Sawa Ryuichi, Doi Takehiko, Misu Shogo, Tsutsumimoto Kota, Nakakubo Sho, Asai Tsuyoshi, Yamada Minoru, Ono Rei
Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
Section for Health Promotion Department for Research and Development to Support Independent Life of Elderly, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan; Japan Society for the Promotion of Science, Tokyo, Japan; Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.
Gait Posture. 2014;40(1):123-7. doi: 10.1016/j.gaitpost.2014.03.002. Epub 2014 Mar 12.
The aim of this study was to explore whether FoF was associated with variability in both leg and trunk movements during gait in community-dwelling elderly. Ninety-three elderly people participated in this study. Each participant was categorized into either Fear or No-Fear group on the basis of having FoF. The participants walked 15m at their preferred speed. The wireless motion recording sensor units were attached to L3 spinous process and right posterior surface of heel during gait. Gait velocity, stride time and stride length were calculated. Variability in lower limb movements was represented by coefficient of variation (CV) of stride time. Trunk variability was represented by autocorrelation coefficients (AC) in three directions (vertical: VT, mediolateral: ML and anteroposterior: AP), respectively. Gait parameters were compared between groups, and further analyses were performed using generalized linear regression models after adjustment of age, sex, fall experience, height, weight, and gait velocity. Although gait velocity, mean stride time and stride length did not differ significantly between groups, stride time CV and all ACs were significantly worse in the Fear group after adjustment for variables, even including gait velocity (stride time CV: p=0.003, β=-0.793; AC-VT: p=0.011, β=0.053; AC-ML: p=0.044, β=0.075; AC-AP: p=0.002, β=0.078). Our results suggest that fear of falling is associated with variability in both leg and trunk movements during gait in community-dwelling elderly. Further studies are needed to prove a causal relationship.
本研究的目的是探讨在社区居住的老年人中，害怕跌倒（FoF）是否与步态中腿部和躯干运动的变异性相关。93名老年人参与了本研究。根据是否存在害怕跌倒，将每位参与者分为害怕组或无害怕组。参与者以其偏好的速度行走15米。在步态过程中，将无线运动记录传感器单元连接到L3棘突和右足跟后表面。计算步态速度、步幅时间和步幅长度。下肢运动的变异性用步幅时间的变异系数（CV）表示。躯干变异性分别用三个方向（垂直：VT、内外侧：ML和前后：AP）的自相关系数（AC）表示。比较两组之间的步态参数，并在调整年龄、性别、跌倒经历、身高、体重和步态速度后，使用广义线性回归模型进行进一步分析。尽管两组之间的步态速度、平均步幅时间和步幅长度没有显著差异，但在对变量进行调整后，包括步态速度在内，害怕组的步幅时间CV和所有ACs均显著更差（步幅时间CV：p = 0.003，β = -0.793；AC-VT：p = 0.011，β = 0.053；AC-ML：p = 0.044，β = 0.075；AC-AP：p = 0.002，β = 0.078）。我们的结果表明，在社区居住的老年人中，害怕跌倒与步态中腿部和躯干运动的变异性相关。需要进一步的研究来证明因果关系。
