Merchant Reshma A, Banerji Subhasis, Singh Gautam, Chew Effie, Poh Chueh L, Tapawan Sarah C, Guo Yan R, Pang Yu W, Sharma Mridula, Kambadur Ravi, Tay Stacey
Department of Medicine, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
J Am Med Dir Assoc. 2016 Jan;17(1):65-70. doi: 10.1016/j.jamda.2015.08.008. Epub 2015 Sep 26.
Many recent guidelines and consensus on sarcopenia have incorporated gait speed and grip strength as diagnostic criteria without addressing early posture changes adopted to maintain gait speed before weakness is clinically evident.
Older adults are known to compensate well for declining physiological reserve through environmental modification and posture adaptation. This study aimed to analyze and identify significant posture adaptation in older adults that is required to maintain gait speed in the face of increasing vulnerability. This would be a useful guide for early posture correction exercise interventions to prevent further decline, in addition to traditional gait, balance, and strength training.
A community-based cross-sectional study.
The participants comprised 90 healthy community-dwelling Chinese men between the ages of 60 and 80 years and 20 Chinese adults between the ages of 21 and 50 years within the normal BMI range as a comparison group.
All the participants underwent handgrip strength testing, 6-minute walk, timed up-and-go (TUG), and motion analysis for gait characteristics. Low function was characterized by slow walking speed (<1.0 m/s) and/or slow TUG (>10 seconds), whereas low strength was determined by hand grip dynamometer testing (<26 kg). The degree of frailty was classified using the Canadian Study for Health and Ageing Clinical Frailty Scale (CSHA-CFS) to differentiate between healthy and vulnerable older adults.
As expected, the vulnerable older adults had lower functional performance and strength compared with the healthy older adults group. However, a significant number demonstrated posture adaptations in walking in all 3 groups, including those who maintained a good walking speed (>1.0 m/s). The extent of such adaptation was larger in the vulnerable group as compared with the healthy group.
Although gait speed is a robust parameter for screening older adults for sarcopenia and frailty, our data suggest that identifying trunk posture adaptation before the onset of decline in gait speed will help in planning interventions in the at-risk community-dwelling older adults even before gait speed declines.
最近许多关于肌肉减少症的指南和共识已将步速和握力纳入诊断标准，但未涉及在临床明显出现虚弱之前为维持步速而采取的早期姿势变化。
众所周知，老年人通过环境改造和姿势适应能很好地补偿生理储备的下降。本研究旨在分析和确定老年人在面对日益增加的脆弱性时为维持步速所需的显著姿势适应。除了传统的步态、平衡和力量训练外，这将为早期姿势矫正运动干预提供有用的指导，以防止进一步衰退。
一项基于社区的横断面研究。
参与者包括90名年龄在60至80岁之间的健康社区居住中国男性，以及20名年龄在21至50岁之间、BMI在正常范围内的中国成年人作为对照组。
所有参与者均接受握力测试、6分钟步行测试、定时起立行走测试（TUG）以及步态特征的运动分析。功能低下的特征为步行速度慢（<1.0米/秒）和/或TUG时间长（>10秒），而力量低下则通过握力计测试确定（<26千克）。使用加拿大健康与老龄化临床衰弱量表（CSHA-CFS）对衰弱程度进行分类，以区分健康和脆弱的老年人。
正如预期的那样，与健康老年人组相比，脆弱老年人的功能表现和力量较低。然而，在所有三组中，包括那些保持良好步行速度（>1.0米/秒）的人，都有相当数量的人在行走时表现出姿势适应。与健康组相比，脆弱组的这种适应程度更大。
尽管步速是筛查老年人肌肉减少症和衰弱的有力参数，但我们的数据表明，在步速下降之前识别躯干姿势适应将有助于为处于风险中的社区居住老年人规划干预措施，甚至在步速下降之前。
