Stroke and Ageing Research Group, Department of Medicine, Southern Clinical School, Monash University, Victoria, Australia.
Gait Posture. 2012 Jul;36(3):510-5. doi: 10.1016/j.gaitpost.2012.05.003. Epub 2012 Jun 8.
To investigate the relationship between fast-walking and falls in older people.
Individuals aged 60-86 years were randomly selected from the electoral roll (n=176). Gait speed, step length, cadence and a walk ratio were recorded during preferred- and fast-walking using an instrumented walkway. Falls were recorded prospectively over 12 months. Log multinomial regression was used to estimate the relative risk of single and multiple falls associated with gait variables during fast-walking and change between preferred- and fast-walking. Covariates included age, sex, mood, physical activity, sensorimotor and cognitive measures.
The risk of multiple falls was increased for those with a smaller walk ratio (shorter steps, faster cadence) during fast-walking (RR 0.92, CI 0.87, 0.97) and greater reduction in the walk ratio (smaller increase in step length, larger increase in cadence) when changing to fast-walking (RR 0.73, CI 0.63, 0.85). These gait patterns were associated with poorer physiological and cognitive function (p<0.05). A higher risk of multiple falls was also seen for those in the fastest quarter of gait speed (p=0.01) at fast-walking. A trend for better reaction time, balance, memory and physical activity for higher categories of gait speed was stronger for fallers than non-fallers (p<0.05).
Tests of fast-walking may be useful in identifying older individuals at risk of multiple falls. There may be two distinct groups at risk--the frail person with short shuffling steps, and the healthy person exposed to greater risk.
研究老年人快走与跌倒的关系。
从选民名单中随机抽取 60-86 岁的个体（n=176）。使用仪器化步道记录其在自然步速和快速行走时的步速、步长、步频和步幅比。前瞻性记录 12 个月内的跌倒情况。采用对数多项回归估计与快速行走时步态变量相关的单次和多次跌倒的相对风险，以及从自然步速转换为快速行走时的变化。协变量包括年龄、性别、情绪、身体活动、感觉运动和认知测量。
在快速行走时步幅比较小（步长较短，步频较快）和改变为快速行走时步幅比减小（步长增加较小，步频增加较大）的人，多次跌倒的风险增加（RR 0.92，CI 0.87，0.97）和（RR 0.73，CI 0.63，0.85）。这些步态模式与较差的生理和认知功能相关（p<0.05）。在快速行走时步速最快的四分之一人群中，多次跌倒的风险也更高（p=0.01）。对于跌倒者来说，更高的步速类别与更好的反应时间、平衡、记忆和身体活动呈更强的趋势，而非跌倒者（p<0.05）。
快速行走测试可能有助于识别有多次跌倒风险的老年人。可能有两个不同的风险群体——步幅短、身体虚弱的人，以及暴露于更大风险的健康人。
