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老年跌倒者行走过程中的矢状面动量控制

Sagittal plane momentum control during walking in elderly fallers.

作者信息

Fujimoto Masahiro, Chou Li-Shan

机构信息

College of Sport and Health Science, Ritsumeikan University, Kusatsu, Shiga 525-8577, Japan; Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA.

Department of Human Physiology, University of Oregon, Eugene, OR 97403, USA.

出版信息

Gait Posture. 2016 Mar;45:121-6. doi: 10.1016/j.gaitpost.2016.01.009. Epub 2016 Jan 27.

Abstract

OBJECTIVE

The purpose of this study was to examine sagittal plane momentum control during walking with the use of center of mass (COM) velocity and acceleration.

METHODS

COM control in the antero-posterior direction during walking of healthy young and elderly adults, and elderly fallers (n=15/group) was examined. Using a single-link-plus-foot inverted pendulum model, boundaries for the region of stability were determined based on the COM position at toe-off and its instantaneous velocity or the peak acceleration prior to toe-off (ROSv or ROSa, respectively).

RESULTS

Although no significant difference in forward COM velocity was detected between healthy young and elderly subjects, the peak forward COM acceleration differed significantly, suggesting age-related differences in momentum control during walking. Elderly fallers demonstrated significantly slower forward COM velocities and accelerations and placed their COM significantly more anterior than healthy young and elderly subjects at toe-off, which resulted in their COM position-velocity combination located within the ROSv. Similar results were obtained in the ROSa, where elderly fallers demonstrated a larger stability margin than healthy young and elderly subjects.

INTERPRETATIONS

Significantly slower peak COM accelerations could be indicative of a poor momentum control ability, which was more pronounced in elderly fallers. Examining COM acceleration, in addition to its velocity, would provide a greater understanding of person's momentum control, which would allow us to better reveal underlying mechanisms of gait imbalance or falls.

摘要

目的

本研究旨在利用质心(COM)速度和加速度来研究步行过程中的矢状面动量控制。

方法

对健康的年轻人、老年人以及老年跌倒者(每组n = 15)在步行过程中前后方向的COM控制进行了研究。使用单连杆加足部倒立摆模型,根据离地时的COM位置及其瞬时速度或离地前的峰值加速度(分别为ROSv或ROSa)确定稳定区域的边界。

结果

尽管在健康的年轻人和老年人之间未检测到向前COM速度的显著差异,但向前COM的峰值加速度存在显著差异,这表明步行过程中动量控制存在与年龄相关的差异。老年跌倒者的向前COM速度和加速度明显较慢,并且在离地时其COM位置比健康的年轻人和老年人更靠前,这导致他们的COM位置 - 速度组合位于ROSv范围内。在ROSa中也获得了类似的结果,老年跌倒者的稳定裕度比健康的年轻人和老年人更大。

解读

显著较慢的COM峰值加速度可能表明动量控制能力较差,这在老年跌倒者中更为明显。除了COM速度之外,检查COM加速度将有助于更深入地了解人的动量控制,从而使我们能够更好地揭示步态失衡或跌倒的潜在机制。

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