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远端到近端关节力学再分配是导致老年人步行经济性降低的主要原因。

Distal-to-proximal joint mechanics redistribution is a main contributor to reduced walking economy in older adults.

机构信息

Department of Movement Science, Human Movement Biomechanics Research Group, Leuven, Belgium.

出版信息

Scand J Med Sci Sports. 2021 May;31(5):1036-1047. doi: 10.1111/sms.13929. Epub 2021 Mar 15.

Abstract

Age-related neural and musculoskeletal declines affect mobility and the quality of life of older adults. To date, the mechanisms underlying reduced walking economy in older adults still remain elusive. In this study, we wanted to investigate which biomechanical factors were associated with the higher energy cost of walking in older compared with young adults. Fourteen younger (24 ± 2 years) and fourteen older (74 ± 4 years) adults were tested. Plantarflexor strength and Achilles tendon stiffness were evaluated during a dynamometer test. Medial gastrocnemius fascicle length, ground reaction forces, joint kinematics, and oxygen consumption were measured during walking treadmill at 0.83 and 1.39 m.s . Energy cost of walking, lower-limb joint mechanics, muscle-tendon unit, and tendinous tissues length were calculated. The energy cost of walking was higher at 0.83 m.s (+16%; P = .005) and plantarflexor strength lower (-31%; P = .007) in older adults. Achilles tendon stiffness and medial gastrocnemius fascicle length changes did not differ between older and young adults. The reduction in ankle mechanics was compensated by increases in hip mechanics in older adults during walking. The hip extensor moment was the only significant predictor of the energy cost of walking (adjusted R : 0.35-0.38). The higher energy cost in older adults is mainly associated with their distal-to-proximal redistribution of joint mechanics during walking possibly due to plantarflexor weakness. In our study, medial gastrocnemius fascicle and tendinous tissue behavior did not explain the higher energy cost of walking in older compared to young adults.

摘要

年龄相关的神经和肌肉骨骼衰退会影响老年人的活动能力和生活质量。迄今为止,老年人步行经济性降低的机制仍不清楚。在这项研究中,我们想探讨哪些生物力学因素与老年人步行能量消耗较高有关。我们测试了 14 名年轻成年人(24 ± 2 岁)和 14 名老年成年人(74 ± 4 岁)。在测力计测试中评估了跖屈肌力量和跟腱刚度。在跑步机上以 0.83 和 1.39 m.s 的速度行走时测量了内侧腓肠肌筋膜长度、地面反作用力、关节运动学和耗氧量。计算了步行的能量消耗、下肢关节力学、肌肉-肌腱单元和肌腱组织长度。在 0.83 m.s 时,老年人的步行能量消耗更高(增加 16%;P =.005),跖屈肌力量更低(降低 31%;P =.007)。跟腱刚度和内侧腓肠肌筋膜长度的变化在老年和年轻成年人之间没有差异。在老年人行走过程中,踝关节力学的降低通过髋关节力学的增加得到了补偿。髋关节伸肌力矩是步行能量消耗的唯一显著预测因素(调整后的 R:0.35-0.38)。老年人的能量消耗较高主要与他们在行走过程中远端到近端的关节力学重新分布有关,这可能是由于跖屈肌力量减弱所致。在我们的研究中,内侧腓肠肌筋膜和肌腱组织的行为并不能解释老年人与年轻人相比步行能量消耗较高的原因。

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