Hicks Gregory E, Sions J Megan, Coyle Peter C, Pohlig Ryan T
Department of Physical Therapy, University of Delaware, Newark, DE, United States.
Department of Physical Therapy, University of Delaware, Newark, DE, United States.
Gait Posture. 2017 Jun;55:172-176. doi: 10.1016/j.gaitpost.2017.04.027. Epub 2017 Apr 23.
Previous studies in older adults have identified that chronic low back pain (CLBP) is associated with slower gait speed. Given that slower gait speed is a predictor of greater morbidity and mortality among older adults, it is important to understand the underlying spatiotemporal characteristics of gait among older adults with CLBP. The purposes of this study were to determine (1) if there are differences in spatiotemporal parameters of gait between older adults with and without CLBP during self-selected and fast walking and (2) whether any of these gait characteristics are correlated with performance of a challenging walking task, e.g. stair negotiation. Spatiotemporal characteristics of gait were evaluated using a computerized walkway in 54 community-dwelling older adults with CLBP and 54 age- and sex-matched healthy controls. Older adults with CLBP walked slower than their pain-free peers during self-selected and fast walking. After controlling for body mass index and gait speed, step width was significantly greater in the CLBP group during the fast walking condition. Within the CLBP group, step width and double limb support time are significantly correlated with stair ascent/descent times. From a clinical perspective, these gait characteristics, which may be indicative of balance performance, may need to be addressed to improve overall gait speed, as well as stair-climbing performance. Future longitudinal studies confirming our findings are needed, as well as investigations focused on developing interventions to improve gait speed and decrease subsequent risk of mobility decline.
以往针对老年人的研究已经证实，慢性下腰痛（CLBP）与步态速度减慢有关。鉴于步态速度减慢是老年人发病率和死亡率升高的一个预测指标，了解患有CLBP的老年人步态的潜在时空特征非常重要。本研究的目的是确定：（1）在自选步行和快速步行过程中，患有和未患有CLBP的老年人在步态时空参数上是否存在差异；（2）这些步态特征是否与具有挑战性的步行任务（如上下楼梯）的表现相关。使用计算机化步道对54名居住在社区的患有CLBP的老年人和54名年龄及性别匹配的健康对照者的步态时空特征进行了评估。患有CLBP的老年人在自选步行和快速步行时比没有疼痛的同龄人走得慢。在控制体重指数和步态速度后，CLBP组在快速步行状态下的步幅明显更宽。在CLBP组中，步幅和双腿支撑时间与上下楼梯时间显著相关。从临床角度来看，这些可能表明平衡能力的步态特征可能需要得到改善，以提高整体步态速度以及上下楼梯的表现。需要未来的纵向研究来证实我们的发现，以及专注于开发干预措施以提高步态速度并降低随后行动能力下降风险的研究。
