Choy N Low, Brauer S, Nitz J
Division of Physiotherapy, School of Health & Rehabilitation Sciences, The University of Queensland, Australia.
Climacteric. 2008 Apr;11(2):144-54. doi: 10.1080/13697130801931821.
To investigate differences in demographics, strength and sensory system function of 254 women aged 40-80 years categorized as stable, unsteady or unstable using simple balance tests.
Demographics (age, height, weight, medications, co-morbidities, falls history, activity level), measures of quadriceps, hip abductor and adductor strength, somatosensory, visual and vestibular function were recorded. Subjects were categorized as stable (completed all trials), unsteady (failed one/two trials) or unstable (failed all trials) after three 10-s trials of bilateral stance (foam surface, eyes closed (EC)) and one-leg stance (firm surface, eyes open (EO)), and the results were compared.
Both balance tasks identified women in their fifties as unstable ( approximately 9%), with 60% of these women failing both tasks. More women were unsteady or unstable on foam EC (27%) than in one-leg stance EO (20%). Unsteady and unstable categories of women were older, reported more co-morbidities and medications and less activity than stable women. The women categorized as unstable in either test recorded weaker hip muscles, higher vibration thresholds, greater joint positioning error, reduced edge contrast sensitivity, low-contrast visual acuity and reduced dynamic visual acuity than the stable categories (p < 0.01). The two tests detected differences in characteristics of unstable women, with those failing one-leg stance EO being heavier, and those failing foam EC having weaker quadriceps.
These data link instability in women from the fifties to multiple demographic and sensorimotor factors associated with increased risk of falls, thus supporting use of balance tests in primary-care settings to assist referral for diagnostic assessment and pre-emptive interventions.
通过简单的平衡测试,调查254名年龄在40 - 80岁之间的女性在人口统计学特征、力量和感觉系统功能方面的差异,这些女性被分为稳定、不稳定或非常不稳定三类。
记录人口统计学特征(年龄、身高、体重、药物使用情况、合并症、跌倒史、活动水平)、股四头肌、髋外展肌和内收肌力量的测量值、躯体感觉、视觉和前庭功能。在进行三次10秒的双侧站立(在泡沫表面,闭眼(EC))和单腿站立(在坚实表面,睁眼(EO))试验后,将受试者分为稳定(完成所有试验)、不稳定(一项/两项试验失败)或非常不稳定(所有试验失败)三类,并比较结果。
两项平衡测试均显示,五十多岁的女性中有约9%被判定为非常不稳定,其中60%的女性两项测试均失败。与单腿站立睁眼(EO)试验(20%)相比,更多女性在泡沫表面闭眼(EC)试验中表现为不稳定或非常不稳定(27%)。不稳定和非常不稳定类别的女性比稳定类别的女性年龄更大,报告的合并症和药物使用情况更多,活动更少。在任何一项测试中被判定为非常不稳定的女性,与稳定类别的女性相比,其髋部肌肉力量较弱、振动阈值较高、关节定位误差较大、边缘对比度敏感度降低、低对比度视力和动态视力下降(p < 0.01)。两项测试检测出非常不稳定女性的特征存在差异,单腿站立睁眼(EO)试验失败的女性体重更重,泡沫表面闭眼(EC)试验失败的女性股四头肌力量较弱。
这些数据表明,五十多岁女性的平衡不稳定与多种人口统计学和感觉运动因素相关,这些因素会增加跌倒风险,因此支持在初级保健环境中使用平衡测试,以协助转诊进行诊断评估和预防性干预。