From the Department of Physical Therapy, Niigata University of Health and Welfare (MM); Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare (MM); Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University (TI, RI, TK, MT, SS, TH, TT, NI); Department of Rehabilitation, Yachiyo Hospital, Aichi, Anjo (MK); Department of Rehabilitation, Sapporo Tokusyukai Hospital, Hokkaido (KA); ASICS Corporation, Institution of Sport Science, Hyogo, Kobe (K. Kusano); and Kita Orthopedic Clinic, Hyogo, Akashi (K. Kita), Japan.
Am J Phys Med Rehabil. 2018 Oct;97(10):715-720. doi: 10.1097/PHM.0000000000000954.
This study aimed to examine the association of independence in activities of daily living with the loads during step ascent motion and other motor functions in 32 nursing home-residing elderly individuals.
Independence in activities of daily living was assessed by using the Functional Independence Measure. The loads at the upper (i.e., pulling up) and lower (i.e., pushing up) levels during the step ascent task was measured on a step ascent platform. Hip extensor, knee extensor, plantar flexor muscle, and quadriceps setting strengths; lower extremity agility using the stepping test; and hip and knee joint pain severities were measured. One-legged stance and functional reach distance for balance and maximal walking speed, timed up-and-go time, five-chair-stand time, and step ascent time were also measured to assess mobility.
Stepwise regression analysis revealed that the load at pushing up during step ascent motion and timed up-and-go time were significant and independent determinants of Functional Independence Measure score. Functional Independence Measure score decreased with decreased load at pushing up and increased timed up-and-go time.
The study results suggest that depending on task specificity, both one step up task's push-up peak load during step ascent motion and timed up-and-go can partially explain activities of daily living's Functional Independence Measure score in nursing home-residing elderly individuals. Lower extremity muscle strength, agility, pain, or balance measures did not add to the prediction.
本研究旨在探讨 32 名居住在养老院的老年人日常生活活动独立性与台阶上升运动中的上下台阶负载及其他运动功能之间的关系。
日常生活活动独立性采用功能独立性测量法进行评估。在台阶上升平台上测量台阶上升任务中上（即拉起）和下（即推起）水平的负载。测量髋关节伸肌、膝关节伸肌、跖屈肌和股四头肌设定强度；使用踏步测试测量下肢敏捷性；测量髋关节和膝关节疼痛严重程度。还测量单腿站立和功能性伸展距离以评估平衡，最大步行速度、计时起立行走时间、五椅站立时间和台阶上升时间用于评估移动能力。
逐步回归分析显示，台阶上升运动中推起时的负载和计时起立行走时间是功能独立性测量评分的显著和独立决定因素。功能独立性测量评分随推起时负载的降低和计时起立行走时间的增加而降低。
研究结果表明，根据任务的特异性，台阶上升运动中的推起峰值负载和计时起立行走可以部分解释养老院老年人日常生活活动的功能独立性测量评分。下肢肌肉力量、敏捷性、疼痛或平衡测量并不能增加预测能力。
