
• Clinical implication: train with feet on floor for reaching in sitting

Question 2

Explain Dean et al, 1999 paper

Answer 2

• Tested reaching in sitting Kinematics
• Stoke, and healthy young and old populations
  Results
• when reaching, head, arms and trunk move towards object by moving at hips.
• Mvmt duration about 1 sec despite distance
• arm never fulling extended
• clinical implications: speed increases with distance

Question 3

What did Dean et al 1999a discover in their study?

Answer 3

• looked at ground reaction force through feet when reaching of varying distances and different task
• further the reach, greater the load through feet. Leg mm activated when reaching beyond arm’s length.
• Clinical implications: increase load on legs, reach beyond arm’s length and use faster grasp

Question 4

What did Dean et al, 1999b find?

Answer 4

• compared reaching forward, ipsilateral and across body with 25, 50, 75% thigh support
• feet in direction of the reach had greatest load
• location of target influences amount of force through feet
• Older patients activated tib ant, soleus and vastus lateralis bilaterally
• Clinical implications: manipulate load in each leg by varying direction of reach

Question 5

What was found in Dean and Shepherd, 1997?

Answer 5

• RCT sitting balance vs placebo for chronic strokes
• 300 reaches in 30 mins
• standard protocol of: reaching beyond arms length at different speeds, direction, distance, thigh support and seat height
• lack of loading affected foot, and slow movement
• training improved leg loading in all directions
• Clinical implications: use high reps, varied movements and speed

Question 6

Dean et al, 2007

Answer 6

• RCT sitting balance vs placebo in sub acute stroke
• standard protocol of: reaching beyond arms length at different speeds, direction, distance, thigh support and seat height
• increased max reach distance, decreased mvmt time, increased peak vertical force through affected foot
• max reach and peak vertical force maintained after 6 months
• Train reaching using speed, distance, direction type of task