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内外侧稳定极限突出了老年人维持动态平衡的运动策略。

Mediolateral Margin of Stability highlights motor strategies for maintaining dynamic balance in older adults.

机构信息

Center for Digital Health & Social Innovation, St. Poelten University of Applied Sciences, St. Pölten, Austria.

Public Health & Sport Sciences, University of Exeter, Exeter, United Kingdom.

出版信息

PLoS One. 2024 Oct 31;19(10):e0313034. doi: 10.1371/journal.pone.0313034. eCollection 2024.

Abstract

The dynamical nature of gait increases fall risk for older adults as the Center of Mass (COM) is constantly displaced inside and outside the Base of Support (BOS). Foot placement and leg joint moments are the primary mechanisms controlling dynamic balance. The Margin of Stability (MOS) quantifies the distance between the COM dynamical state and the BOS. While research examined how aging affects the relationship between foot placement and MOS, the relationship to leg moments is unexamined. Examining this relationship would elucidate whether aging increases fall risk from changes in the joint moments controlling the COM. Fourteen older (66.9 ± 4.3 years) and sixteen young (26.3 ± 3.6 years) adults walked along a 12m path for three trials. The MOS, hip and ankle moments in sagittal and frontal planes were analyzed. For the knee, only the sagittal plane was analyzed. MOS was calculated as the distance between the extrapolated-COM and the Center of Pressure per step. Statistical Parametric Mapping independent t-tests assessed group differences. Cross-correlation quantified MOS and joint moment relationships per plane during single-stance. No group differences in walking speed were observed. A larger frontal plane MOS, hip abduction and ankle eversion moment occurred for older adults. Cross-correlation demonstrated moderate and strong relationships for the hip-MOS for both groups in the sagittal plane. Older adults had a larger sagittal plane hip-MOS correlation than young adults. The larger mediolateral MOS in older adults may indicate attempts to avoid lateral balance loss by shifting their COM away from their BOS lateral boundaries during single-stance. However, this strategy moves the COM toward the BOS medial borders potentially pre-maturely terminating the contralateral swing phase during medial destabilization. The stronger sagittal plane hip-MOS relationship in older adults may reflect increased coupling between hip moments and the COM to control dynamic balance.

摘要

步态的动力学特性会增加老年人跌倒的风险,因为质心 (COM) 不断在支撑基础 (BOS) 内外移动。足部位置和腿部关节力矩是控制动态平衡的主要机制。稳定裕度 (MOS) 量化了 COM 动力学状态与 BOS 之间的距离。虽然研究已经检验了衰老如何影响足部位置与 MOS 之间的关系,但对于与腿部力矩的关系还没有进行研究。研究这种关系可以阐明衰老是否通过控制 COM 的关节力矩的变化增加了跌倒的风险。14 名老年人(66.9 ± 4.3 岁)和 16 名年轻人(26.3 ± 3.6 岁)沿着 12m 的路径走了三趟。分析了矢状面和额状面的 MOS、髋关节和踝关节力矩。对于膝关节,只分析了矢状面。MOS 是通过每步的外推 COM 与压力中心之间的距离来计算的。统计参数映射独立 t 检验评估了组间差异。交叉相关量化了单足站立期间 MOS 和关节力矩在各个平面的关系。没有观察到行走速度的组间差异。老年人的额状面 MOS、髋关节外展和踝关节外翻力矩较大。交叉相关表明,在矢状面,两组的髋关节-MOS 之间存在中度和高度的关系。老年人的矢状面髋关节-MOS 相关性大于年轻人。老年人的外侧 MOS 较大,可能表明他们在单足站立时通过将 COM 从 BOS 的外侧边界移开,试图避免侧向平衡丧失。然而,这种策略会将 COM 移向 BOS 的内侧边界,从而在内侧失稳时过早地终止对侧摆动阶段。老年人矢状面髋关节-MOS 关系较强,可能反映了髋关节力矩与 COM 之间的耦合增加,以控制动态平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1390/11527164/b92dac644490/pone.0313034.g001.jpg

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