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步宽在双重任务行走中的变化可预测跌倒。

Changes in step-width during dual-task walking predicts falls.

机构信息

Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, S-901 87 Umeå, Sweden.

出版信息

Gait Posture. 2010 May;32(1):92-7. doi: 10.1016/j.gaitpost.2010.03.012. Epub 2010 Apr 15.

DOI:10.1016/j.gaitpost.2010.03.012
PMID:20399100
Abstract

The aim was to evaluate whether gait pattern changes between single- and dual-task conditions were associated with risk of falling in older people. Dual-task cost (DTC) of 230 community living, physically independent people, 75 years or older, was determined with an electronic walkway. Participants were followed up each month for 1 year to record falls. Mean and variability measures of gait characteristics for 5 dual-task conditions were compared to single-task walking for each participant. Almost half (48%) of the participants fell at least once during follow-up. Risk of falling increased in individuals where DTC for performing a subtraction task demonstrated change in mean step-width compared to single-task walking. Risk of falling decreased in individuals where DTC for carrying a cup and saucer demonstrated change compared to single-task walking in mean step-width, mean step-time, and step-length variability. Degree of change in gait characteristics related to a change in risk of falling differed between measures. Prognostic guidance for fall risk was found for the above DTCs in mean step-width with a negative likelihood ratio of 0.5 and a positive likelihood ratio of 2.3, respectively. Findings suggest that changes in step-width, step-time, and step-length with dual tasking may be related to future risk of falling. Depending on the nature of the second task, DTC may indicate either an increased risk of falling, or a protective strategy to avoid falling.

摘要

目的在于评估老年人在单任务和双任务条件下的步态模式变化是否与跌倒风险相关。通过电子步道确定了 230 名生活在社区、身体独立、75 岁及以上的老年人的双任务成本(DTC)。对参与者进行了为期 1 年的每月随访,以记录跌倒情况。对每个参与者的 5 种双任务条件下的步态特征的均值和变异性指标与单任务行走进行了比较。在随访期间,几乎有一半(48%)的参与者至少跌倒过一次。与单任务行走相比,执行减法任务时 DTC 的均值步幅发生变化的个体,跌倒风险增加。与单任务行走相比,在均值步幅、均值步时和步长变异性方面,DTC 为携带杯碟时的个体跌倒风险降低。与跌倒风险变化相关的步态特征变化程度因测量指标而异。对于上述 DTC 在均值步幅上的跌倒风险,负似然比为 0.5,正似然比为 2.3,分别为负似然比为 0.5,正似然比为 2.3,发现结果表明,双任务时步幅、步时和步长的变化可能与未来跌倒风险有关。根据第二项任务的性质,DTC 可能表明跌倒风险增加,或者是一种避免跌倒的保护策略。

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