Reeves N D, Spanjaard M, Mohagheghi A A, Baltzopoulos V, Maganaris C N
Institute for Biomedical Research into Human Movement and Health, Manchester Metropolitan University, MMU Cheshire, Alsager campus, United Kingdom.
Gait Posture. 2008 Aug;28(2):327-36. doi: 10.1016/j.gaitpost.2008.01.014. Epub 2008 Mar 11.
The high incidence of falls in older adults during stair negotiation suggests that this task is physically challenging and potentially dangerous. The present study aimed to examine the influence of light handrail use on the biomechanics of stair negotiation in old age. Thirteen older adults ascended and descended a purpose-built staircase at their self-selected speed: (i) unaided and (ii) with light use of the handrails. Ground reaction forces (GRFs) were measured from force platforms mounted into each step and motion capture was used to collect kinematic data. Knee and ankle joint moments were calculated using the kinetic and kinematic data. The horizontal separation between the centre of mass (COM) and the centre of pressure (COP) was assessed in the sagittal and frontal planes. During stair ascent, handrail use caused a different strategy to be employed compared to unaided ascent with a redistribution of joint moments. Specifically, the ankle joint moment (of the trailing leg) was reduced with handrail use, which has previously been shown to approach its limits during unaided stair ascent, but the knee joint moment (of the leading leg) increased. Previous research has shown that a larger joint moment reserve is available at the knee during unaided stair ascent. During stair descent, the ankle joint moment increased with handrail use, this was associated, however, with a more effective control of balance as shown by a reduced COM-COP separation in the direction of progression compared to unaided descent. These results indicate that although the biomechanical mechanisms are different for stair ascent and descent, the safety of stair negotiation is improved for older adults with light use of the handrails.
老年人在上下楼梯过程中跌倒的发生率较高，这表明这项任务对身体具有挑战性且存在潜在危险。本研究旨在探讨轻度使用扶手对老年人上下楼梯生物力学的影响。13名老年人以自己选择的速度上下专门建造的楼梯：(i) 不借助扶手；(ii) 轻度使用扶手。通过安装在每个台阶上的力平台测量地面反作用力 (GRF)，并使用动作捕捉来收集运动学数据。利用动力学和运动学数据计算膝关节和踝关节力矩。在矢状面和额状面评估重心 (COM) 和压力中心 (COP) 之间的水平间距。在楼梯上升过程中，与不借助扶手上升相比，使用扶手会采用不同的策略，关节力矩会重新分布。具体而言，使用扶手时（后脚的）踝关节力矩减小，先前研究表明，在不借助扶手爬楼梯时踝关节力矩接近其极限，但（前脚的）膝关节力矩增加。先前的研究表明，在不借助扶手爬楼梯时膝关节有更大的关节力矩储备。在楼梯下降过程中，使用扶手时踝关节力矩增加，然而，这与更有效的平衡控制有关，与不借助扶手下降相比，在前进方向上COM - COP间距减小表明了这一点。这些结果表明，尽管上下楼梯的生物力学机制不同，但轻度使用扶手可提高老年人上下楼梯的安全性。
