增加障碍物距离任务对老年非跌倒者和跌倒者步态起始时姿势稳定性变量的影响。

Effect of Increasing Obstacle Distances Task on Postural Stability Variables During Gait Initiation in Older Nonfallers and Fallers.

作者信息

Rathore Roshita, Tucker Carole A, Jeka John J, Wright W Geoffrey, Hurt Christopher P

机构信息

Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama; Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama; Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, Pennsylvania.

School of Health Professions, University of Texas Medical Branch, Galveston, Texas.

出版信息

Arch Phys Med Rehabil. 2022 Dec;103(12):2303-2310. doi: 10.1016/j.apmr.2022.04.006. Epub 2022 May 10.

DOI:10.1016/j.apmr.2022.04.006

PMID:35550139

Abstract

OBJECTIVE

To compare the scaling of the postural stability variables between older nonfallers and fallers during gait initiation (GI) while stepping over increasing obstacle distances.

DESIGN

Cross-sectional study.

SETTING

University research laboratory.

PARTICIPANTS

A sample of participants (N=24) divided into 2 groups: older nonfallers (n=12) and older fallers (n=12). Participants had no known neurologic, musculoskeletal, or cardiovascular conditions that could have affected their walking, and all were independent walkers. All the participants had an adequate cognitive function to participate as indicated by a score of more than 24 on the Mini-Mental State Examination.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The primary dependent variables were peak anterior-posterior (AP) center of mass (CoM)-center of pressure (CoP) separation during anticipatory postural adjustments (APAs), AP CoM-CoP separation at the toe-off, and peak AP CoM-CoP separation during the swing. Secondary dependent variables were AP trunk angle during GI. Within- and between-repeated measures analysis of variance was used to compare means between groups across different task conditions for all the dependent variables.

RESULTS

There was a main effect of group for peak AP CoM-CoP separation during APA (P=.018), an interaction effect between group and condition for AP CoM-CoP separation at toe-off (P=.009), and a main effect of condition for peak AP CoM-CoP separation during the swing (P<.001). We also found a main effect of group for peak AP trunk angle during the swing (P=.028).

CONCLUSIONS

For GI while stepping over increasing obstacle distances, older fallers adopt a more conservative strategy of AP CoM-CoP separation than nonfallers prior to toe-off and demonstrate increased peak AP trunk lean during the swing. AP CoM-CoP separation prior to toe-off during the GI task may be a critical marker to identify fallers and warrants additional investigation.

摘要