School of Medical Imaging, Xuzhou Medical University, Xuzhou, China; Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, USA.
School of Medical Imaging, Xuzhou Medical University, Xuzhou, China.
J Biomech. 2021 Jan 22;115:110116. doi: 10.1016/j.jbiomech.2020.110116. Epub 2020 Nov 10.
Although a significant proportion of patient falls occur during egress from the hospital bed, the biomechanical adaptations during egress from different bed heights are still largely unknown. The purpose of this study was to evaluate the effect of hospital bed height on natural transition during egress in patients with Parkinson disease (PD). Twelve patients with PD and fourteen healthy elderly adults (HEA) were recruited and the natural transition during egress from three different bed heights (low, medium and high) were recorded for each participant using a motion capture system and force plates. The bed egress time, joint kinematics, ground reaction force and center of mass (CoM) were compared using a two-factor repeated ANOVA to determine the effects of three bed heights and two groups. The results showed that patients with PD had a significantly increased bed egress time, decreased peak of pelvis anterior tilt, hip flexion, and anteroposterior distance between pelvis center and CoM compared to HEA. Additionally, both PD and HEA groups increased the peak of trunk, hip and knee flexions to generate forward CoM momentum and joint torque to rise from a low bed height. These findings indicated that patients with PD invoked a more conservative movement pattern than HEA during egress to improve postural stability. The low bed height increased demands of balance and postural control during egress which exacerbates the risk of falls for patients with PD.
尽管相当一部分患者的跌倒发生在离开病床时，但不同床高离开时的生物力学适应仍知之甚少。本研究旨在评估病床高度对帕金森病（PD）患者离开时自然过渡的影响。招募了 12 名 PD 患者和 14 名健康老年人（HEA），并使用运动捕捉系统和力板记录每位参与者从三种不同床高（低、中、高）离开时的自然过渡。使用双因素重复方差分析比较床离床时间、关节运动学、地面反力和质心（CoM），以确定三种床高和两组的影响。结果表明，与 HEA 相比，PD 患者的床离床时间显著增加，骨盆前倾、髋关节屈曲和骨盆中心与 CoM 之间的前后距离的峰值降低。此外，PD 和 HEA 组都增加了躯干、髋关节和膝关节的屈曲峰值，以产生向前的 CoM 动量和关节扭矩，从而从低床高上升。这些发现表明，与 HEA 相比，PD 患者在离开时采用了更保守的运动模式，以提高姿势稳定性。低床高增加了离开时的平衡和姿势控制要求，这增加了 PD 患者跌倒的风险。
