Pan Hui-Fen, Hsu Horng-Chaung, Chang Wei-Ning, Renn Jenn-Huei, Wu Hong-Wen
Department of Orthopaedics, Kaohsiung Veterans General Hospital, Taiwan.
Department of Orthopaedics, China Medical University Hospital, Taiwan.
J Phys Ther Sci. 2016 May;28(5):1614-20. doi: 10.1589/jpts.28.1614. Epub 2016 May 31.
[Purpose] Tripping is a frequent cause of falls among aging adults. Appropriate limb movements while negotiating obstacles are critical to trip avoidance. The aim of our study was to investigate the mechanics of obstacle crossing in older adults at low or high risk of falling. [Subjects and Methods] Twenty community-dwelling adults aged ≥55 years, were evaluated with the Tinetti Balance and Gait scale and classified as being at high or low risk of falling. Between-group comparisons of kinematics were evaluated for obstacle heights of 10%, 20%, and 30% of leg length. [Results] The high-risk group demonstrated greater toe-obstacle clearance of the leading leg. Increasing obstacle height led to increased maximal toe-obstacle clearance, toe-obstacle distance, and shortened swing phase of the leading limb. Adaptation of clearance height was greater for the trailing leg. Individuals at high risk of falling demonstrated less symmetry between the leading and trailing legs and a narrower step width, features that increase the likelihood of tripping. [Conclusion] Kinematic parameters of obstacle clearance, including the symmetry index described in our study, could provide clinicians with a quick screening tool to identify patients at risk of falling and to evaluate outcomes of training programs.
[目的]绊倒在老年人跌倒原因中很常见。在通过障碍物时进行适当的肢体运动对于避免绊倒至关重要。我们研究的目的是调查高跌倒风险或低跌倒风险老年人跨越障碍物的力学原理。[对象与方法]选取20名年龄≥55岁的社区居住成年人，采用Tinetti平衡与步态量表进行评估，并分为高跌倒风险组或低跌倒风险组。对腿长的10%、20%和30%的障碍物高度进行组间运动学比较评估。[结果]高风险组前腿的脚趾与障碍物间隙更大。障碍物高度增加导致前腿最大脚趾与障碍物间隙、脚趾与障碍物距离增加，前肢摆动期缩短。后腿间隙高度的适应性更大。高跌倒风险个体的前后腿对称性较低，步幅较窄，这些特征增加了绊倒的可能性。[结论]障碍物间隙的运动学参数，包括我们研究中描述的对称指数，可以为临床医生提供一种快速筛查工具，以识别跌倒风险患者并评估训练计划的效果。
