Physical Therapy Department, Transitions Healthcare, Washington, PA, 15301.
Department of Physical Therapy, New York University, NY, USA.
Gait Posture. 2020 Jan;75:14-21. doi: 10.1016/j.gaitpost.2019.09.025. Epub 2019 Sep 28.
Approximately one-third of falls are caused by the swing foot contacting an object or the ground, resulting in a trip. The increased incidence of trip-related falls among older adults may be explained by greater within-person minimum toe clearance (MTC) variability.
Will kinematic variability at any of the 6 major joints in the lower limbs, individually or in combination, be associated with MTC variability?
This cross-sectional study investigated whether single or multiple joint movements best explained MTC variability in older adults. Twenty healthy older adults (7 males, 13 females; mean age = 71.3 ± 7.2 years) were recruited. Participants were fitted with a modified Cleveland Clinic marker set and walked for 50 trials at self-selected speeds over a 7-meter walkway (with a rest at 25 trials) while 6 infrared cameras recorded kinematics.
Seven joint movements were evaluated, and swing hip flexion-extension variability was the only joint movement significantly associated with MTC variability (r = 0.577, p = 0.008) and explained 29.6% (adjusted R) of the variance of MTC variability in older adults (F (1, 18) = 8.897, p = 0.008).
Identifying the joint movement/s associated with inconsistencies in toe clearance will improve our understanding of endpoint control in older adults and may lead to the development of effective trip prevention strategies.
大约三分之一的跌倒事件是由于摆动脚接触到物体或地面而导致绊倒。老年人绊倒相关跌倒的发生率增加可能是由于个人内最小脚趾间隙（MTC）的变异性增加所致。
下肢 6 个主要关节中的任意一个或多个关节的运动学变异性是否与 MTC 变异性相关？
本横断面研究调查了单个或多个关节运动是否能最好地解释老年人的 MTC 变异性。共招募了 20 名健康的老年人（7 名男性，13 名女性；平均年龄 71.3±7.2 岁）。参与者佩戴了改良的克利夫兰诊所标记套件，并在 7 米长的人行道上以自选速度行走 50 次（在 25 次行走时休息），同时 6 个红外摄像机记录运动学。
评估了 7 个关节运动，摆动髋关节屈伸变异性是唯一与 MTC 变异性显著相关的关节运动（r=0.577，p=0.008），并解释了老年人 MTC 变异性的 29.6%（调整后的 R）（F（1,18）=8.897，p=0.008）。
确定与脚趾间隙不一致相关的关节运动/将有助于我们更好地了解老年人的终点控制，并可能导致有效的防绊倒策略的发展。
