Osoba Muyinat Y, Rao Ashwini K, Agrawal Sunil K, Lalwani Anil K
Columbia University Vagelos College of Physicians and Surgeons New York New York.
Department of Rehabilitation and Regenerative Medicine Columbia University Vagelos College of Physicians and Surgeons New York New York.
Laryngoscope Investig Otolaryngol. 2019 Feb 4;4(1):143-153. doi: 10.1002/lio2.252. eCollection 2019 Feb.
The prevalence of balance and gait deficits increases with age and is associated with the increased incidence of falls seen in the elderly population; these falls are associated with significant morbidity and mortality.
To review changes in gait and balance associated with aging and the effect of visual perturbations on gait and balance in the elderly to provide a basis for future research.
PubMed and Cochrane Library were searched for articles from 1980 to present pertaining to gait and balance in older adults (>60) and younger adults (<60). Search terms included balance, posture, gait, locomotion, gait variability, gait disorders, gait disturbance, elderly, aging, falls, vision, visual, vestibular, and virtual reality. The references section of queried articles was also used to find relevant studies. Studies were excluded if subjects had a diagnosed gait or balance disorder.
Elderly adults show age-related decline in sensory systems and reduced ability to adapt to changes in their environment to maintain balance. Elderly adults are particularly dependent on vision to maintain postural stability. Distinct changes in spatiotemporal gait parameters are associated with aging, such as slower gait and increased gait variability, which are amplified with exposure to visual perturbations. Increased gait variability, specifically with mediolateral perturbations, poses a particular challenge for elderly adults and is linked to increased falls risk. Virtual reality training has shown promising effects on balance and gait.
Elderly adults show age-related decline in balance and gait with increased gait variability and an associated increased risk of falls.
平衡和步态缺陷的患病率随年龄增长而增加，并且与老年人群中跌倒发生率的增加相关；这些跌倒与显著的发病率和死亡率相关。
综述与衰老相关的步态和平衡变化以及视觉干扰对老年人步态和平衡的影响，为未来研究提供依据。
在PubMed和Cochrane图书馆中检索1980年至今有关老年人（>60岁）和年轻人（<60岁）步态和平衡的文章。检索词包括平衡、姿势、步态、运动、步态变异性、步态障碍、步态紊乱、老年人、衰老、跌倒、视觉、视力、前庭和虚拟现实。还利用查询文章的参考文献部分查找相关研究。如果受试者被诊断患有步态或平衡障碍，则排除该研究。
老年人的感觉系统呈现与年龄相关的衰退，并且适应环境变化以维持平衡的能力下降。老年人尤其依赖视觉来维持姿势稳定性。时空步态参数的明显变化与衰老相关，例如步态变慢和步态变异性增加，在受到视觉干扰时这些变化会加剧。步态变异性增加，特别是在受到内外侧干扰时，对老年人构成了特殊挑战，并且与跌倒风险增加相关。虚拟现实训练已显示出对平衡和步态有良好效果。
老年人的平衡和步态呈现与年龄相关的衰退，步态变异性增加，且跌倒风险相应增加。
5级。
