Jerome Gerald J, Ko Seung-uk, Kauffman Danielle, Studenski Stephanie A, Ferrucci Luigi, Simonsick Eleanor M
Department of Kinesiology, Towson University, Towson, MD, USA.
Department of Mechanical Engineering, Chonnam National University, Yeosu, South Korea.
Arch Gerontol Geriatr. 2015 Mar-Apr;60(2):239-43. doi: 10.1016/j.archger.2015.01.007. Epub 2015 Jan 13.
Understanding the mechanisms that contribute to walking speed decline can provide needed insight for developing targeted interventions to reduce the rate and likelihood of decline.
Examine the association between gait characteristics and walking speed decline in older adults.
Participants in the Baltimore Longitudinal Study of Aging aged 60 to 89 were evaluated in the gait laboratory which used a three dimensional motion capture system and force platforms to assess cadence, stride length, stride width, percent of gait cycle in double stance, anterior-posterior mechanical work expenditure (MWE), and medial-lateral MWE. Usual walking speed was assessed over 6 m at baseline and follow-up. Gait characteristics associated with meaningful decline (decline≥0.05 m/s/y) in walking speed were evaluated by logistic regression adjusted for age, sex, race, height, weight, initial walking speed and follow-up time.
Among 362 participants, the average age was 72.4 (SD=8.1) years, 51% were female, 27% were black and 23% were identified has having meaningful decline in usual walking speed with an average follow-up time of 3.2 (1.1) years. In the fully adjusted model, faster cadence [ORadj=0.65, 95% CI (0.43,0.97)] and longer strides [ORadj=0.87, 95% CI (0.83,0.91)] were associated with lower odds of decline. However age [ORadj=1.04, 95% CI (0.99,1.10)] was not associated with decline when controlling for gait characteristics and other demographics.
A sizable proportion of healthy older adults experienced walking speed decline over an average of 3 years. Longer stride and faster cadence were protective against meaningful decline in usual walking speed.
了解导致步行速度下降的机制可为制定有针对性的干预措施提供必要的见解,以降低下降速度和可能性。
研究老年人步态特征与步行速度下降之间的关联。
对巴尔的摩老年纵向研究中60至89岁的参与者在步态实验室进行评估,该实验室使用三维运动捕捉系统和测力平台来评估步频、步长、步宽、双支撑期占步态周期的百分比、前后方向的机械功消耗(MWE)以及内外侧MWE。在基线和随访时评估6米的常规步行速度。通过对年龄、性别、种族、身高、体重、初始步行速度和随访时间进行调整的逻辑回归,评估与步行速度有意义下降(下降≥0.05米/秒/年)相关的步态特征。
在362名参与者中,平均年龄为72.4(标准差=8.1)岁,51%为女性,27%为黑人,23%被确定为常规步行速度有意义下降,平均随访时间为3.2(1.1)年。在完全调整模型中,步频较快[校正比值比=0.65,95%置信区间(0.43,0.97)]和步长较长[校正比值比=0.87,95%置信区间(0.83,0.91)]与下降几率较低相关。然而,在控制步态特征和其他人口统计学因素时,年龄[校正比值比=1.04,95%置信区间(0.99,1.10)]与下降无关。
相当一部分健康老年人在平均3年的时间里经历了步行速度下降。步长较长和步频较快可预防常规步行速度的有意义下降。