Moniz-Pereira Vera, Kepple Thomas M, Cabral Silvia, João Filipa, Veloso António P
Universidade de Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
C-Motion, Inc., Germantown, MD, USA.
J Biomech. 2018 Oct 5;79:105-111. doi: 10.1016/j.jbiomech.2018.07.040. Epub 2018 Aug 4.
Falls are a serious problem faced by the elderly. Older adults report mostly to fall while performing locomotor activities, especially the ones requiring stair negotiation. During these tasks, older adults, when compared with young adults, seem to redistribute their lower limb joint moments. This may indicate that older adults use a different strategy to accelerate the body upward during these tasks. The purposes of this study were to quantify the contributions of each lower limb joint moment to vertically accelerate the center of mass during stair ascent and descent, in a sample of community-dwelling older adults, and to verify if those contributions were correlated with age and functional fitness level. A joint moment induced acceleration analysis was performed in 29 older adults while ascending and descending stairs at their preferred speed. Agreeing with previous studies, during both tasks, the ankle plantarflexor and the knee extensor joint moments were the main contributors to support the body. Although having a smaller contribution to vertically accelerate the body, during stair descent, the hip joint moment contribution was related with the balance score. Further, older adults, when compared with the results reported previously for young adults, seem to use more their knee extensor moment than the ankle plantarflexor moment to support the body when the COM downward velocity is increasing. By contributing for a better understanding of stair negotiation in community dwelling older adults, this study may help to support the design of interventions aiming at fall prevention and/or mobility enhancement within this population.
跌倒问题是老年人面临的一个严重问题。老年人报告称，他们大多在进行移动活动时跌倒，尤其是那些需要上下楼梯的活动。在这些任务中，与年轻人相比，老年人似乎会重新分配他们下肢关节的力矩。这可能表明，老年人在这些任务中使用了不同的策略来向上加速身体。本研究的目的是在一组社区居住的老年人样本中，量化在上下楼梯过程中每个下肢关节力矩对垂直加速质心的贡献，并验证这些贡献是否与年龄和功能健康水平相关。对29名老年人以他们偏好的速度上下楼梯时进行了关节力矩诱导加速度分析。与先前的研究一致，在这两项任务中，踝关节跖屈肌和膝关节伸肌的关节力矩是支撑身体的主要因素。虽然在垂直加速身体方面贡献较小，但在楼梯下行过程中，髋关节力矩的贡献与平衡得分相关。此外，与先前报道的年轻人的结果相比，当质心向下速度增加时，老年人似乎更多地使用膝关节伸肌力矩而不是踝关节跖屈肌力矩来支撑身体。通过有助于更好地理解社区居住老年人的上下楼梯情况，本研究可能有助于支持针对该人群预防跌倒和/或增强活动能力的干预措施的设计。
