Qiao Mu, Feld Jody A, Franz Jason R
Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, United States.
Human Movement Science Curriculum, University of North Carolina at Chapel Hill, United States.
Gait Posture. 2018 May;62:27-33. doi: 10.1016/j.gaitpost.2018.02.020. Epub 2018 Feb 21.
Older adults are more susceptible to balance perturbations during walking than young adults. However, we lack an individual joint-level understanding of how aging affects the neuromechanical strategies used to accommodate balance perturbations.
We investigated gait phase-dependence in and aging effects on leg joint kinematic variability during walking with balance perturbations. We hypothesized that leg joint variability would: 1) vary across the gait cycle and 2) increase with balance perturbations. We also hypothesized that perturbation effects on leg joint kinematic variability would be larger and more pervasive in older versus young adults.
We collected leg joint kinematics in young and older adults walking with and without mediolateral optical flow perturbations of different amplitudes.
We first found that leg joint variability during walking is gait phase-dependent, with step-to-step adjustments occurring predominantly during push-off and early swing. Second, young adults accommodated perturbations almost exclusively by increasing coronal plane hip joint variability, likely to adjust step width. Third, perturbations elicited larger and more pervasive increases in all joint kinematic outcome measures in older adults. Finally, we also provide insight into which joints contribute more to foot placement variability in walking, adding that variability in sagittal plane knee and coronal plane hip joint angles contributed most to that in step length and step width, respectively.
Taken together, our findings may be highly relevant to identifying specific joint-level therapeutic targets to mitigate balance impairment in our aging population.
与年轻人相比,老年人在行走过程中更容易受到平衡干扰的影响。然而,我们缺乏对衰老如何影响用于适应平衡干扰的神经力学策略的个体关节水平的理解。
我们研究了在有平衡干扰的行走过程中腿部关节运动学变异性的步态阶段依赖性和衰老效应。我们假设腿部关节变异性会:1)在步态周期中变化,以及2)随着平衡干扰而增加。我们还假设,与年轻人相比,干扰对老年人腿部关节运动学变异性的影响会更大且更普遍。
我们收集了年轻人和老年人在有和没有不同幅度的内外侧光流干扰情况下行走时的腿部关节运动学数据。
我们首先发现,行走过程中腿部关节变异性是步态阶段依赖性的,逐步步态调整主要发生在蹬离期和摆动初期。其次,年轻人几乎完全通过增加冠状面髋关节变异性来适应干扰,这可能是为了调整步幅宽度。第三,干扰在老年人所有关节运动学结果测量指标中引起了更大且更普遍的增加。最后,我们还深入了解了哪些关节对行走时足部放置变异性的贡献更大,并补充说矢状面膝关节和冠状面髋关节角度的变异性分别对步长和步幅宽度的变异性贡献最大。
综上所述,我们的研究结果可能与确定特定的关节水平治疗靶点以减轻老年人群的平衡障碍高度相关。