Deshpande Nandini, Simonsick Eleanor, Metter E Jeffrey, Ko Seunguk, Ferrucci Luigi, Studenski Stephanie
Faculty of Health Sciences, Queen's University, Louise D Acton Building, 31 George Street, Kingston, ON, K7L 3N6, Canada.
Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA.
Age (Dordr). 2016 Jun;38(3):53. doi: 10.1007/s11357-016-9918-x. Epub 2016 May 4.
Ankle proprioceptive information is integrated by the central nervous system to generate and modulate muscle contractions for maintaining standing balance. This study evaluated the association of ankle joint proprioception with objective and self-report measures of balance, mobility, and physical function across the adult life span. Seven hundred and ninety participants (age range 24-97 years, 362 women) who completed ankle proprioception assessment between 2010 and 2014 were included in the present study from the population-based cohort of the Baltimore Longitudinal Study of Aging (BLSA), USA. Outcome measures included ankle joint proprioception measured as threshold for perception of passive movement (TPPM); single leg stance time; perceived difficulty for standing balance; usual, fastest, and narrow-path gait speed; walking index; short physical performance battery score; and self-reported activity restriction due to fear of falling. Descriptive variables included age, sex, body mass index, education, strength, and cognition. Analyses of covariance (ANCOVA) in general linear model (GLM) or multinomial logistic regression analyses were performed, as appropriate, to test the hypothesis that balance, mobility, and physical function were significantly different according to TPPM quintiles even after adjusting for relevant covariates. Those with TPPM >2.2° consistently demonstrated poor balance, mobility, and physical function. However, with increase in challenge (single leg stance, fastest walking speed, and SPPB), TPPM >1.4° was associated with significantly worse performance. In conclusion, ankle proprioceptive acuity has an overall graded relationship with objective and self-report measures of balance, mobility, and physical function. However, the cutoff proprioceptive acuity associated with substantial decline or inability to perform could depend on the challenge induced.
踝关节本体感觉信息由中枢神经系统整合,以产生和调节肌肉收缩来维持站立平衡。本研究评估了踝关节本体感觉与成年期客观及自我报告的平衡、活动能力和身体功能指标之间的关联。本研究纳入了790名参与者(年龄范围24 - 97岁,362名女性),他们于2010年至2014年期间完成了踝关节本体感觉评估,来自美国巴尔的摩纵向衰老研究(BLSA)这一基于人群的队列。结局指标包括以被动运动感知阈值(TPPM)衡量的踝关节本体感觉;单腿站立时间;站立平衡的感知难度;平常、最快和窄道步态速度;步行指数;简短体能表现电池测试得分;以及因害怕跌倒而自我报告的活动受限情况。描述性变量包括年龄、性别、体重指数、教育程度、力量和认知。根据情况进行一般线性模型(GLM)中的协方差分析(ANCOVA)或多项逻辑回归分析,以检验即使在调整相关协变量后,平衡、活动能力和身体功能根据TPPM五分位数仍存在显著差异这一假设。TPPM >2.2°的参与者始终表现出平衡、活动能力和身体功能较差。然而,随着挑战增加(单腿站立、最快步行速度和简短体能表现电池测试),TPPM >1.4°与显著更差的表现相关。总之,踝关节本体感觉敏锐度与平衡、活动能力和身体功能的客观及自我报告指标总体上呈分级关系。然而,与功能大幅下降或无法完成任务相关的本体感觉敏锐度临界值可能取决于所引发的挑战。