Michalska Justyna, Juras Grzegorz, Kamieniarz Anna, Rudzińska-Bar Monika, Knast Katarzyna, Słomka Kajetan J
Department of Human Motor Behavior, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
Department of Neurology, Faculty of Medicine and Health Sciences, The Andrzej Frycz Modrzewski Kraków University, Kraków, Poland.
Exp Brain Res. 2022 May;240(5):1605-1616. doi: 10.1007/s00221-022-06355-1. Epub 2022 Apr 1.
Elderly individuals may be at increased risk of falls than their peers. Early identification of balance disorders and their appropriate intervention are crucial for patients with dementia. The aim of this study was to identify postural instability in patients from mild to moderate dementia while performing transitional locomotor tasks under different conditions. Fifty-four patients with dementia and 30 healthy controls voluntarily participated in the study. The transitional locomotor task was performed on two force platforms under four conditions: unimpeded transition, obstacle clearance, step-up and step-down trials. The recording of center of foot pressure displacements was divided into three distinct phases: 1st phase-quiet standing before the transitional locomotor task, 2nd phase-forward stepping, 3rd phase-quiet standing after the transitional locomotor task. Patients with dementia were characterized by a longer transitional locomotor task time than the control group under all conditions (P < 0.03). Significant differences in quiet standing before the transitional locomotor task were observed between patients with dementia and the control group, but only in unimpeded transition and obstacle clearance trials (P < 0.02). No significant differences in quiet standing after step transition were observed between patients with dementia and the control group (P > 0.05). Postural control research in patients with dementia should focus on the functional motor task rather than on a simple motor task (quiet standing). Because even patients with mild dementia have impaired dynamic balance, the assessment of transitional locomotor tasks performed by patients with dementia might provide an indicator of an early diagnosis of dementia and might lead to better individualized physiotherapy.
与同龄人相比,老年人跌倒的风险可能更高。早期识别平衡障碍并进行适当干预对痴呆症患者至关重要。本研究的目的是在不同条件下进行过渡性运动任务时,识别轻度至中度痴呆症患者的姿势不稳情况。54名痴呆症患者和30名健康对照者自愿参与了该研究。在两个测力平台上,在四种条件下进行过渡性运动任务:无障碍过渡、越过障碍物、上台阶和下台阶试验。足压力中心位移的记录分为三个不同阶段:第一阶段——过渡性运动任务前的安静站立,第二阶段——向前迈步,第三阶段——过渡性运动任务后的安静站立。在所有条件下,痴呆症患者的特点是过渡性运动任务时间比对照组更长(P<0.03)。在痴呆症患者和对照组之间,观察到过渡性运动任务前安静站立存在显著差异,但仅在无障碍过渡和越过障碍物试验中(P<0.02)。在痴呆症患者和对照组之间,未观察到步长过渡后安静站立的显著差异(P>0.05)。对痴呆症患者的姿势控制研究应侧重于功能性运动任务,而不是简单的运动任务(安静站立)。因为即使是轻度痴呆症患者也存在动态平衡受损的情况,对痴呆症患者进行的过渡性运动任务评估可能为痴呆症的早期诊断提供一个指标,并可能带来更好的个性化物理治疗。