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躯干和下肢运动范围随年龄变化对步态的影响。

Effects of age-related changes in trunk and lower limb range of motion on gait.

机构信息

School of Sports and Health, Nanjing Sport Institute, Nanjing, Jiangsu, China.

Physical Activity, Sport and Exercise Research Theme, Faculty of Health, Southern Cross University, 2480, Lismore, NSW, Australia.

出版信息

BMC Musculoskelet Disord. 2023 Mar 28;24(1):234. doi: 10.1186/s12891-023-06301-4.

Abstract

BACKGROUND

The ability to walk is crucial for maintaining independence and a high quality of life among older adults. Although gait characteristics have been extensively studied in older adults, most studies have investigated muscle activity in the joints of the trunk or the lower limbs without assessing their interactions. Thus, the causes of altered trunk and lower limb movement patterns in older adults remain to explore. Therefore, this study compared the joint kinematic parameters of both trunk and lower limbs between young and older adults to identify kinematic factors associated with changes in gait among older adults.

METHODS

In total, 64 older (32 males, aged 68.34 ± 7.38 years; 32 females, aged 67.16 ± 6.66 years) and 64 young (32 males, aged 19.44 ± 0.84 years; 32 females, aged 19.69 ± 0.86 years) healthy adults participated in this study. The range of motion (ROM) of the thorax, pelvis, and trunk in the horizontal plane and of the hip, knee, and ankle joints of the lower limbs in the sagittal plane were measured using a motion capture system with wearable sensors. Two-way analysis of variance assessed differences in ROM by group, sex, and spatio-temporal gait parameters; Pearson correlation analysis assessed the correlation of the trunk and lower limbs.

RESULTS

Step length, gait speed, and stride length were greater in young adults (p < 0.001) than in older adults, but older women displayed the fastest gait speed (p < 0.05). ROM values for the pelvis, thorax, trunk, knee joint, and ankle joint of young adults were greater (p < 0.05) than those in older adults. However, hip ROM in older adults was significantly greater than that in young adults (p < 0.05).

CONCLUSION

With increasing age, ROM of the lower limbs, especially the ankle joint, decreased significantly, resulting in a significant decrease in gait speed. As ROM of the pelvis decreased, stride length decreased significantly in older adults, who compensate through thoracic rotation. Thus, older adults should enhance muscle strength and increase ROM to improve gait patterns.

摘要

背景

行走能力对于老年人保持独立和生活质量至关重要。尽管已经广泛研究了老年人的步态特征,但大多数研究都只调查了躯干或下肢关节的肌肉活动,而没有评估它们之间的相互作用。因此,老年人改变躯干和下肢运动模式的原因仍有待探索。因此,本研究比较了年轻和老年人的躯干和下肢关节运动学参数,以确定与老年人步态变化相关的运动学因素。

方法

本研究共纳入 64 名老年人(32 名男性,年龄 68.34±7.38 岁;32 名女性,年龄 67.16±6.66 岁)和 64 名年轻成年人(32 名男性,年龄 19.44±0.84 岁;32 名女性,年龄 19.69±0.86 岁)。使用带有可穿戴传感器的运动捕捉系统测量了胸、骨盆和躯干在水平面上的运动范围(ROM)以及下肢在矢状面上的髋关节、膝关节和踝关节的 ROM。通过组间、性别和时空步态参数的双向方差分析评估了 ROM 的差异;通过 Pearson 相关性分析评估了躯干和下肢的相关性。

结果

年轻成年人的步幅、步速和步长大于老年人(p<0.001),但老年女性的步速最快(p<0.05)。年轻人的骨盆、胸部、躯干、膝关节和踝关节的 ROM 值较大(p<0.05)。然而,老年人的髋关节 ROM 明显大于年轻人(p<0.05)。

结论

随着年龄的增长,下肢尤其是踝关节的 ROM 明显下降,导致步态速度明显下降。由于骨盆 ROM 减小,老年人的步长明显减小,他们通过胸部旋转来代偿。因此,老年人应增强肌肉力量并增加 ROM,以改善步态模式。

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