Department of Health Sciences, P.O. Box 35 (LL), 40014 University of Jyväskylä, Jyväskylä, Finland.
Aging Clin Exp Res. 2010 Feb;22(1):47-53. doi: 10.1007/BF03324815.
Prospective studies on the simultaneous effects of multiple determinants on objectively assessed mobility are few. The aim of this study was to analyse mobility performance, its stability and sensory, psychomotor and musculoskeletal determinants in an older population from age 75 to age 80.
Sixty-three men and 121 women aged 75 participated at baseline and, five years later, in the follow-up phase of this population-based prospective study. Maximal walking speed and step-mounting height were assessed at baseline and follow-up. Maximal isometric knee extension strength, standing balance on force platform, reaction time, visual acuity and limitations in range of motion (ROM) of hips and knees were assessed at baseline. Structural equation modeling was used to analyse the associations.
The stability of mobility performance from baseline to the five-year follow- up was high (coefficient 0.80 in men, 0.78 in women). In men, knee extension strength, standing balance, ROM limitations and visual acuity explained 69% of the variation in mobility performance at baseline and, indirectly, 59% of that variation at follow-up. Among women, knee extension strength, standing balance, visual acuity and reaction time explained 52% of the variation of mobility performance at baseline and, indirectly, 30% at the five-year follow-up.
Results indicate that the predictive effects of sensory, psychomotor and musculoskeletal functions on mobility performance extend over five years in older people. In seeking to prevent mobility limitations, vision, reaction time and lower extremity ROM need to be targeted, in addition to muscle strength and balance.
关于多个决定因素对客观评估的移动能力的同时影响的前瞻性研究较少。本研究的目的是分析 75 岁至 80 岁老年人的移动性能、其稳定性以及感觉、运动和肌肉骨骼决定因素。
63 名男性和 121 名女性在基线时（75 岁）参加了该基于人群的前瞻性研究的随访阶段，五年后参加了随访阶段。在基线和随访时评估最大步行速度和跨步高度。在基线时评估最大等长膝关节伸展力量、力平台上的站立平衡、反应时间、视力和髋关节和膝关节活动范围的限制。使用结构方程模型分析关联。
从基线到五年随访期间移动性能的稳定性很高（男性为 0.80，女性为 0.78）。在男性中，膝关节伸展力量、站立平衡、ROM 限制和视力解释了基线时移动性能的 69%变化，间接地解释了随访时的 59%变化。在女性中，膝关节伸展力量、站立平衡、视力和反应时间解释了基线时移动性能的 52%变化，间接地解释了五年随访时的 30%变化。
结果表明，在老年人中，感觉、运动和肌肉骨骼功能对移动能力的预测影响可延长五年。在寻求预防移动能力受限时，除了肌肉力量和平衡外，还需要针对视力、反应时间和下肢 ROM。
