Bierbaum Stefanie, Peper Andreas, Arampatzis Adamantios
Department of Training and Movement Sciences, Humboldt-University Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany.
Age (Dordr). 2013 Oct;35(5):1905-15. doi: 10.1007/s11357-012-9481-z. Epub 2012 Oct 10.
Unexpected changes during gait challenge elderly individuals to a greater degree than young adults. However, the adaptive potential of elderly seems to be retained, and therefore, the training of the mechanisms of dynamic stability as well as muscle strength training may improve the dynamic stability after unexpected perturbations. Thirty-eight subjects (65-75 years) participated in the study, divided into two experimental groups (stability training group, ST, n = 14 and mixed training group, MT, n = 14) and a control group (CG, n = 10). Both experimental groups performed exercises which focused on the mechanisms of dynamic stability. Additionally, the MT group executed a training to improve muscle strength. Session volume and duration were equal for both groups (14 weeks, twice a week, ~1.5 h per session). Pre- and post-intervention, subjects performed a gait protocol with an induced unexpected perturbation. Post-intervention, the margin of stability was significantly increased after the unexpected perturbation in the ST group, indicating an improvement in stability state (pre, -30.3 ± 5.9 cm; post, -24.1 ± 5.2 cm). Further, both intervention groups increased their base of support after the intervention to regain balance after gait perturbation, whereas only the ST group showed a statistically significant improvement (STpre, 90.9 ± 6.6 cm, STpost, 98.2 ± 8.5 cm; MTpre, 91.4 ± 6.2 cm; MTpost, 97.9 ± 12.7 cm). The CG showed no differences between pre- and post-measurements. The exercise of the mechanisms of dynamic stability led to a better application of these mechanisms after an unexpected perturbation during gait. We suggest that the repeated exercise of the mechanisms of dynamic stability contributes to significant improvements in postural stability. Additional strength training for healthy elderly individuals, however, shows no further effect on the ability to recover balance after unexpected perturbations during gait.
与年轻人相比，步态中的意外变化对老年人的挑战更大。然而，老年人似乎仍保留着适应潜力，因此，训练动态稳定机制以及进行肌肉力量训练可能会改善意外扰动后的动态稳定性。38名受试者（65 - 75岁）参与了该研究，分为两个实验组（稳定训练组，ST，n = 14；混合训练组，MT，n = 14）和一个对照组（CG，n = 10）。两个实验组都进行了专注于动态稳定机制的练习。此外，MT组还进行了旨在提高肌肉力量的训练。两组的训练量和持续时间相同（14周，每周两次，每次约1.5小时）。干预前后，受试者进行了带有诱发意外扰动的步态测试。干预后，ST组在意外扰动后的稳定裕度显著增加，表明稳定状态有所改善（干预前，-30.3±5.9厘米；干预后，-24.1±5.2厘米）。此外，两个干预组在干预后都增加了支撑基底以在步态扰动后重新获得平衡，而只有ST组显示出统计学上的显著改善（ST干预前，90.9±6.6厘米，ST干预后，98.2±8.5厘米；MT干预前，91.4±6.2厘米；MT干预后，97.9±12.7厘米）。CG组在测量前后没有差异。动态稳定机制的练习使得在步态中出现意外扰动后这些机制得到了更好的应用。我们认为，重复练习动态稳定机制有助于显著改善姿势稳定性。然而，对健康老年人进行额外的力量训练，对步态中意外扰动后恢复平衡的能力没有进一步影响。
