Motor Performance Laboratory, School of Rehabilitation Therapy, Queen's University, 31 George St., Kingston, Ontario, Canada.
Gait Posture. 2011 Jan;33(1):54-60. doi: 10.1016/j.gaitpost.2010.09.024. Epub 2010 Oct 30.
Stair negotiation is an essential skill required for independent mobility, and is described by older adults as a challenging task that is associated with high fall risk. Little is known about the age-related changes in joint kinetics and the relative contribution of lower limb joint moments during stair negotiation. This study characterized lower extremity joint kinetics and their variability associated with stair ascent and descent in young and older adults. Twenty three young and 32 older adults (>55 years) participated. Three dimensional, bilateral gait analysis provided ankle, knee, and hip moment profiles, which in the sagittal plane were summed to provide the support moment. In addition, intra- and inter-subject coefficients of variation were calculated for ensemble averaged curves. Age-related differences were found in the magnitudes of the moment contributions during event transitions for stair ascent and descent. Within groups, the moment profiles were generally consistent. Ankle and knee moments predominantly contributed to extensor support in the sagittal plane. In the frontal plane, proximal joint abductor moments maintained lateral stability and were larger at the hip in older adults. Understanding age-related alterations in movement control during functional tasks can help inform the rehabilitation management and assessment of patient populations.
楼梯上下是独立移动的基本技能，老年人称其为具有挑战性的任务，与高跌倒风险相关。对于楼梯上下时下肢关节动力学及其变化与跌倒风险的关系，目前知之甚少。本研究旨在描述年轻人和老年人在上楼梯和下楼梯时下肢关节动力学及其变异性。共纳入 23 名年轻人和 32 名老年人（>55 岁）。三维双侧步态分析提供了踝关节、膝关节和髋关节力矩曲线，在矢状面将这些力矩曲线相加得到支撑力矩。此外，还计算了整体平均曲线的个体内和个体间变异系数。研究发现，年轻人和老年人在上楼梯和下楼梯时的运动转换瞬间力矩贡献的大小存在差异。在组内，力矩曲线通常是一致的。在矢状面，踝关节和膝关节主要提供伸肌支撑力矩。在额状面，近端关节外展肌力矩维持侧向稳定性，且在老年人中髋关节处的力矩更大。了解功能任务中运动控制的年龄相关性变化有助于为康复管理和患者人群评估提供信息。
