University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands.
Ageing Res Rev. 2013 Mar;12(2):618-27. doi: 10.1016/j.arr.2013.03.001. Epub 2013 Mar 15.
Maintaining and increasing walking speed in old age is clinically important because this activity of daily living predicts functional and clinical state. We reviewed evidence for the biomechanical mechanisms of how strength and power training increase gait speed in old adults. A systematic search yielded only four studies that reported changes in selected gait biomechanical variables after an intervention. A secondary analysis of 20 studies revealed an association of r(2)=0.21 between the 22% and 12% increase, respectively, in quadriceps strength and gait velocity in 815 individuals age 72. In 6 studies, there was a correlation of r(2)=0.16 between the 19% and 9% gains in plantarflexion strength and gait speed in 240 old volunteers age 75. In 8 studies, there was zero association between the 35% and 13% gains in leg mechanical power and gait speed in 150 old adults age 73. To increase the efficacy of intervention studies designed to improve gait speed and other critical mobility functions in old adults, there is a need for a paradigm shift from conventional (clinical) outcome assessments to more sophisticated biomechanical analyses that examine joint kinematics, kinetics, energetics, muscle-tendon function, and musculoskeletal modeling before and after interventions.
维持和提高老年人的步行速度在临床上很重要，因为这种日常活动可以预测功能和临床状态。我们回顾了力量和功率训练如何增加老年人步行速度的生物力学机制的证据。系统搜索仅发现了四项研究报告了干预后选定步态生物力学变量的变化。对 20 项研究的二次分析显示，在 815 名 72 岁的个体中，股四头肌力量分别增加 22%和 12%，与步态速度的 r(2)=0.21 相关。在 6 项研究中，在 240 名 75 岁的老年志愿者中，跖屈力量分别增加 19%和 9%，与步态速度的 r(2)=0.16 相关。在 8 项研究中，在 150 名 73 岁的老年人中，腿部机械功率分别增加 35%和 13%，与步态速度的 r(2)=0 没有关联。为了提高旨在提高老年人步态速度和其他关键移动功能的干预研究的效果，需要从传统（临床）结果评估转变为更复杂的生物力学分析，在干预前后检查关节运动学、动力学、能量学、肌肉-肌腱功能和骨骼肌肉建模。
