School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.
Gait Posture. 2011 Oct;34(4):529-32. doi: 10.1016/j.gaitpost.2011.07.008. Epub 2011 Aug 3.
Stair ambulation is one of the most challenging and hazardous types of locomotion for older adults and often requires the adoption of compensatory strategies such as increased handrail use to mitigate disability and increase stability. Centre of pressure velocity (VCOP) describes the neuromuscular response to shifts of the body's centre of mass and serves as an indicator of stability. Knowledge of VCOP may provide some understanding of strategies to improve measured and perceived stability during stair negotiation. The aim of this study was to compare VCOP during stair ascent and descent with and without a handrail in young, older and older adults with a fear of falling (FOF) populations.
COP velocities of 23 young adults (23.7±3.0 yrs), 26 older adults (66.4±8.3 yrs), and 3 older adults with FOF (80.2±8.0 yrs) were analyzed while they ascended and descended a custom 4-step staircase. VCOP were obtained using a force plate mounted on concrete blocks centered on the second step of the staircase.
During stair ascent and descent with and without a handrail, the VCOP between young and older adults were comparable. The three adults with FOF demonstrated reduced VCOP during ascent and descent without the handrail and even slower VCOP when ascending and descending stairs with the handrail. These results suggest that handrail use does not increase biomechanical stability for healthy, older adults. However, in the presence of fear of falling the use of the handrail enhances dynamic stability, particularly during stair descent.
This study provides the first detailed description of dynamic stability during stair ambulation with and without a handrail. Observations from those with FOF aid in understanding the nature of compensations to improve actual and perceived stability.
对于老年人来说，楼梯步行是最具挑战性和危险性的运动类型之一，通常需要采取补偿策略，例如增加扶手的使用，以减轻残疾并提高稳定性。 中心压力速度（VCOP）描述了身体重心转移的神经肌肉反应，是稳定性的指标。 对 VCOP 的了解可能有助于了解在楼梯协商期间提高测量和感知稳定性的策略。 本研究的目的是比较有和没有扶手的情况下年轻人，老年人和有跌倒恐惧（FOF）的老年人在楼梯上升和下降时的 VCOP。
当 23 名年轻成年人（23.7±3.0 岁），26 名老年人（66.4±8.3 岁）和 3 名有 FOF 的老年人（80.2±8.0 岁）登上和下一个定制的 4 级楼梯时，分析了他们的 COP 速度。 VCOP 是通过安装在混凝土块上的力板获得的，该力板位于楼梯的第二个台阶的中心。
在有和没有扶手的楼梯上升和下降过程中，年轻人和老年人之间的 VCOP 相当。 有 3 名 FOF 的成年人在没有扶手的情况下上升和下降时，VCOP 降低，甚至在使用扶手上升和下降楼梯时，VCOP 更慢。 这些结果表明，扶手的使用并不能提高健康老年人的生物力学稳定性。 但是，在存在跌倒恐惧的情况下，扶手的使用增强了动态稳定性，特别是在楼梯下降时。
本研究首次详细描述了有和没有扶手的楼梯步行时的动态稳定性。 对 FOF 患者的观察有助于理解补偿的性质，以提高实际和感知的稳定性。
