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行走过程中运动协同与稳定质心和未来跌倒风险的关系:一项为期 1 年的纵向研究。

The relation between kinematic synergy to stabilize the center of mass during walking and future fall risks: a 1-year longitudinal study.

机构信息

Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe, Hyogo, 657-0011, Japan.

Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo, Kyoto, 606-8507, Japan.

出版信息

BMC Geriatr. 2021 Apr 13;21(1):240. doi: 10.1186/s12877-021-02192-z.

Abstract

BACKGROUND

Incorrect body weight shifting is a frequent cause of falls, and the control of the whole-body center of mass (CoM) by segmental coordination is essential during walking. Uncontrolled manifold (UCM) analysis is a method of examining the relation between variance in segmental coordination and CoM stability. However, no prospective cohort study has thoroughly investigated how variance in segmental configurations to stabilize the CoM relates to future falls. This study explored whether variance to stabilize the CoM was related to future falls.

METHODS

At the baseline visit, 30 community-dwelling older adults walked 20 times on a 6-m walkway. Using kinematic data collected during walking by a three-dimensional motion capture system, UCM analysis was performed to investigate how segmental configuration contributes to CoM stability in the frontal plane. One year after the baseline visit, we evaluated whether the subjects experienced falls. Twelve subjects had experienced falls, and 16 had not. Comparisons of variance between older adults with and without falls were conducted by covariate analysis.

RESULTS

No significant differences in variance were found in the mediolateral direction, whereas in the vertical direction, older adults with fall experiences had a greater variance, reflecting an unstable CoM, than those with no fall experiences.

CONCLUSIONS

We verified that the high variance in segmental configurations that destabilize the CoM in the vertical direction was related to future falls. The variables of UCM analysis can be useful for evaluating fall risk.

摘要

背景

不正确的体重转移是导致跌倒的常见原因,而在行走过程中通过节段协调来控制整个身体的质心(CoM)是至关重要的。非受控制的流形(UCM)分析是一种检查节段协调的变化与 CoM 稳定性之间关系的方法。然而,没有前瞻性队列研究彻底调查了节段配置的变化如何与未来的跌倒有关。本研究探讨了 CoM 的稳定性变化是否与未来的跌倒有关。

方法

在基线访视时,30 名居住在社区的老年人在 6 米的步行道上行走 20 次。使用三维运动捕捉系统在行走过程中收集的运动学数据,进行 UCM 分析,以研究节段配置如何在额状面有助于 CoM 的稳定性。在基线访视后 1 年,我们评估了受试者是否经历过跌倒。有 12 名受试者经历过跌倒,16 名受试者没有。通过协变量分析比较了有跌倒经历和无跌倒经历的老年人之间的方差差异。

结果

在横向方向上没有发现方差的显著差异,而在垂直方向上,有跌倒经历的老年人的 CoM 更不稳定,其方差更大,反映出 CoM 不稳定。

结论

我们验证了垂直方向上破坏 CoM 稳定性的节段配置的高方差与未来的跌倒有关。UCM 分析的变量可用于评估跌倒风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5f2/8045323/25a37225aee8/12877_2021_2192_Fig1_HTML.jpg

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