Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States; School of Kinesiology, University of Michigan, Ann Arbor, MI, United States.
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, United States; School of Kinesiology, University of Michigan, Ann Arbor, MI, United States; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States.
Gait Posture. 2021 Jul;88:72-77. doi: 10.1016/j.gaitpost.2021.05.007. Epub 2021 May 11.
Neuromuscular changes that occur with aging or joint pathology likely alter the coordinative strategies that adults use to walk and to recover from perturbations during gait. Differences in coordination patterns or in how coordination changes in response to a challenge may provide insight into neuromuscular targets for falls prevention interventions.
Do young asymptomatic adults, older asymptomatic adults, and older adults with knee OA alter their lower extremity segment coordination differently in response to an increase in walking speed?.
We captured lower extremity kinematics using inertial measurement units as 29 participants (10 young, 10 older, 9 older with knee osteoarthritis) walked on a treadmill at self-selected preferred and faster speeds. We calculated lower extremity segment coordination and coordination variability using vector coding. We compared coordination and its variability among groups and speeds.
There were no significant interactions between group and speed. Overall group or speed differences in coordination or variability occurred mostly during terminal swing or early stance. Coordination patterns differed between young adults and adults with knee osteoarthritis in all segment couples during terminal swing and at the foot vs. shank during early stance. During these same gait cycle phases for the foot vs. shank and shank vs. thigh segment couples, coordination patterns shifted towards those of young adults when participants walked faster. Where coordination variability differed by group or speed, it was lower in the young adults than in the older adults with or without knee osteoarthritis and at faster walking speed.
Our results identified that older adults with knee osteoarthritis have a different strategy for transitioning from swing to stance compared to young adults, especially at distal limb segments. These results may help target fall prevention interventions to specific gait cycle phases or strategies.
随着年龄的增长或关节病变，神经肌肉会发生变化，这可能会改变成年人在行走和从步态中恢复时使用的协调策略。协调模式的差异或协调如何响应挑战而变化，可能为预防跌倒的神经肌肉干预目标提供深入了解。
年轻无症状成年人、老年无症状成年人和膝骨关节炎老年人在增加行走速度时，是否会以不同的方式改变下肢节段的协调？
我们使用惯性测量单元捕捉下肢运动学，29 名参与者（10 名年轻、10 名老年、9 名老年膝骨关节炎）在跑步机上以自我选择的舒适速度和更快速度行走。我们使用矢量编码计算下肢节段的协调和协调变异性。我们比较了组间和速度间的协调和变异性。
组间和速度间没有显著的相互作用。总体而言，组间或速度间的协调或变异性差异主要发生在终末期摆动或早期站立期。在终末期摆动和早期站立期的足部与小腿之间，年轻人和膝骨关节炎成年人的所有节段对之间的协调模式不同。在足部与小腿和小腿与大腿之间的节段对的相同步态周期阶段，当参与者行走速度加快时，协调模式向年轻人的模式转变。在协调或变异性因组或速度而异的情况下，年轻人的协调或变异性低于有或没有膝骨关节炎的老年成年人，且在行走速度较快时更低。
我们的研究结果表明，与年轻人相比，膝骨关节炎老年人在从摆动到站立的过渡中采用了不同的策略，尤其是在远端肢体节段。这些结果可能有助于针对特定步态周期阶段或策略来实施预防跌倒的干预措施。
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