Sung Paul S, Danial Pamela
Department of Physical Therapy, Central Michigan University, Health Professions Building 1220, Mt. Pleasant, MI 48859, United States.
Department of Physical Therapy, Central Michigan University, Health Professions Building 1220, Mt. Pleasant, MI 48859, United States.
Clin Biomech (Bristol). 2017 Dec;50:56-62. doi: 10.1016/j.clinbiomech.2017.09.014. Epub 2017 Sep 28.
The trunk coordination pattern has been extensively studied, and there is a higher pain prevalence and asymmetry in female older adults. However, there is a lack of investigation of different directions of trunk rotation and asymmetrical compensatory strategies of motor control between genders. The purpose of this study was to investigate shoulder and pelvic ranges of motion (ROM) as well as relative phases (RP) for the different directions of trunk rotation between genders in healthy older adults.
There were 62 right hand dominant older adults in this study (31 female subjects (68.4 [5.62]years) and 31 male subjects (68.7 [5.68]years)). The participants performed trunk axial rotation from the left to the right direction (RP1) and then returned to the left side (RP2), three times repeatedly in standing. The measurements included shoulder and pelvic ROM, RP1, and RP2. The RP was defined as the average absolute relative phase, which was the difference between the phase angle of the shoulder and the phase angle of the pelvis during trunk rotation.
The female group demonstrated significantly greater pelvic rotation compared to the male group (98.64 [24.67] vs. 86.96 [18.97]; t=2.09, p=0.04) during trunk rotation. The pelvic ROM demonstrated a significant positive correlation with shoulder ROM in both genders; however, the RP was negatively correlated with the pelvis. For pelvic rotation, the male group demonstrated a negative correlation with RP1 (r=-0.68, p<0.01) and RP2 (r=-0.60, p<0.01) while the female group demonstrated a negative correlation with RP2 (r=-0.53, p<0.01). The ageing factor demonstrated negative correlations with ROM for the shoulder and pelvis in both genders.
Although no gender difference was indicated on the direction of RP, the pelvic ROM was significantly lesser in the male group. The male group demonstrated lesser pelvic rotation in both directions of rotation; however, the female group showed lesser pelvic rotation in RP2. The male group demonstrated stiffened pelvic rotation and greater shoulder rotation in both directions while the female group demonstrated pelvic stiffness only in the direction from right to left rotation. Clinicians need to consider this directional asymmetry of trunk rotation to enhance integrated shoulder-pelvic coordination in female older adults.
A coordinative pattern of different directions of trunk rotation was investigated in healthy older adults. The pelvic range of motion was lesser in the male group compared with the female group. The female group demonstrated pelvic stiffness only in the direction from right to left rotation, while the male group demonstrated pelvic stiffness in both directions. Clinicians need to understand the gender difference of directional coordination as integrated coordination in female older adults.
躯干协调模式已得到广泛研究，老年女性的疼痛患病率更高且存在不对称性。然而，缺乏对不同躯干旋转方向以及性别间运动控制不对称补偿策略的研究。本研究的目的是调查健康老年人中不同躯干旋转方向的肩部和骨盆活动范围（ROM）以及相对相位（RP）。
本研究纳入62名右利手老年人（31名女性受试者（68.4 [5.62]岁）和31名男性受试者（68.7 [5.68]岁））。参与者站立位进行从左至右方向的躯干轴向旋转（RP1），然后回到左侧（RP2），重复三次。测量指标包括肩部和骨盆ROM以及RP1和RP2。RP定义为平均绝对相对相位，即躯干旋转过程中肩部相位角与骨盆相位角的差值。
在躯干旋转过程中，女性组骨盆旋转幅度显著大于男性组（98.64 [24.67] 对86.96 [18.97]；t = 2.09，p = 0.04）。男女两性的骨盆ROM与肩部ROM均呈显著正相关；然而，RP与骨盆呈负相关。对于骨盆旋转，男性组与RP1（r = -0.68，p < 0.01）和RP2（r = -0.60，p < 0.01）呈负相关，而女性组与RP2（r = -0.53，p < 0.01）呈负相关。年龄因素与男女两性的肩部和骨盆ROM均呈负相关。
尽管在RP方向上未显示出性别差异，但男性组的骨盆ROM显著较小。男性组在两个旋转方向上的骨盆旋转幅度均较小；然而，女性组在RP2时骨盆旋转幅度较小。男性组在两个方向上均表现出骨盆旋转僵硬和肩部旋转幅度较大，而女性组仅在从右至左旋转方向上表现出骨盆僵硬。临床医生需要考虑这种躯干旋转的方向不对称性，以增强老年女性的肩部 - 骨盆综合协调性。
在健康老年人中研究了不同方向的躯干旋转协调模式。男性组的骨盆活动范围小于女性组。女性组仅在从右至左旋转方向上表现出骨盆僵硬，而男性组在两个方向上均表现出骨盆僵硬。临床医生需要了解方向协调性的性别差异，作为老年女性综合协调性的一部分。
