Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA; Department of Health, Kinesiology, and Recreation, University of Utah, Salt Lake City, UT, USA.
Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA.
Exp Gerontol. 2019 Jul 15;122:60-66. doi: 10.1016/j.exger.2019.04.011. Epub 2019 Apr 26.
Community ambulation requires the ability to adapt walking patterns to task demands. For example, complex walking tasks, such as obstacle crossing (OBS) and backwards walking (BW), require modification of gait kinematics to complete the task, maintain stability and prevent falling. More women than men fall each year, but few studies have investigated gender differences in performance of adaptive walking tasks.
The purpose of this study was to determine gender differences in two common adaptive tasks.
Walking performance was assessed from 54 age and gender matched participants (72 ± 5 yrs.) while they completed forward walking (FW), OBS and BW. Gait outcomes and the distance of the lead foot and the trail foot from the obstacle were normalized by leg length and assessed using multivariate analysis of variance. Additionally, performance in a battery of clinical physical and cognitive measures as well as self-reported activity levels were associated with adaptive gait behavior.
Gait speed and step width were not different between genders in any walking task. Compared to FW and OBS, women only decreased step length in BW, resulting in significantly shorter step lengths than men in OBS (p = 0.02) and BW (p = 0.04), a conservative walking strategy. Women crossed the obstacle in a manner that may limit recovery steps in case of a trip: stepping closer to the obstacle during approach without increasing trail toe-clearance. The Timed Up and Go mobility test, Short Physical Performance Battery, and Trail Making Test of processing speed and executive function were associated with gender differences in adaptive gait patterns.
The findings revealed that older adult women adapt walking in a way that might predispose them to tripping or falling (i.e. shorter steps and closer obstacle approach). Gender differences in adaptive walking are related to functional test performance and processing speed. Clinicians should consider targeting step length during adaptive walking tasks in women that may be at risk of mobility impairments.
社区行走需要能够根据任务需求调整行走模式。例如，复杂的行走任务，如跨越障碍物（OBS）和倒退行走（BW），需要改变步态运动学来完成任务，保持稳定性并防止摔倒。每年女性跌倒的人数多于男性，但很少有研究调查性别差异在适应行走任务中的表现。
本研究旨在确定两种常见适应性任务中的性别差异。
对 54 名年龄和性别匹配的参与者（72±5 岁）进行行走评估，他们完成了正向行走（FW）、OBS 和 BW。步态结果和前导脚和尾随脚与障碍物的距离通过腿长进行归一化，并使用多变量方差分析进行评估。此外，还将在一系列临床物理和认知测量以及自我报告的活动水平方面的表现与适应性步态行为相关联。
在任何行走任务中，男女之间的步速和步宽都没有差异。与 FW 和 OBS 相比，女性仅在 BW 中减小了步长，导致 OBS（p=0.02）和 BW（p=0.04）中步长明显短于男性，这是一种保守的行走策略。女性在接近障碍物时以一种可能限制恢复步骤的方式跨越障碍物：在接近时靠近障碍物而不增加尾随足的离地间隙。计时起立行走测试、简短体能表现电池和追踪测试的处理速度和执行功能与适应性步态模式的性别差异相关。
研究结果表明，老年女性以一种可能使她们容易绊倒或摔倒的方式适应行走（即步幅较短且接近障碍物）。适应行走的性别差异与功能测试表现和处理速度有关。临床医生应考虑在可能存在移动障碍风险的女性中针对适应性行走任务中的步长进行靶向治疗。
