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平衡感觉输入:感觉缺失的老年人通过本体感觉重新分配到触觉感觉来维持姿势稳定性。

Balancing sensory inputs: somatosensory reweighting from proprioception to tactile sensation in maintaining postural stability among older adults with sensory deficits.

机构信息

College of Sports and Health, Shandong Sport University, Jinan, China.

出版信息

Front Public Health. 2023 May 4;11:1165010. doi: 10.3389/fpubh.2023.1165010. eCollection 2023.

Abstract

BACKGROUND

Sensory deficits increase the risk of falls among older adults. The purpose of this study was to investigate the correlations of lower extremity muscle strength, proprioception, and tactile sensation to postural stability among older adults with and without sensory deficits, to understand the contribution of each factor to postural stability, and to explore sensory reweighting among the two populations.

METHODS

A total of 103 participants were recruited and divided into two older adult groups with (female = 24, male = 26, age = 69.1 ± 3.15 years, height = 162.72 ± 6.94 cm, body mass = 64.05 ± 9.82 kg) and without sensory deficits (female = 26, male = 27, age = 70.02 ± 4.9 years, height = 163.76 ± 7.60 cm, body mass = 65.83 ± 10.31 kg), based on whether a 5.07 Semmes-Weinstein monofilament could be detected at foot soles. Their Berg Balance Scale (BBS), lower extremity muscle strength, proprioception, and tactile sensation were tested and compared between the two groups. Pearson's or Spearman's correlations were used to explore the relationships between the BBS and each variable. Factor analysis and multivariate linear regression were used to verify the degrees of correlation between the generated factors and the postural stability.

RESULTS

Low BBS ( = 0.003, η = 0.088) scores and higher proprioception thresholds (knee flexion: = 0.015, η = 0.059; knee extension: = 0.011, η = 0.065; ankle plantarflexion: = 0.006, η = 0.075; ankle dorsiflexion: = 0.001, η = 0.106) were detected among older adults with sensory deficits compared with those without sensory deficits. Lower extremity muscle strength (ankle plantarflexion: = 0.342, = 0.002; hip abduction: = 0.303, = 0.041) and proprioception (knee flexion: = -0.419, = 0.004; knee extension: = -0.292, = 0.049; ankle plantarflexion: = -0.450, = 0.002; ankle dorsiflexion: = -0.441, = 0.002) were correlated with BBS among older adults without sensory deficits, while lower extremity muscle strength (ankle plantarflexion: = 0.501, p<0.001; hip abduction: = 0.302, = 0.041) and tactile sensation (great toe: = -0.388, = 0.008; 5th metatarsal: = -0.301, = 0.042) were correlated with BBS among older adults with sensory deficits.

CONCLUSION

Older adults with sensory deficits have poorer proprioception and postural stability. Somatosensory reweighting occurs from proprioception to tactile sensation among older adults with sensory deficits in maintaining postural stability.

摘要

背景

感觉功能减退会增加老年人跌倒的风险。本研究旨在探讨下肢肌肉力量、本体感觉和触觉与有和无感觉缺陷的老年人姿势稳定性之间的相关性,了解每个因素对姿势稳定性的贡献,并探讨这两个群体之间的感觉重新加权。

方法

共招募了 103 名参与者,并根据足底是否能检测到 5.07 号 Semmes-Weinstein 单丝,将他们分为有感觉缺陷的(女性=24,男性=26,年龄=69.1±3.15 岁,身高=162.72±6.94cm,体重=64.05±9.82kg)和无感觉缺陷的(女性=26,男性=27,年龄=70.02±4.9 岁,身高=163.76±7.60cm,体重=65.83±10.31kg)两组老年人。对两组老年人的 Berg 平衡量表(BBS)、下肢肌肉力量、本体感觉和触觉进行了测试和比较。使用 Pearson 或 Spearman 相关系数来探讨 BBS 与每个变量之间的关系。使用因子分析和多元线性回归来验证生成的因子与姿势稳定性之间的相关程度。

结果

与无感觉缺陷的老年人相比,有感觉缺陷的老年人的 BBS 评分较低(=0.003,η=0.088),本体感觉阈值较高(膝关节屈曲:=0.015,η=0.059;膝关节伸展:=0.011,η=0.065;踝关节跖屈:=0.006,η=0.075;踝关节背屈:=0.001,η=0.106)。无感觉缺陷的老年人的下肢肌肉力量(踝关节跖屈:=0.342,=0.002;髋关节外展:=0.303,=0.041)和本体感觉(膝关节屈曲:=−0.419,=0.004;膝关节伸展:=−0.292,=0.049;踝关节跖屈:=−0.450,=0.002;踝关节背屈:=−0.441,=0.002)与 BBS 相关,而无感觉缺陷的老年人的下肢肌肉力量(踝关节跖屈:=0.501,p<0.001;髋关节外展:=0.302,=0.041)和触觉(大脚趾:=−0.388,=0.008;第 5 跖骨:=−0.301,=0.042)与 BBS 相关。

结论

有感觉缺陷的老年人本体感觉和姿势稳定性较差。有感觉缺陷的老年人在维持姿势稳定性时,从本体感觉到触觉发生感觉重新加权。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ed9/10194835/e34cc1e06819/fpubh-11-1165010-g0001.jpg

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