Using Grab Bars Increases Postural Stability of Older Adults When Rising from a Toilet

Background/Purpose: Older adults, especially females, are 28% more prone to falls when standing up from a toilet (the U.S. Centre for Disease Control and Prevention). This study investigated the effects of adding a bilateral grab bar to a toilet on the sit-to-stand movement in older females.

Method: Eight young (21.5±0.7yrs) and eight older (72.6±5.9yrs) females executed four sit-to-stand tasks on a normal toilet without (NT) and with grab bars (NTB). Surface electromyography (EMG) was recorded from the tibialis anterior (TA), soleus (SOL), medial (MG) and lateral gastrocnemii (LG), vastus medialis (VM) and biceps femoris (BF) of the dominant limb. Feet were positioned on the Pedar-X Insole system to measure plantar pressure distributionand COP-related parameters. The ease of the sit-to-stand task, time to rise and postural stability were determined. A 2 (NT, NTB) x y 2 (young, old) repeated measures ANOVA was conducted.

Results: The COP velocity during rising declined with grab bars in young and older adults by 5% and 21%, respectively (p=0.019). In older adults, grab bars decreased the time between peak hindfoot to peak forefoot pressure by 8% (p=0.03) and the total time of rising by 5% (p=0.005). EMG in all muscles, except for TA and MG, was less with grab bars (p<0.048).

Discussion: Grab bars increased the ease of standing, decreased COP velocity, and decreased time to quiet stance. The decreased COP velocity shows increased postural stability and decreased forward fall risk. Reduction in EMG activity supports that the grab bars reduce task effort.

Conclusion: The difficulty and the high risk of falling associated with the sit-to-stand motion are reduced when a bilateral grab bar is attached to a standard household toilet.