School of Physical Therapy, Texas Woman's University, 8194 Walnut Hill Lane, Dallas, TX 75231, USA.
PM R. 2011 Sep;3(9):811-6. doi: 10.1016/j.pmrj.2011.03.013. Epub 2011 Jun 29.
To assess functional reach (FR) ability in 4 contexts in older adults (≥ 60 years) with high balance confidence (HBC) and low balance confidence (LBC).
A repeated-measures design was used to compare 2 groups in 4 reaching contexts.
Community setting.
Twenty-four healthy older adults with HBC and 27 healthy older adults with LBC.
FR distance was assessed in 4 contexts presented in random order: (1) traditional FR (TFR); (2) functional reach on foam (FRF); (3) object present functional reach (OPFR); and (4) object present functional reach on foam (OPFRF). For TFR and FRF, 3 trials were performed for each task, and the average reach distance across 3 trials was calculated. During the OPFR and OPFRF contexts, the object was moved toward or away from the participant in 1.3-cm increments until maximal reach distance to the object was obtained.
Maximal reach distance in each of the 4 FR contexts.
Participants in the HBC group scored significantly higher than did participants in the LBC group regardless of reaching contexts (P =.004). For both balance confidence groups, reaching distance increased significantly from FRF to TFR to OPFRF to OPFR (P < .001).
The results of this study highlight the beneficial effect of an external target on balance performance, even with the added challenge of an unstable surface. These findings suggest that although balance performance is greater for persons with HBC, the same pattern of reaching ability in differing FR contexts is found regardless of whether balance confidence is high or low. The clinical utility of these findings pertain to the importance of the use of task objects during FR balance assessment to determine an individual's balance capacity. Future research is needed to assess the effectiveness of context-oriented reaching tasks in balance training programs.
评估高平衡信心（HBC）和低平衡信心（LBC）的老年（≥60 岁）个体在 4 种情境下的功能性伸展（FR）能力。
使用重复测量设计比较 4 种伸展情境下的 2 组个体。
社区环境。
24 名具有 HBC 的健康老年人和 27 名具有 LBC 的健康老年人。
FR 距离在 4 种随机呈现的情境下进行评估：（1）传统 FR（TFR）；（2）泡沫上的功能性伸展（FRF）；（3）物体存在时的功能性伸展（OPFR）；（4）泡沫上的物体存在时的功能性伸展（OPFRF）。对于 TFR 和 FRF，每个任务进行 3 次试验，计算 3 次试验的平均伸展距离。在 OPFR 和 OPFRF 情境中，物体以 1.3cm 的增量向参与者移动或远离参与者，直到获得最大的物体伸展距离。
4 种 FR 情境下的最大伸展距离。
无论伸展情境如何，HBC 组的参与者得分均显著高于 LBC 组的参与者（P=.004）。对于平衡信心两组，从 FRF 到 TFR 再到 OPFRF 再到 OPFR，伸展距离均显著增加（P<.001）。
本研究结果强调了外部目标对平衡表现的有益影响，即使在不稳定表面的额外挑战下也是如此。这些发现表明，尽管具有 HBC 的个体的平衡表现更大，但在不同 FR 情境下的伸展能力呈现相同的模式，无论平衡信心高低。这些发现的临床应用涉及在 FR 平衡评估中使用任务物体的重要性，以确定个体的平衡能力。需要进一步的研究来评估面向情境的伸展任务在平衡训练计划中的有效性。
