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老年人中,恐惧跌倒和慢性下腰痛患者的姿势控制。

Postural control among older adults with fear of falling and chronic low back pain.

机构信息

Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.

Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran.

出版信息

BMC Geriatr. 2024 Oct 23;24(1):862. doi: 10.1186/s12877-024-05455-7.

Abstract

OBJECTIVE

Altered Postural control could increase the risk of falling in older adults. Factors such as low back pain and fear of falling can be contributing factors to postural control instability. This study aimed to investigate the effect of chronic low back pain (CLBP) and fear of falling (FOF) on postural control of older adults.

METHOD

Forty-one older adults were included (27 LBP and 14 control). Among the participants, 22 people had high FOF, and 19 had low FOF based on Falls efficacy scale cut-off of ≥ 26. For postural control evaluation Center of pressure parameters (COP) of Standard deviation (Sd) of velocity, Sd of amplitude, path length and mean velocity in both Medial-lateral (ML) and Anterior-Posterior (AP) directions were measured. Mixed-model anova with two between group factor (Health status; with and without CLBP, and with high and low FES-I groups) and one within factor postural condition (four conditions with and without vision and Achill tendon vibration) was used.

RESULT

No significant interaction between groups (health status and FES-I) and group with condition (health status and condition or FES-I and condition) was observed for all COP parameters in both AP and ML direction. There was main effect of FES-I for all COP parameters in ML direction, with greater Sd of velocity, Sd of amplitude, path length and mean velocity in older adults with high FES-I compared to low FES-I in the ML direction.

CONCLUSION

High levels of FOF influenced static postural control in the ML direction. Therefore, paying attention to the lateral stability of older adults is of great importance.

摘要

目的

姿势控制的改变会增加老年人跌倒的风险。下腰痛和跌倒恐惧等因素可能是姿势控制不稳定的促成因素。本研究旨在探讨慢性下腰痛(CLBP)和跌倒恐惧(FOF)对老年人姿势控制的影响。

方法

纳入 41 名老年人(27 名有下腰痛,14 名无下腰痛)。根据跌倒效能量表(FES-I)的截点值(≥26),22 名参与者有高 FOF,19 名参与者有低 FOF。为了评估姿势控制,测量了中心压力参数(COP)的标准偏差(Sd)的速度、Sd 的振幅、路径长度和平均速度在前后(AP)和内外(ML)方向。采用混合模型方差分析,有两个组间因素(健康状况,有无 CLBP,以及 FES-I 高、低组)和一个组内因素姿势条件(有、无视觉和跟腱振动的四种条件)。

结果

在 AP 和 ML 方向的所有 COP 参数中,组间因素(健康状况和 FES-I)和组与条件因素(健康状况和条件或 FES-I 和条件)之间没有显著的相互作用。FES-I 对 ML 方向的所有 COP 参数都有主要影响,与 FES-I 低的老年人相比,FES-I 高的老年人的 ML 方向的速度、振幅、路径长度和平均速度的 Sd 更大。

结论

高水平的 FOF 影响了 ML 方向的静态姿势控制。因此,重视老年人的侧向稳定性非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6955/11520166/1509ce234139/12877_2024_5455_Fig1_HTML.jpg

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