Journal of Long-Term Effects of Medical Implants
The Sit & Stand™ Chair. A Revolutionary Advance in Adaptive Seating Systems
Michael H. Galumbeck
Galumbeck Consultants, Abingdon, Maryland
Ralph M. Buschbacher
Clinical Associate Professor & Interim Chair. Department of Physical Medicine&Rehabilitation, Indiana University School of Medicine,CL 368,541 North Clinical Drive, Indianapolis IN 46202, USA
Robert P. Wilder
Associate Professor of Physical Medicine and Rehabilitation; Director, Division of Spine and Sports Care; Medical Director, The Runner's Clinic at University of Virginia Health Sciences System, Charlottesville, Virginia
Kathryne L. Winters
Website Manager and Information Specialist, Trauma Specialists, LLP, Legacy Emanuel Hospital, Portland, Oregon, 1917 NE 97th St. Vancouver WA 98665, USA
Mary Anne Hudson
Public Health Nurse, Coos County Public Health Department, 1975 McPherson St. #, North Bend, Oregon, OR 97459, USA
Legacy Verified Level I Shock Trauma Center Pediatrics and Adults, Legacy Emanual Hospital; and Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health System, USA
A major factor governing independence for the elderly and persons with disabilities is the ability to stand from a chair. Factors such as pain, reduced joint range of motion, stiffness, and muscle weakness frequently limit the ability to stand. Sit-to-stand position is even further reduced in patients whose hands and shoulders are afflicted with rheumatoid arthritis. When achieving a sit-to-stand position in the elderly and persons with disabilities, there is considerable risk of the individual falling and sustaining bone fracture. The purposes of this scientific report are to achieve the following goals: (1) to provide a narrative discussion of the senior author's contributions to furniture manufacturing as well as his successful patent application for the SIT & STAND™ chair, (2) to describe the steps involved in the development of the SIT & STAND™ prototype, and (3) to examine the performance of the SIT & STAND™ chair in assisting the elderly or persons with disabilities in achieving a sit-to-stand position.
The invention of the SIT & STAND™ chair by the senior author, Michael Galumbeck, was a culmination of his lifelong interest in adaptive seating systems. His electrically operated chair has the unique ability to assist the occupant to achieve safely a sit-to-stand position. The rear portion of his chair remains in a fixed position to support the buttocks of the user during mechanical lift. The front portion of the seat folds down incrementally as the chair rises to allow the feet of the user to be positioned in a more posterior position firmly on the floor. Using its actuator, the height that the chair rises will vary with the length of the legs of the occupant. Using the drawing program Solid Works (Solid Works, Concord, Massachusetts), drawings of the chair were made. To visualize the operation and performance of the chair, separate drawings were made in the lateral position. The prototype of the SIT & STAND™ chair was manufactured with an electric actuator that allows elevation of the back portion of the seat. The design of this chair ensured that there were no pinch points that could endanger the user or assistant. Its framework ensured that it was stable and did not tip over. After the prototype chair is manufactured, it is being sent to Underwriters Laboratory Inc. (Los Angeles, California) for review and certification.
The performance of the SIT & STAND™ chair was determined in a clinical study involving seven elderly or disabled individuals who complained of difficulty in rising from a chair from a seated position. During each performance evaluation, a mechanical chest and shoulder harness attached to an overhead sling encircled the individual to ensure that he/she would not fall. In the first part of the evaluation, these individuals were asked to achieve a standing position after being seated in the SIT & STAND™ chair without the use of the actuator. Three individuals were unable to achieve a standing position, while four achieved this standing position with considerable difficulty and potential instability. When these participants used the SIT & STAND™ chair with the use of the electrical actuator, all individuals achieved a standing position without difficulty or instability. All individuals expressed disappointment that the SIT & STAND™ chair was not commercially available for them to purchase and use in their homes.
Because the SIT & STAND™ chair allows the individual to achieve a standing position without assistance, the SIT & STAND™ chair has other potential benefits not evaluated in this study. The beneficial effects of standing have been documented by comprehensive scientific studies. These benefits include reduction of seating pressure, decreased bone demineralization, increased bladder pressure, enhanced circulatory regulation, reduction in muscular tone, decrease in upper extremity muscle stress, and participation in activities of daily living. Another irrefutable benefit of the SIT & STAND™ chair is that the chair eliminates the need for physical assistance from family members or health care personnel, preventing the development of disabling back injuries in personal care assistants. In addition, the SIT & STAND™ chair entirely removes the risk of pain or harm to the individual, which sometimes occurs with manual assist to stand, such as dislocation or fracture of frail shoulders with the under-axilla lift. Realizing the medical benefits of the SIT & STAND™ chair, Aetna completed a clinical policy bulletin that states that the seat lift mechanism is a medically necessary durable medical product. On the basis of this extensive product and performance evaluation, we recommend the SIT & STAND™ chair for the elderly as well as persons with disability to safely achieve a sit-to-stand position.