Weerdesteyn Vivian, Nienhuis Bart, Duysens Jacques
Department of Rehabilitation, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
Hum Mov Sci. 2008 Oct;27(5):738-48. doi: 10.1016/j.humov.2008.03.003. Epub 2008 Jun 3.
Fall prevention programs have rarely been evaluated by quantitative movement analysis methods. Quantitative movement analyses could provide insight into the mechanisms underlying the effects of training. A treadmill obstacle avoidance task under time pressure has recently been used to evaluate a fall prevention exercise program for community-dwelling elderly people and it showed that participants improved their obstacle avoidance success rates. The mechanism, by which the increased success rates were achieved, however, remained to be determined. Participants were elderly who had fallen at least once in the year prior to participation. They were assigned to either the exercise or the control group. The control group did not receive any specific treatment. The exercise group was administered a five week exercise program, which consisted of exercises on a functionally oriented obstacle course, walking exercises, and practice of fall techniques. Pre- and post-intervention laboratory obstacle avoidance tests were conducted. Three possible determinants of success were investigated, namely avoidance reaction times, the distribution of avoidance strategies, and three spatial parameters (toe distance, foot clearance and heel distance). Analysis yielded significant TimexGroup interactions in heel distances. The exercise group increased heel distance, while the control group did not. Increased heel distance may result in reduced risk of heel contact with the obstacle and, consequently, larger success rates. The remaining parameters showed no effect of training. In conclusion, the training program was effective in improving time-critical obstacle avoidance skills. In every day life, these effects of training may contribute to less obstacle-related fall incidents in elderly. In addition, these findings could indicate that the execution of other time-critical events, like an actual fall, could also be improved by training.
预防跌倒项目很少通过定量运动分析方法进行评估。定量运动分析可以深入了解训练效果背后的机制。最近，一种在时间压力下的跑步机避障任务被用于评估针对社区老年人的预防跌倒运动项目，结果显示参与者提高了避障成功率。然而，成功率提高的机制仍有待确定。参与者是在参与前一年至少跌倒过一次的老年人。他们被分为运动组或对照组。对照组未接受任何特殊治疗。运动组接受了为期五周的运动项目，包括在功能导向的障碍课程上进行锻炼、步行锻炼以及跌倒技巧练习。在干预前后进行了实验室避障测试。研究了三个可能决定成功的因素，即避障反应时间、避障策略的分布以及三个空间参数（脚趾距离、脚部间隙和脚跟距离）。分析得出脚跟距离存在显著的时间×组交互作用。运动组增加了脚跟距离，而对照组没有。脚跟距离增加可能会降低脚跟与障碍物接触的风险，从而提高成功率。其余参数未显示出训练效果。总之，该训练项目在提高对时间要求严格的避障技能方面是有效的。在日常生活中，这些训练效果可能有助于减少老年人与障碍物相关的跌倒事件。此外，这些发现可能表明，通过训练也可以改善其他对时间要求严格的事件的执行情况，比如实际跌倒。
