Rheumatology Division, Universidade Federal de São Paulo-Escola Paulista de Medicina, São Paulo, Brazil.
Gait Posture. 2011 Jun;34(2):208-12. doi: 10.1016/j.gaitpost.2011.04.013. Epub 2011 May 23.
Falls are a serious health problem for aged people, causing social and economic burden. Despite being an important determinant of balance, the positioning of the center of mass (COM) has not been evaluated as a risk factor for falls. This study examined the association between the percentage height of COM (%COM) and the risk of falls in the elderly. Healthy women aged 60 years and older were consecutively selected in a case-control study. Forty-eight individuals classified as "fallers" (having suffered two or more falls in the previous year) were the cases while 48 age and weight-matched women with one fall or no falls in the previous year were the controls ("non-fallers"). Body composition and bone mineral density (BMD) by DXA, 30-second chair stand test, abdominal circumference, Berg's balance scale and %COM using the reaction board method were evaluated in all participants. Body composition parameters were not significantly different between groups. Spine and hip BMD tended to be lower in the fallers, but the difference was significant only at the femoral neck (0.80±0.10g/cm(2) versus 0.87±0.76g/cm(2); p<0.01). Berg's balance scale scores were lower among fallers than non-fallers (p<0.05). Percentage height of COM was significantly higher among fallers (p<0.001) and this was associated with a higher number of fractures (p<0.05). Percentage height of COM is significantly higher in the elderly with frequent falls. Further work is needed in order to determine the value of board reaction measurements in a clinical setting to identify patients at high risk.
跌倒对老年人来说是一个严重的健康问题,会造成社会和经济负担。尽管身体重心(COM)的位置是平衡的一个重要决定因素,但它并未被评估为跌倒的危险因素。本研究旨在探讨 COM 高度百分比(%COM)与老年人跌倒风险之间的关系。在一项病例对照研究中,连续选择了 60 岁及以上的健康女性。48 名被分类为“跌倒者”(在过去一年中遭受了两次或更多次跌倒)的个体为病例组,而 48 名年龄和体重匹配、在过去一年中只有一次跌倒或没有跌倒的女性为对照组(“非跌倒者”)。对所有参与者进行了身体成分和骨密度(DXA)、30 秒椅立测试、腹围、Berg 平衡量表和使用反应板法的%COM 评估。两组间的身体成分参数无显著差异。尽管脊柱和髋部 BMD 在跌倒者中趋于较低,但仅在股骨颈处的差异有统计学意义(0.80±0.10g/cm(2) 与 0.87±0.76g/cm(2);p<0.01)。与非跌倒者相比,跌倒者的 Berg 平衡量表评分较低(p<0.05)。跌倒者的 COM 高度百分比显著较高(p<0.001),且与更多的骨折有关(p<0.05)。经常跌倒的老年人的 COM 高度百分比显著较高。需要进一步的研究来确定在临床环境中使用反应板测量值的价值,以识别高风险患者。