养老院居民的步态速度特征及其时空决定因素：一项横断面研究。

Gait Speed Characteristics and Their Spatiotemporal Determinants in Nursing Home Residents: A Cross-Sectional Study.

机构信息

Faculty of Health Science and Medicine, Bond University, Robina, Australia.

Southern Cross Care, North Plympton, Australia.

出版信息

J Geriatr Phys Ther. 2019 Jul/Sep;42(3):E148-E154. doi: 10.1519/JPT.0000000000000160.

DOI:10.1519/JPT.0000000000000160

PMID:29200084

Abstract

BACKGROUND AND PURPOSE

Low and slowing gait speeds among nursing home residents are linked to a higher risk of disability, cognitive impairment, falls, and mortality. A better understanding of the spatiotemporal parameters of gait that influence declining mobility could lead to effective rehabilitation and preventative intervention. The aims of this study were to objectively quantify the spatiotemporal characteristics of gait in the nursing home setting and define the relationship between these parameters and gait speed.

METHODS

One hundred nursing home residents were enrolled into the study and completed 3 habitual gait speed trials over a distance of 3.66 m. Trials were performed using an instrumented gait analysis. The manner in which the spatiotemporal parameters predicted gait speed was examined by univariate and multivariable regression modeling.

RESULTS

The nursing home residents had a habitual mean (SD) gait speed of 0.63 (0.19) m/s, a stride length of 0.83 (0.15) m, a support base of 0.15 (0.06) m, and step time of 0.66 (0.12) seconds. Multivariable linear regression revealed stride length, support base, and step time predicted gait speed (R = 0.89, P < .05). Step time had the greatest influence on gait speed, with each 0.1-second decrease in step time resulting in a 0.09 m/s (95% confidence interval, 0.08-0.10) increase in habitual gait speed.

CONCLUSIONS

This study revealed step time, stride length, and support base are the strongest predictors of gait speed among nursing home residents. Future research should concentrate on developing and evaluating intervention programs that were specifically designed to focus on the strong predictors of gait speed in nursing home residents. We would also suggest that routine assessments of gait speed, and if possible their spatiotemporal characteristics, be done on all nursing home residents in an attempt to identify residents with low or slowing gait speed.

摘要

背景与目的

养老院居民的步速较低且逐渐变慢与残疾、认知障碍、跌倒和死亡风险增加有关。更好地了解影响行动能力下降的步态时空参数，可能会导致有效的康复和预防干预。本研究的目的是客观地量化养老院环境中的步态时空特征，并定义这些参数与步速之间的关系。

方法

100 名养老院居民参加了这项研究，在 3.66 米的距离内完成了 3 次习惯性步行速度试验。试验是使用仪器步态分析进行的。通过单变量和多变量回归模型检查时空参数如何预测步速。

结果

养老院居民的习惯性平均（SD）步速为 0.63（0.19）m/s，步长为 0.83（0.15）m，支撑基础为 0.15（0.06）m，步时为 0.66（0.12）秒。多变量线性回归显示，步长、支撑基础和步时预测步速（R=0.89，P<0.05）。步时对步速的影响最大，步时每减少 0.1 秒，习惯性步速就会增加 0.09 m/s（95%置信区间，0.08-0.10）。