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[移动性与平衡]

[Mobility and balance].

作者信息

Schmitt Katrin, Kressig Reto W

机构信息

Akutgeriatrische Universitätsklinik, Universitätsspital Basel, Petersgraben 4, Basel, Switzerland.

出版信息

Ther Umsch. 2008 Aug;65(8):421-6. doi: 10.1024/0040-5930.65.8.421.

Abstract

Quality of life is strongly associated with the mobility of elderly people. Falls often cause restricted mobility, a decline in activities of daily living and an increased risk of institutionalisation. Frailty, commonly associated with aging, is a biologic syndrome of decreased resistance to stressors, resulting from declines across multiple physiological systems. Changes in mobility and gait constitute part of the frailty syndrome. Since more than one third of persons over the age of 65 fall each year, prevention of falls is very important. Already while taking the patients' history special emphasis should be laid on matters associated with an increased risk of falling, such as the use of more than four medications. To assess mobility several brief tests exist (i.e. Timed up & go [17], Walking while Talking [20]) which immediately yield information regarding mobility and falling risk. Patients with poor performance on such tests or those with a history of several falls should undergo a spatio-temporal gait analysis in order to determine a possible cause as well as suitable interventions. Additionally, the objective measurement of temporo-spatial gait parameters under dual task conditions may detect deficits in cognitive function. Several interventions have been shown to have favourable effects on gait stability and the occurrence of falls. Proprioceptive problems can be partially compensated for by wearing special shoes. Also, different movement exercises such as Tai Chi Chuan, Jaques-Dalcroze eurhythmics and social dancing are associated with better balance and gait safety, and a reduction of falls.

摘要

生活质量与老年人的行动能力密切相关。跌倒常常导致行动受限、日常生活活动能力下降以及入住养老机构的风险增加。衰弱通常与衰老相关,是一种对应激源抵抗力下降的生物学综合征,由多个生理系统的衰退所致。行动能力和步态的变化是衰弱综合征的一部分。由于每年超过三分之一的65岁以上老人会跌倒,预防跌倒非常重要。在采集患者病史时,就应特别关注与跌倒风险增加相关的事项,比如使用四种以上药物。为评估行动能力,有几种简短测试(如定时起立行走测试[17]、边走边说测试[20]),这些测试能立即得出有关行动能力和跌倒风险的信息。在这类测试中表现不佳的患者或有多次跌倒史的患者,应接受时空步态分析,以确定可能的原因以及合适的干预措施。此外,在双重任务条件下对时空步态参数进行客观测量,可能会检测出认知功能缺陷。已证明几种干预措施对步态稳定性和跌倒发生率有积极影响。穿着特殊鞋子可部分补偿本体感觉问题。同样,不同的运动锻炼,如太极拳、雅克 - 达尔克罗兹韵律操和社交舞蹈,都与更好的平衡和步态安全性以及跌倒次数减少有关。

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