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区分跌倒者与非跌倒者的步态变量。

Gait variables differentiating fallers from nonfallers.

作者信息

Newstead Ann H, Walden J Gail, Gitter Andrew J

机构信息

The University of Texas Health Science Center at San Antonio, School of Allied Health Sciences, Department of Physical Therapy, San Antonio, TX 78229, USA.

出版信息

J Geriatr Phys Ther. 2007;30(3):93-101. doi: 10.1519/00139143-200712000-00003.

Abstract

PURPOSE

This study examined the qualitative and quantitative differences between 2 groups of older adults, fallers and nonfallers. We compared walking differences during overground walking to a task of obstacle clearance.

METHODS

Forty-eight community dwelling older adults (18 fallers and 30 nonfallers) participated. The mean age of the participants was 78.1 +/- 7.2 years (fallers) and 75.8 +/- 5.1 years (nonfallers). Walking differences within and between fallers and nonfallers during a single visit for 6 conditions were examined: (1) baseline walking, (2) slow walking, (3) fast walking, and (4) 5 cm obstacle clearance - approach, during, and exit. Quantitative differences of temporal-spatial walking measures were analyzed using a multifactorial ANOVA adjusted for age, gender, height, and BMI with a Scheffe correction (p < 0.05) applied for multiple testing. Qualitative data were analyzed using Chi-square fisher's exact test.

RESULTS

There were interaction effects for group by walking condition for single support (p = 0.002) and step length (p = 0.05), while 1st double support approached significance (p = 0.06). Main Group effects were found during the comfortable walk (p < 0.001-0.05) for all 7 gait variables. Qualitatively, the fallers demonstrated increased knee flexion during both over ground walking (c2 = 9.01 ; p < 0.006), and the fallers consistently took several small steps immediately prior to the obstacle clearance (c2 = 8.42 ; p = 0.007).

CONCLUSION

There were significant differences in quantitative and qualitative walking characteristics differentiating fallers from nonfallers during over-ground walking at different velocities and during obstacle clearance.

摘要

目的

本研究探讨了两组老年人(跌倒者和未跌倒者)之间的定性和定量差异。我们比较了在地面行走与跨越障碍物任务时的行走差异。

方法

48名社区居住的老年人(18名跌倒者和30名未跌倒者)参与了研究。参与者的平均年龄为78.1±7.2岁(跌倒者)和75.8±5.1岁(未跌倒者)。在一次就诊期间,对跌倒者和未跌倒者在6种情况下的行走差异进行了检查:(1)基线行走,(2)慢走,(3)快走,以及(4)跨越5厘米障碍物——接近、跨越和离开时。使用多因素方差分析对时空行走测量的定量差异进行分析,并对年龄、性别、身高和体重指数进行调整,采用谢弗校正(p<0.05)进行多重检验。定性数据采用卡方费舍尔精确检验进行分析。

结果

在单支撑(p = 0.002)和步长(p = 0.05)方面,组间与行走条件存在交互作用,而首次双支撑接近显著水平(p = 0.06)。在舒适行走期间,所有7个步态变量均发现主要组效应(p<0.001 - 0.05)。定性方面,跌倒者在地面行走时膝关节屈曲增加(c2 = 9.01;p<0.006),并且跌倒者在跨越障碍物之前始终会连续迈出几步小步(c2 = 8.42;p = 0.007)。

结论

在不同速度的地面行走和跨越障碍物过程中,跌倒者和未跌倒者在行走特征的定量和定性方面存在显著差异。

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