Effects of bilateral swing-away grab bars on the biomechanics of stand-to-sit and sit-to-stand toilet transfers. 2019

Su Jin Lee, and Ricky Mehta-Desai, and Kyunggeune Oh, and Jon Sanford, and Boris I Prilutsky
a Center for Assistive Technology and Environmental Access, College of Design , Georgia Institute of Technology , Atlanta , GA , USA.

Kinetic characteristics of transfers to and from a toilet performed using bilateral grab bars are not fully quantified to inform grab bar design and configuration. The purpose of this study was to (1) determine effects of bilateral swing-away grab bars on peaks of ankle, knee and hip joint moments during grab bar assisted stand-to-sit and sit-to-stand transfers; and (2) determine effects of three different heights and widths of swing-away grab bars on the same kinetic characteristics. Healthy subjects (N = 11, age 25-58 years) performed stand-to-sit and sit-to-stand transfers with and without grab bars. In transfers with grab bars, 9 grab bar configurations were tested by varying their height from the floor (0.787 m, 0.813 m, 0.838 m; 31″-33″) and width, the distance of each grab bar from the toilet's centerline (0.330 m, 0.356 m, 0.381 m; 13″-15″). Motion capture, force plate and inverse dynamics analysis were used to determine lower limb joint moments. The use of bilateral grab bars generally reduced the peak magnitude of extension moments at lower limb joints during stand-to-sit and sit-to-stand transfers (p < .05), except the ankle joint moments during stand-to-sit transfers. Relatively few differences in peak joint moments were found between studied grab bar widths or heights. The obtained results suggest that the studied ranges of grab bar configurations reduce moment demands on the leg joints and thus decrease difficulty and required lower limb muscle effort to perform the transfers. Implications for Rehabilitation Maximizing the benefits of assistive technology in the built environment requires a careful assessment of their spatial and configurational dimensions, especially in respect to the needs and abilities of the intended users. Examining the kinetic characteristics of transfers to and from a toilet using the swing-away grab bars is useful for informing grab bar design and configuration recommendations for assisted living and skilled nursing facilities. Our findings suggest that the swing-away grab bars located at certain ranges are a reasonable alternative to the grab bars mandated by the current Americans with Disabilities Act (ADA) Accessibility Guidelines. Future research investigating the effects of grab bars on transfer performance should consider additional factors, such as a wider range of abilities and transfer methods of the users.

UI MeSH Term Description Entries
D008297 Male Males
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000058 Accidental Falls Falls due to slipping or tripping which may result in injury. Falls, Accidental,Falling,Falls,Slip and Fall,Accidental Fall,Fall and Slip,Fall, Accidental
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001696 Biomechanical Phenomena The properties, processes, and behavior of biological systems under the action of mechanical forces. Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic
D012656 Self-Help Devices Devices, not affixed to the body, designed to help persons having musculoskeletal or neuromuscular disabilities to perform activities involving movement. Assistive Devices,Assistive Technology,Assistive Device,Assistive Technologies,Device, Assistive,Device, Self-Help,Devices, Assistive,Devices, Self-Help,Self Help Devices,Self-Help Device,Technologies, Assistive,Technology, Assistive
D014038 Toilet Facilities Facilities containing equipment for disposal of human excrement, often with an accompanying hand-washing station. Latrines,Bathrooms,Lavatories,Restrooms,Bathroom,Facilities, Toilet,Facility, Toilet,Latrine,Lavatory,Restroom,Toilet Facility

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