School of Physical and Occupational Therapy, McGill University, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Québec, Canada.
School of Physical and Occupational Therapy, McGill University, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Lethbridge-Layton-Mackay Rehabilitation Centre, Montreal, Québec, Canada.
Gait Posture. 2021 Mar;85:251-257. doi: 10.1016/j.gaitpost.2021.02.009. Epub 2021 Feb 16.
Falls among community-dwelling older adults are often triggered by uneven walkways. Joint coordination and its variability change with age and may place older adults at risk of falling. It is unclear how irregular surfaces impact lower-limb joint coordination and if such changes are exacerbated by aging.
To what extent do lower-limb inter-joint coordination and its variability, over flat and uneven brick walkways, differ between older and young healthy adults?
A motion-capture system collected kinematic data from walking trials on flat and uneven walkways in seventeen older (72.0 ± 4.2 years) and eighteen younger (27.0 ± 4.7 years) healthy adults. Continuous relative phase analyses were performed for the Knee-Hip and Ankle-Knee joint pairs. Mean Absolute Relative Phase (MARP) quantified coordination amplitude. Deviation Phase (DP) quantified coordinative variability. Two-way mixed ANOVA's tested for effects of age, surface, and age × surface interactions.
Uneven surfaces prompted more in-phase MARP inter-joint coordination in adults during most gait phases (p ≤ 0.024). Age × surface interactions were observed during initial contact (Ankle-Knee: p = 0.021, Knee-Hip: p = 0.001) and loading response (Knee-Hip: p = 0.017), with post-hoc analyses showing coordination accentuated in older adults. Uneven surfaces induced higher DP in Knee-Hip (p = 0.017) and Ankle-Knee joint coupling (p < 0.001) during gait, largely independent of age. An age × surface interaction was observed during mid-swing (p = 0.050), with post-hoc analysis revealing increased variability in older adults.
More in-phase and variable lower-limb gait behavior was observed on uneven walkways. These differences were accentuated in older adults during early stance phase (more tightly coordinated) and mid-swing (more variable). This may reflect a cautious gait strategy on challenging walkways to maintain stability and help prevent falls.
社区居住的老年人经常因步道不平整而摔倒。关节协调及其可变性会随年龄增长而变化，这可能使老年人更容易摔倒。目前尚不清楚不规则表面如何影响下肢关节协调，以及这种变化是否会因衰老而加剧。
在平坦和不平坦的砖步道上，下肢关节间的协调及其可变性在老年人和年轻健康成年人之间有何不同？
运动捕捉系统从 17 名老年人（72.0±4.2 岁）和 18 名年轻人（27.0±4.7 岁）在平坦和不平坦步道上的行走试验中收集运动学数据。连续相对相位分析用于膝关节-髋关节和踝关节-膝关节关节对。平均绝对相对相位（MARP）量化了协调幅度。偏差相位（DP）量化了协调的可变性。双向混合方差分析测试了年龄、表面和年龄×表面相互作用的影响。
在大多数步态阶段，不平坦的表面促使成年人的 MARP 关节间协调更加同相（p≤0.024）。在初始接触（踝关节-膝关节：p=0.021，膝关节-髋关节：p=0.001）和负重反应（膝关节-髋关节：p=0.017）期间观察到年龄×表面相互作用，事后分析显示在老年人中协调更加突出。在步态中，不平坦的表面导致膝关节-髋关节（p=0.017）和踝关节-膝关节关节耦合（p<0.001）的 DP 更高，这在很大程度上与年龄无关。在中间摆动期间观察到年龄×表面相互作用（p=0.050），事后分析显示老年人的可变性增加。
在不平坦的步道上观察到更同步和可变的下肢步态行为。在老年人中，这些差异在早期站立阶段（更紧密的协调）和中间摆动阶段（更可变）更为明显。这可能反映了在挑战性步道上谨慎的步态策略，以保持稳定性并帮助防止摔倒。
