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老年人姿势变形与站立平衡之间的关系。

The Relationship between Postural Deformation and Standing Balance in Elderly Person.

作者信息

Maejima Hiroshi, Takeishi Kiyohisa, Sunahori Hitoshi, Yamawaki Akiko, Nakajima Kiyomi, Yoshimura Osamu

机构信息

Institute of Health Sciences, Hiroshima University School of Medicine, Hiroshima 734-8551, Japan.

Fukuoka Wajiro Hospital, Fukuoka 811-0213, Japan.

出版信息

J Jpn Phys Ther Assoc. 2004;7(1):7-14. doi: 10.1298/jjpta.7.7.

Abstract

Falling due to unstable standing balance is considered to be the main cause of bone fractures, which lead elderly persons to becoming bedridden. Thus, the standing balance of elderly persons is being given increasingly greater attention. On the other hand, postural deformation caused by deformation in the spine and lower leg joints is considered to have an effect on standing balance. The objective of this study is to clarify the effect of postural deformation on the following three categories of standing balance; 1) the ability to immobilize Center of Gravity (COG) in standing statically, 2) the ability to control COG during movement and 3) the postural response induced by postural sway. Fifty elderly persons (age:77.7 ± 6.4 years old, fifty females) participated in this study. Postural deformation was measured using a Spinal Mouse, a device for non-invasive measurement of spinal curvature and photographic image in sagittal plane. In line with to Nakata's classification of postural deformation, subjects were classified by extension type, S-character deformation type, flexion type, hands on the knee type and normal group. In order to assess the ability to immobilize COG in static standing, Center of Pressure (COP) in static standing was measured for 30 sec. In order to assess the ability to control COG during movement, functional reach, maximal length of stride and the period of 10 m gait were measured. Postural response was induced by fore-aft perturbation of the platform on which the subjects stood. Postural responses were assessed by measuring both COP, and electromyography (EMG) of muscles in the lower legs. There was little significant difference among the five groups concerning postural deformation in every measured item, neither in the ability to immobilize COP in static standing, nor in the postural response induced by postural sway. However, the results of measured items concerning the ability to control COG during movement were significantly worse in flexion type and hands on the knee type compared with the normal group. It was suggested that postural deformation in elderly persons effects exclusively on the ability to control COG during movement in standing balance.

摘要

站立平衡不稳定导致的跌倒被认为是骨折的主要原因,这会使老年人卧床不起。因此,老年人的站立平衡越来越受到关注。另一方面,脊柱和小腿关节变形引起的姿势变形被认为会影响站立平衡。本研究的目的是阐明姿势变形对以下三类站立平衡的影响:1)静态站立时固定重心(COG)的能力;2)运动过程中控制COG的能力;3)姿势摆动引起的姿势反应。五十名老年人(年龄:77.7±6.4岁,均为女性)参与了本研究。使用脊柱鼠标测量姿势变形,脊柱鼠标是一种用于非侵入性测量脊柱曲率和矢状面摄影图像的设备。根据中田对姿势变形的分类,受试者分为伸展型、S型变形型、屈曲型、手扶膝盖型和正常组。为了评估静态站立时固定COG的能力,测量了静态站立30秒时的压力中心(COP)。为了评估运动过程中控制COG的能力,测量了功能性伸展、最大步幅和10米步态周期。姿势反应是通过对受试者站立平台进行前后扰动来诱发的。通过测量COP和小腿肌肉的肌电图(EMG)来评估姿势反应。在每个测量项目的姿势变形方面,五组之间几乎没有显著差异,在静态站立时固定COP的能力以及姿势摆动引起的姿势反应方面也没有显著差异。然而,与正常组相比,屈曲型和手扶膝盖型在运动过程中控制COG能力的测量项目结果明显更差。结果表明,老年人的姿势变形仅对站立平衡中运动过程中控制COG的能力有影响。

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