Kemoun Gilles, Thoumie Philippe, Boisson Dominique, Guieu Jean Daniel
Physical Medicine Department, General Hospital, Wattrelos, France.
J Rehabil Med. 2002 Nov;34(6):278-83. doi: 10.1080/165019702760390374.
The aim of this study was to investigate the kinematic and kinetic characteristics of walking in healthy non-faller elderly in order to develop predictive parameters for falls. A 1-year prospective trial was completed on a walking circuit with two integrated force platforms and an optoelectronic system for three-dimensional movement analysis. Gait was investigated in 54 volunteers who were healthy people over 60 who had not fallen in the previous year. The subjects were contacted 2-monthly over a period of 1 year. The results showed that 16 of the 54 people tested had fallen. There was no significant age difference between the group of fallers and the group of non-fallers. Fallers walked more slowly and tended to use a double support for a longer period of time. Fallers were less powerful but mainly showed fewer power and moment variations. The range of motion at the ankle and the hip was reduced. We noticed a change in the walking pattern, showing a delay in the dorsiflexion of the ankle at the swing phase. In conclusion, subclinical gait parameters occur in older people. The advent of neuromotor pattern alterations when walking is related to the tendency to fall. Ankle dorsiflexion delays, in particular, appear to be predictive of falls.
本研究的目的是调查健康非跌倒老年人行走的运动学和动力学特征，以便制定跌倒的预测参数。在一个配备两个集成测力平台和一个用于三维运动分析的光电系统的步行道上完成了一项为期1年的前瞻性试验。对54名志愿者的步态进行了研究，这些志愿者是60岁以上的健康人群，且上一年未发生过跌倒。在1年的时间里，每两个月与受试者联系一次。结果显示，54名测试者中有16人跌倒。跌倒组和未跌倒组之间在年龄上没有显著差异。跌倒者行走速度较慢，并且倾向于在更长时间内采用双支撑。跌倒者力量较小，但主要表现为力量和力矩变化较少。踝关节和髋关节的活动范围减小。我们注意到行走模式发生了变化，在摆动期踝关节背屈出现延迟。总之，亚临床步态参数在老年人中出现。行走时神经运动模式改变的出现与跌倒倾向有关。特别是踝关节背屈延迟似乎可预测跌倒。
