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健康的年轻人和老年人在稳态行走过程中平衡控制的差异。

Differences in balance control between healthy younger and older adults during steady-state walking.

作者信息

Vistamehr Arian, Neptune Richard R

机构信息

Motion Analysis Center, Brooks Rehabilitation, Jacksonville, FL, USA.

Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX, USA.

出版信息

J Biomech. 2021 Nov 9;128:110717. doi: 10.1016/j.jbiomech.2021.110717. Epub 2021 Aug 28.

Abstract

Each year approximately one third of older adults fall and experience extensive musculoskeletal injuries and functional disabilities. An important element in maintaining dynamic balance is the regulation of whole-body angular momentum, which is achieved by proper foot placement with respect to the body center-of-mass as well as generation of appropriate ground reaction forces. Analyzing these quantities in younger and older adults may provide insight into differences in their underlying mechanics for maintaining dynamic balance. This study examined three-dimensional whole-body angular momentum in 13 healthy older (71.8 ± 8.3 years) and 9 younger (23.2 ± 2.8 years) adults walking at their self-selected and fastest-comfortable speeds. The older adults had a significantly higher range of frontal-plane angular momentum compared to the younger adults at both speeds, suggesting poorer mediolateral balance control. This difference was related to the older adults having a wider foot placement with respect to the body center-of-mass, which when combined with the vertical ground reaction force, created a higher destabilizing external moment during single-limb stance that acts to rotate the body towards the contralateral swing leg. To counteract this destabilizing moment, the older adults generated a higher hip abduction moment. There were no differences in the range of sagittal- and transverse-plane angular momentum between age groups at either speed. These results suggest that control of dynamic balance in the frontal-plane is more challenging than in the sagittal-plane for older adults and highlight the importance of proper weight transfer mechanisms and hip abductor force production for maintaining mediolateral balance during walking.

摘要

每年约有三分之一的老年人跌倒,并遭受严重的肌肉骨骼损伤和功能障碍。维持动态平衡的一个重要因素是全身角动量的调节,这是通过相对于身体质心的适当足部放置以及产生适当的地面反作用力来实现的。分析年轻人和老年人的这些量可能有助于深入了解他们维持动态平衡的潜在力学差异。本研究检测了13名健康老年人(71.8±8.3岁)和9名年轻人(23.2±2.8岁)以自我选择的最快舒适速度行走时的三维全身角动量。在两种速度下,老年人的额面角动量范围均显著高于年轻人,表明其内外侧平衡控制较差。这种差异与老年人相对于身体质心的足部放置更宽有关,这与垂直地面反作用力相结合,在单腿站立期间产生了更高的使身体向对侧摆动腿旋转的不稳定外力矩。为了抵消这种不稳定力矩,老年人产生了更高的髋关节外展力矩。在任何一种速度下,年龄组之间矢状面和横断面角动量范围均无差异。这些结果表明,对于老年人来说,控制额面的动态平衡比矢状面更具挑战性,并强调了适当的体重转移机制和髋关节外展肌力产生对于维持行走期间内外侧平衡的重要性。

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