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老年人在双重任务条件下开始行走时,对跌倒的恐惧与延长的预期姿势调整有关。

Fear of falling is associated with prolonged anticipatory postural adjustment during gait initiation under dual-task conditions in older adults.

机构信息

Department of Physical Therapy, Graduate School of Medicine, Nagoya University, Japan.

出版信息

Gait Posture. 2012 Feb;35(2):282-6. doi: 10.1016/j.gaitpost.2011.09.100. Epub 2011 Oct 22.

Abstract

Little is known about dynamic balance control under dual-task conditions in older adults with fear of falling (FoF). The purpose of this study was to examine the effect of FoF on anticipatory postural adjustment (APA) during gait initiation under dual-task conditions in older adults. Fifty-seven elderly volunteers (age, 79.2 [6.8] years) from the community participated in this study. Each participant was categorised into either the Fear (n=24) or No-fear (n=33) group on the basis of the presence or absence of FoF. Under single- and dual-task conditions, centre of pressure (COP) data were collected while the participants performed gait initiation trials from a starting position on a force platform. We also performed a 10-m walking test (WT), a timed up & go test (TUG), and a functional reach test (FR). The reaction and APA phases were measured from the COP data. The results showed that under the dual-task condition, the Fear group had significantly longer APA phases than the No-fear group, although no significant differences were observed between the 2 groups in the reaction and APA phases under the single-task condition and in any clinical measurements (WT, TUG, and FR). Our findings suggest that specific deficits in balance control occur in subjects with FoF during gait initiation while dual tasking, even if their physical functions are comparable to subjects without FoF.

摘要

关于在有跌倒恐惧(Fear of Falling,FoF)的老年人在双重任务条件下的动态平衡控制,人们知之甚少。本研究的目的是探讨 FoF 对老年人在双重任务条件下起始步态时的预期姿势调整(Anticipatory Postural Adjustment,APA)的影响。 本研究共纳入了 57 名来自社区的老年志愿者(年龄 79.2[6.8]岁)。根据是否存在 FoF,每位参与者被分为恐惧组(n=24)或无恐惧组(n=33)。在单任务和双重任务条件下,参与者从力平台上的起始位置开始进行起始步态试验时,收集了中心压力(Centre of Pressure,COP)数据。我们还进行了 10 米步行测试(10-m Walking Test,WT)、计时起立行走测试(Timed Up & Go Test,TUG)和功能性伸展测试(Functional Reach Test,FR)。从 COP 数据中测量了反应和 APA 阶段。结果表明,在双重任务条件下,恐惧组的 APA 阶段明显长于无恐惧组,尽管在单任务条件下和任何临床测量(WT、TUG 和 FR)中,两组在反应和 APA 阶段均无显著差异。我们的研究结果表明,即使 FoF 患者的身体功能与无 FoF 患者相当,在进行双重任务时,他们在起始步态时的平衡控制也会出现特定的缺陷。

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