Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA 02129, USA.
J Orthop Sports Phys Ther. 2012 May;42(5):474-81. doi: 10.2519/jospt.2012.3562. Epub 2012 Apr 30.
Controlled laboratory study using a cross-sectional design.
To compare lower extremity force applications during a sit-to-stand (STS) task with and without upper extremity assistance in older individuals post-hip fracture to those of age-matched controls.
A recent study documented the dependence on upper extremity assistance and the uninvolved lower limb during an STS task in individuals post-hip fracture. This study extends this work by examining the effect of upper extremity assistance on symmetry of lower extremity force applications.
Twenty-eight community-dwelling elderly subjects, 14 who had recovered from a hip fracture and 14 controls, participated in the study. All participants were independent ambulators. Four force plates were used to determine lower extremity force applications during an STS task with and without upper extremity assistance. The summed vertical ground reaction forces (vGRFs) of both limbs were used to determine STS phases (preparation/rising). The lower extremity force applications were assessed statistically using analysis of variance models.
During the preparation phase, side-to-side symmetry of the rate of force development was significantly lower for the hip fracture group for both STS tasks (P<.001). During the rising phase, the vGRF impulse of the involved limb was significantly lower for the hip fracture group for both STS tasks (P = .045). The vGRF impulse for the uninvolved limb was significantly increased when participants with hip fracture did not use upper extremity assistance compared to elderly controls (P = .002). This resulted in a significantly lower vGRF symmetry for the hip fracture group during both STS tasks (P<.001).
Participants with hip fracture who were discharged from rehabilitative care demonstrated decreased side-to-side symmetry of lower extremity loading during an STS task, irrespective of whether upper extremity assistance was provided. These findings suggest that learned motor control strategies may influence movement patterns post-hip fracture.
采用横断面设计的对照实验室研究。
比较髋部骨折后老年人在使用和不使用上肢辅助进行坐站（STS）任务时下肢力的应用情况，并与年龄匹配的对照组进行比较。
最近的一项研究记录了髋部骨折后个体在 STS 任务中对上肢辅助和未受累下肢的依赖。本研究通过检查上肢辅助对下肢力应用对称性的影响，扩展了这方面的工作。
28 名居住在社区的老年受试者，14 名髋部骨折康复患者和 14 名对照组参加了研究。所有参与者均为独立步行者。使用四个力板来确定在使用和不使用上肢辅助进行 STS 任务时下肢力的应用情况。通过分析方差模型对双侧下肢力应用进行统计学评估。
在准备阶段，髋部骨折组在两种 STS 任务中，力的发展速率的双侧对称性显著较低（P<.001）。在上升阶段，髋部骨折组在两种 STS 任务中，受累肢体的 vGRF 冲量显著较低（P =.045）。当髋部骨折患者不使用上肢辅助时，未受累肢体的 vGRF 冲量显著增加，与老年对照组相比（P =.002）。这导致髋部骨折组在两种 STS 任务中 vGRF 对称性显著降低（P<.001）。
从康复护理出院的髋部骨折患者在进行 STS 任务时，下肢加载的双侧对称性降低，无论是否提供上肢辅助。这些发现表明，习得的运动控制策略可能会影响髋部骨折后的运动模式。
