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肥胖和跌倒风险对社区居住老年人步态和姿势的影响。

Effects of Obesity and Fall Risk on Gait and Posture of Community-Dwelling Older Adults.

作者信息

Lockhart Thurmon E, Frames Christopher W, Soangra Rahul, Lieberman Abraham

机构信息

School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ,85281, USA.

Barrow Neurological Institute, Phoenix, AZ, USA.

出版信息

Int J Progn Health Manag. 2019;10(1).

Abstract

Epidemiological studies link increased fall risk to obesity in older adults, but the mechanism through which obesity increases falls and fall risks is unknown. This study investigates if obesity (Body Mass Index: BMI>30 kg/m) influenced gait and standing postural characteristics of community dwelling older adults leading to increased risk of falls. One hundred healthy older adults (age 74.0±7.6 years, range of 56-90 years) living independently in a community participated in this study. Participants' history of falls over the previous two years was recorded, with emphasis on frequency and characteristics of falls. Participants with at least two falls in the prior year were classified as fallers. Each individual was assessed for postural stability during quiet stance and gait stability during 10 meters walking. Fall risk parameters of postural sway (COP area, velocity, path-length) were measured utilizing a standard forceplate coupled with an accelerometer affixed at the sternum. Additionally, parameters of gait stability (walking velocity, double support time, and double support time variability) were assessed utilizing an accelerometer affixed at the participant's sternum. Gait and postural stability analyses indicate that obese older adults who fell have significantly altered gait pattern (longer double support time and greater variability) exhibiting a loss of automaticity in walking and, postural instability as compared to their counterparts (i.e., higher sway area and path length, and higher sway velocity) further increasing the risk of a fall given a perturbation. Body weight/BMI is a risk factor for falls in older adults as measured by gait and postural stability parameters.

摘要

流行病学研究表明,老年人跌倒风险增加与肥胖有关,但肥胖增加跌倒及跌倒风险的机制尚不清楚。本研究调查肥胖(体重指数:BMI>30 kg/m²)是否会影响社区居住的老年人的步态和站立姿势特征,从而导致跌倒风险增加。100名独立生活在社区中的健康老年人(年龄74.0±7.6岁,范围56 - 90岁)参与了本研究。记录了参与者过去两年的跌倒史,重点是跌倒的频率和特征。前一年至少跌倒两次的参与者被归类为跌倒者。对每个人在安静站立时的姿势稳定性和10米步行时的步态稳定性进行评估。利用与固定在胸骨处的加速度计相连的标准测力板测量姿势摆动的跌倒风险参数(COP面积、速度、路径长度)。此外,利用固定在参与者胸骨处的加速度计评估步态稳定性参数(步行速度、双支撑时间和双支撑时间变异性)。步态和姿势稳定性分析表明,跌倒的肥胖老年人的步态模式有显著改变(双支撑时间更长且变异性更大),表现出步行自动性丧失,并且与同龄人相比姿势不稳定(即摆动面积和路径长度更大,摆动速度更高),在受到干扰时进一步增加了跌倒风险。通过步态和姿势稳定性参数测量,体重/体重指数是老年人跌倒的一个风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d87c/7111245/730038c4bfaa/nihms-1048431-f0005.jpg

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