Alqahtani Bader A, Ferchak Mary Ann, Huppert Theodore J, Sejdic Ervin, Perera Subashan, Greenspan Susan L, Sparto Patrick J
Department of Physical Therapy, 433 Eye and Ear Institute, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA.
Department of Medicine, University of Pittsburgh, 3471 Fifth Avenue Kaufmann Medical Building, Suite 500, Pittsburgh, PA, 15213, USA.
Aging Clin Exp Res. 2017 Oct;29(5):1021-1030. doi: 10.1007/s40520-016-0693-4. Epub 2016 Dec 20.
Research on balance and mobility in older adults has been conducted primarily in lab-based settings in individuals who live in the community. Although they are at greater risk of falls, residents of long-term care facilities, specifically residential care communities (RCCs), have been investigated much less frequently. We sought to determine the feasibility of using portable technology-based measures of balance and muscle strength (i.e., an accelerometer and a load cell) that can be used in any RCC facility. Twenty-nine subjects (age 87 ± 6 years) living in RCCs participated. An accelerometer placed on the back of the subjects measured body sway during different standing conditions. Sway in antero-posterior and mediolateral directions was calculated. Lower extremity strength was measured with a portable load cell and the within-visit reliability was determined. Assessments of grip strength, gait speed, frailty, and comorbidity were also examined. A significant increase in postural sway in both the AP and ML directions occurred as the balance conditions became more difficult due to alteration of sensory feedback (p < 0.001) or reducing the base of support (p < 0.001). There was an association between increased sway and increased frailty, more comorbidities and slower gait speed. All strength measurements were highly reliable (ICC = 0.93-0.99). An increase in lower extremity strength was associated with increased grip strength and gait speed. The portable instruments provide inexpensive ways for measuring balance and strength in the understudied RCC population, but additional studies are needed to examine their relationship with functional outcomes.
关于老年人平衡和活动能力的研究主要是在社区居住个体的实验室环境中进行的。尽管长期护理机构的居民,特别是居住护理社区(RCCs)的居民跌倒风险更高,但对他们的研究却少得多。我们试图确定使用基于便携式技术的平衡和肌肉力量测量方法(即加速度计和测力传感器)在任何RCC设施中使用的可行性。29名居住在RCCs的受试者(年龄87±6岁)参与了研究。放置在受试者背部的加速度计测量不同站立条件下的身体摇摆。计算前后方向和内外侧方向的摇摆。使用便携式测力传感器测量下肢力量,并确定每次就诊内的可靠性。还检查了握力、步态速度、虚弱和合并症的评估。随着由于感觉反馈改变(p<0.001)或减小支撑面(p<0.001)导致平衡条件变得更加困难,前后方向和内外侧方向的姿势摇摆均显著增加。摇摆增加与虚弱增加、合并症增多和步态速度减慢之间存在关联。所有力量测量结果都具有高度可靠性(ICC=0.93-0.99)。下肢力量增加与握力和步态速度增加相关。便携式仪器为在研究较少的RCC人群中测量平衡和力量提供了廉价的方法,但需要更多研究来检查它们与功能结果的关系。