Herman Seth, Kiely Dan K, Leveille Suzanne, O'Neill Evelyn, Cyberey Sharon, Bean Jonathan F
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA.
J Gerontol A Biol Sci Med Sci. 2005 Apr;60(4):476-80. doi: 10.1093/gerona/60.4.476.
Lower limb muscle power impairments are modifiable factors underlying mobility limitations in older adults. This study examined relationships between upper and lower limb muscle power and their role in predicting mobility performance among community-dwelling older adults.
A cross-sectional analysis was conducted. Participants included 37 mobility-limited adults (24 women, 13 men), aged 65 to 93 years. Measures included upper (elbow extension) and lower limb (double leg press) one repetition maximum (1RM), and muscle power at both 40% and 70% one repetition maximum. Physical performance measures included stair climb time, the Short Physical Performance Battery, and 4-meter walk time. Factors commonly mediating the relationship between impairments and physical performance were analyzed as covariates.
Participants had a mean age of 76 years, had five chronic medical conditions, and manifested moderate mobility limitations. Although the associations between the upper and lower limbs were strong (p <.001), the magnitude of association was greater for power (r =.88-.89) as compared to strength (r =.69). Multivariate regression analyses revealed consistently strong relationships between limb muscle power and mobility performance measures. Substituting upper for lower limb power within these models did not materially weaken the relationships.
Muscle power appears to be a more generalized attribute between the upper and lower limbs than is muscle strength, suggesting that mechanisms underlying velocity of movement, as opposed to force production, may be important factors underlying muscle power in elderly persons. Additionally, upper limb muscle power measures may serve as a useful surrogate measure of limb power having implications for clinicians and researchers.
下肢肌肉力量受损是老年人行动能力受限的可改变因素。本研究探讨了社区居住老年人上肢和下肢肌肉力量之间的关系及其在预测行动能力表现中的作用。
进行横断面分析。参与者包括37名行动能力受限的成年人(24名女性,13名男性),年龄在65至93岁之间。测量指标包括上肢(肘部伸展)和下肢(双腿推举)的一次重复最大负荷量(1RM),以及40%和70%一次重复最大负荷量时的肌肉力量。身体表现指标包括爬楼梯时间、简短身体表现量表和4米步行时间。将通常介导损伤与身体表现之间关系的因素作为协变量进行分析。
参与者的平均年龄为76岁,患有五种慢性疾病,行动能力有中度受限。虽然上肢和下肢之间的关联很强(p<.001),但与力量(r=.69)相比,力量的关联程度更大(r=.88-.89)。多变量回归分析显示,肢体肌肉力量与行动能力表现指标之间始终存在很强的关系。在这些模型中用上肢力量替代下肢力量并没有实质性地削弱这种关系。
肌肉力量似乎比肌肉力量在上下肢之间更具普遍性,这表明与力量产生相反,运动速度的潜在机制可能是老年人肌肉力量的重要因素。此外,上肢肌肉力量测量可能作为肢体力量的有用替代测量指标,对临床医生和研究人员具有重要意义。