Side-Dependent Trunk Muscle Modulation During Sit-to-Stand After Stroke: An Exploratory EMG and Kinematic Study

Sit-to-stand (STS) is a fundamental functional task frequently impaired after stroke and widely used in rehabilitation to assess motor control and balance. While lower-limb kinematic and muscular asymmetries during STS have been documented, the contribution of trunk muscle coordination to compensatory strategies has received limited attention. We investigated STS performance in seven individuals with chronic right-sided hemiparesis under two conditions (free arms and crossed arms) to characterize phase-dependent kinematic asymmetries and side-dependent trunk muscle modulation relevant to rehabilitation practice. Optoelectronic motion capture was synchronized with bilateral surface electromyography, providing time-aligned kinematic and neuromuscular signals for sensor-based assessment of STS. Participants exhibited prolonged and highly variable STS durations, along with ankle asymmetries during the rising and lowering phases and hip asymmetries during upright standing, indicating increased reliance on the less impaired limb. Electromyography revealed side-dependent modulation of trunk muscles, notably latissimus dorsi, erector spinae longissimus, and multifidus, characterized by a prolonged relative contribution on the more impaired side. These findings suggest that altered trunk muscle modulation contributes to compensatory STS strategies after stroke and highlight the importance of trunk-focused neuromuscular assessment to guide individualized rehabilitation interventions aimed at improving symmetry, postural stability, and movement efficiency.