Christiansen Cory L
Physical Medicine and Rehabilitation Department, University of Colorado Denver, Aurora, CO 80045, USA.
Arch Phys Med Rehabil. 2008 Aug;89(8):1421-8. doi: 10.1016/j.apmr.2007.12.043.
To examine effects of hip and ankle stretching on gait function of older people.
Randomized controlled trial.
Flexibility training was performed in participants' homes. Assessments were performed in a biomechanics laboratory.
Forty healthy volunteers (mean age +/- SD, 72.1+/-4.7 y) randomized to 2 groups: intervention (n=20) and control (n=20).
Intervention participants performed an 8-week stretching program, and control group participants maintained activity level for 8 weeks. One investigator made weekly visits to instruct and monitor participants.
Primary outcome measures were passive joint motion for hip extension and ankle dorsiflexion and freely chosen gait speed. Secondary outcome measures were gait parameters during freely chosen gait speed and set gait speed walking (stride length, joint displacement).
Compared with the control group, the intervention group had increased combined hip and knee motion (P=.023), ankle motion (P=.020), and freely chosen gait speed (P=.016). The intervention group showed statistically nonsignificant trends of increased stride length at freely chosen gait speed and set gait speed.
Findings suggest joint motion is a modifiable impairment that is effectively targeted with flexibility training for older people. Participants in the intervention group had improvements in joint motion as well as increased freely chosen gait speed. Mechanisms responsible for changes in freely chosen gait speed warrant further investigation.
研究髋部和踝部拉伸对老年人步态功能的影响。
随机对照试验。
在参与者家中进行柔韧性训练。在生物力学实验室进行评估。
40名健康志愿者（平均年龄±标准差，72.1±4.7岁）随机分为两组：干预组（n = 20）和对照组（n = 20）。
干预组参与者进行为期8周的拉伸计划，对照组参与者在8周内保持活动水平。一名研究人员每周进行访视，指导和监测参与者。
主要观察指标为髋关节伸展和踝关节背屈的被动关节活动度以及自由选择的步态速度。次要观察指标为自由选择步态速度和设定步态速度行走时的步态参数（步长、关节位移）。
与对照组相比，干预组的髋关节和膝关节联合活动度增加（P = 0.023）、踝关节活动度增加（P = 0.020）以及自由选择的步态速度增加（P = 0.016）。干预组在自由选择步态速度和设定步态速度时步长增加的趋势在统计学上无显著意义。
研究结果表明关节活动度是一种可改变的损伤，针对老年人的柔韧性训练可有效改善这一损伤。干预组参与者的关节活动度得到改善，自由选择的步态速度也有所增加。自由选择步态速度变化的机制值得进一步研究。
