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老年跌倒者在面对不同步行速度的挑战时,手臂和躯干运动的灵活性会降低。

Old adult fallers display reduced flexibility of arm and trunk movements when challenged with different walking speeds.

作者信息

Shishov Nataliya, Gimmon Yoav, Rashed Hisham, Kurz Ilan, Riemer Raziel, Shapiro Amir, Debi Ronen, Melzer Itshak

机构信息

Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

出版信息

Gait Posture. 2017 Feb;52:280-286. doi: 10.1016/j.gaitpost.2016.12.004. Epub 2016 Dec 5.

DOI:10.1016/j.gaitpost.2016.12.004
PMID:28013150
Abstract

Specific patterns of pelvic and thorax motions are required to maintain stability during walking. This cross-sectional study explored older-adults' gait kinematics and their kinematic adaptations to different walking speeds, with the purpose of identifying mechanisms that might be related to increased risk for falls. Fifty-eight older adults from self-care residential facilities walked on a treadmill, whose velocity was systematically increased with increments of 0.1meters/second (m/s) from 0.5 to 0.9m/s, and then similarly decreased. Thorax, pelvis, trunk, arms, and legs angular total range of motion (tROM), stride time, stride length, and step width were measured. Twenty-one of the subjects reported falling, and 37 didn't fall. No significant effect of a fall history was found for any of the dependent variables. A marginally significant interaction effect of fall history and walking speed was found for arms' tROM (p=0.098). Speed had an effect on many of the measures for both groups. As the treadmill's velocity increased, the non-fallers increased their arm (15.9±8.6° to 26.6±12.7°) and trunk rotations (4.7±1.9° to 7.2±2.8°) tROM, whereas for the fallers the change of arm (14.7±14.8° to 20.8±13°) and trunk (5.5±2.9° to 7.3±2.3°) rotations tROM were moderate between the different walking speeds. We conclude that walking speed manipulation exposed different flexibility trends. Only non-fallers demonstrated the ability to adapt trunk and arm ROM to treadmill speed i.e., had a more flexible pattern of behavior for arm and trunk motions, supporting the upper-body's importance for stability while walking.

摘要

行走过程中需要特定的骨盆和胸部运动模式来维持稳定性。这项横断面研究探讨了老年人的步态运动学及其对不同步行速度的运动学适应情况,目的是确定可能与跌倒风险增加相关的机制。来自自理型居住设施的58名老年人在跑步机上行走,跑步机速度从0.5米/秒系统地增加到0.9米/秒,每次增加0.1米/秒,然后以类似方式降低。测量了胸部、骨盆、躯干、手臂和腿部的角总运动范围(tROM)、步幅时间、步幅长度和步宽。21名受试者报告有跌倒经历,37名没有跌倒。在任何因变量上均未发现跌倒史有显著影响。在手臂tROM方面发现跌倒史和步行速度之间存在边缘显著的交互作用(p = 0.098)。速度对两组的许多测量指标都有影响。随着跑步机速度增加,未跌倒者增加了手臂(从15.9±8.6°增加到26.6±12.7°)和躯干旋转(从4.7±1.9°增加到7.2±2.8°)的tROM,而对于跌倒者,不同步行速度之间手臂(从14.7±14.8°增加到20.8±13°)和躯干(从5.5±2.9°增加到7.3±2.3°)旋转tROM的变化较为适中。我们得出结论,步行速度的改变揭示了不同的灵活性趋势。只有未跌倒者表现出能够使躯干和手臂ROM适应跑步机速度的能力,即在手臂和躯干运动方面具有更灵活的行为模式,这支持了上半身在行走时对稳定性的重要性。

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