Department of Biomedical Engineering, State University of New York, Stony Brook, New York, USA.
PLoS One. 2013 Aug 5;8(8):e70566. doi: 10.1371/journal.pone.0070566. Print 2013.
Poor balance in older persons contributes to a rise in fall risk and serious injury, yet no consensus has developed on which measures of postural sway can identify those at greatest risk of falling. Postural sway was measured in 161 elderly individuals (81.8y±7.4), 24 of which had at least one self-reported fall in the prior six months, and compared to sway measured in 37 young adults (34.9y±7.1). Center of pressure (COP) was measured during 4 minutes of quiet stance with eyes opened. In the elderly with fall history, all measures but one were worse than those taken from young adults (e.g., maximal COP velocity was 2.7× greater in fallers than young adults; p<0.05), while three measures of balance were significantly worse in fallers as compared to older persons with no recent fall history (COP Displacement, Short Term Diffusion Coefficient, and Critical Displacement). Variance of elderly subjects' COP measures from the young adult cohort were weighted to establish a balance score ("B-score") algorithm designed to distinguish subjects with a fall history from those more sure on their feet. Relative to a young adult B-score of zero, elderly "non-fallers" had a B-score of 0.334, compared to 0.645 for those with a fall history (p<0.001). A weighted amalgam of postural sway elements may identify individuals at greatest risk of falling, allowing interventions to target those with greatest need of attention.
老年人平衡能力差会增加跌倒风险和严重伤害,但对于哪些姿势摆动测量指标可以识别出最易跌倒的人,尚未达成共识。本研究共测量了 161 名老年人(81.8 岁±7.4 岁)和 37 名年轻人(34.9 岁±7.1 岁)的姿势摆动。其中 24 名老年人在过去 6 个月内至少有一次自述跌倒史。在有跌倒史的老年人中,除了一项指标外,所有指标都比年轻人差(例如,跌倒者的最大 COP 速度比年轻人快 2.7 倍;p<0.05),而与无近期跌倒史的老年人相比,有 3 项平衡指标在跌倒者中明显更差(COP 位移、短期扩散系数和临界位移)。老年人 COP 测量值与年轻成人队列的方差进行加权,以建立一个平衡评分(“B 评分”)算法,旨在区分有跌倒史的受试者和更稳健的受试者。与年轻成人的 B 评分为零相比,无跌倒史的老年人的 B 评分为 0.334,而有跌倒史的老年人的 B 评分为 0.645(p<0.001)。姿势摆动要素的加权综合可能可以识别出最易跌倒的人,从而可以针对最需要关注的人进行干预。