Sakurai R, Fujiwara Y, Yasunaga M, Suzuki H, Sakuma N, Imanaka K, Montero-Odasso M
Ryota Sakurai, Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan,
J Nutr Health Aging. 2017;21(6):721-726. doi: 10.1007/s12603-016-0811-1.
Understanding of the underlying mechanisms of Fear of Falling (FoF) could help to expand potential treatments. Given the nature of motor performance, the decline in the planning stage of motor execution may be associated with an expression of FoF. The aim of this study was to assess the planning/prediction accuracy in motor execution in people with FoF using gait-related motor imagery (MI).
Cross-sectional case/control study.
Three health centers in Japan.
Two hundred and eighty-three community-dwelling older adults were recruited and stratified by presence of FoF as FoF group (n=178) or non-FoF group (n=107).
Participants were tested for both imagery and execution tasks of a Timed Up and Go (TUG) test. The participants were first asked to imagine the trial (iTUG) and estimate the time it would take, and then perform the actual trial (aTUG). The difference between iTUG and aTUG (Δ TUG) was calculated.
The FoF group was significantly slower in aTUG, but iTUG duration was almost identical between the two groups, resulting in significant overestimation in the FoF group. The adjusted logistic regression analysis showed that increased Δ TUG (i.e., tendency to overestimate) was significantly associated with FoF (OR = 1.05; 95% CI = 1.02-1.10). Low frequency of going outdoors was also associated with FoF (OR 2.95; 95% CI: 1.16-7.44).
Older adults with FoF overestimate their TUG performance, reflecting impairment in motor planning. Overestimation of physical capabilities can be an additional explanation of the high risk of falls in this population.
了解跌倒恐惧（FoF）的潜在机制有助于拓展潜在治疗方法。鉴于运动表现的本质，运动执行计划阶段的下降可能与FoF的表现有关。本研究旨在使用与步态相关的运动想象（MI）评估有跌倒恐惧的人群在运动执行中的计划/预测准确性。
横断面病例对照研究。
日本的三个健康中心。
招募了283名社区居住的老年人，并根据是否存在跌倒恐惧分为跌倒恐惧组（n = 178）或无跌倒恐惧组（n = 107）。
参与者接受定时起立行走测试（TUG）的想象和执行任务测试。首先要求参与者想象试验（iTUG）并估计所需时间，然后进行实际试验（aTUG）。计算iTUG和aTUG之间的差异（ΔTUG）。
跌倒恐惧组的aTUG明显较慢，但两组的iTUG持续时间几乎相同，导致跌倒恐惧组有明显的高估。调整后的逻辑回归分析表明，ΔTUG增加（即高估倾向）与跌倒恐惧显著相关（OR = 1.05；95%CI = 1.02 - 1.10）。户外活动频率低也与跌倒恐惧有关（OR 2.95；95%CI：1.16 - 7.44）。
有跌倒恐惧的老年人高估了他们的TUG表现，反映出运动计划受损。对身体能力的高估可能是该人群跌倒风险高的另一种解释。
