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肌肉力量作为社区居住老年人两年后步态变异性的预测指标。

Muscle Strength as a Predictor of Gait Variability after Two Years in Community-Living Older Adults.

作者信息

Bogen B, Moe-Nilssen R, Aaslund M K, Ranhoff A H

机构信息

Bård Bogen, Institute of Health and Function, Western Norway University of Applied Science., Norway, Email:

出版信息

J Frailty Aging. 2020;9(1):23-29. doi: 10.14283/jfa.2019.24.

Abstract

BACKGROUND

Stride-to-stride fluctuations, or gait variability, can be captured easily using body worn inertial sensors. Previously, sensor-measured gait variability has been found to be associated with fall risk and central nervous changes. However, further research is needed to clarify the clinical relevance of this method.

OBJECTIVES

In this study, we look at how gait variability is associated with muscle strength, measured two years earlier.

DESIGN, SETTING AND PARTICIPANTS: This is study of longitudinal associations. Participants were community-dwelling volunteers between 70-81 years.

MEASUREMENTS

Participants were tested while walking with a single sensor at their lower back, and they walked back and forth over a distance of 6.5 meters under four conditions: at preferred speed, at fast speed, with an added cognitive task, and while walking across an uneven surface. Gait variability in the anteroposterior (AP), mediolateral (ML) and vertical (V) directions was identified. A muscle strength score was composed by transforming hand grip strength, isometric knee extension strength and the 30 second chair rise-test to z-scores and adding them.

RESULTS

56 individuals were analysed (mean age at baseline 75.8 (SD 3.43), 60 percent women). In a backwards regression method using age, gender and baseline walking speed as covariates, muscle strength predicted gait variability after two years for AP variability during preferred speed (Beta= .314, p=.025) and uneven surface walking (Beta=.326, p=.018). Further, muscle strength was associated with ML variability during preferred speed (Beta=.364, p=.048) and fast speed (Beta=.419, p=.042), and V variability during preferred speed (Beta=.402, p=.002), fast speed (Beta=.394, p=.004) and uneven surface walking (Beta=.369, p=.004).

CONCLUSIONS

Sensor-measured gait variability tended to be associated with muscle strength measured two years earlier. This finding could emphasize the relevance of this relatively novel measure of gait in older adults for both research and clinical practice.

摘要

背景

步幅间波动,即步态变异性,可通过佩戴在身体上的惯性传感器轻松获取。此前,已发现传感器测量的步态变异性与跌倒风险和中枢神经变化有关。然而,需要进一步研究来阐明该方法的临床相关性。

目的

在本研究中,我们观察步态变异性与两年前测量的肌肉力量之间的关联。

设计、背景和参与者:这是一项纵向关联研究。参与者为年龄在70至81岁之间的社区居住志愿者。

测量

参与者在下背部佩戴单个传感器行走时接受测试,他们在四种条件下在6.5米的距离上来回行走:以首选速度、快速、添加认知任务以及在不平坦表面行走。确定前后(AP)、内外侧(ML)和垂直(V)方向的步态变异性。通过将握力、等长膝关节伸展力量和30秒椅子起立测试转换为z分数并相加来组成肌肉力量得分。

结果

对56名个体进行了分析(基线时的平均年龄为75.8岁(标准差3.43),60%为女性)。在使用年龄、性别和基线步行速度作为协变量的向后回归方法中,肌肉力量预测了两年后的步态变异性,包括首选速度时的AP变异性(β = 0.314,p = 0.025)和不平坦表面行走时的AP变异性(β = 0.326,p = 0.018)。此外,肌肉力量与首选速度时的ML变异性(β = 0.364,p = 0.048)和快速时的ML变异性(β = 0.419,p = 0.042)以及首选速度时的V变异性(β = 0.402,p = 0.002)、快速时的V变异性(β = 0.394,p = 0.004)和平坦表面行走时的V变异性(β = 0.369,p = 0.004)相关。

结论

传感器测量的步态变异性往往与两年前测量的肌肉力量有关。这一发现可能强调了这种相对新颖步态测量方法在老年人研究和临床实践中的相关性。

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