Xu Chen, Ishii Yosuke, Mizutani Masanosuke, Hashizume Takato, Nakamura Ryoichi, Kurumadani Hiroshi, Takahashi Makoto
Biomechanics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN.
Rehabilitation, Medical Technology, Shimura Hospital, Hiroshima, JPN.
Cureus. 2024 Oct 17;16(10):e71733. doi: 10.7759/cureus.71733. eCollection 2024 Oct.
Aim Older inpatients have reduced physical function and walking ability with a higher risk of falls after being discharged home. Gait variability can assess ambulation and is strongly related to the risk of falls. However, the clinical factors affecting gait variability in inpatients have not been identified. The purpose of this study was to investigate the predictive factors affecting gait variability in older inpatients. Methods A total of 42 older orthopedic inpatients with fractures of the hip, spine, and other segments and 18 healthy volunteers as the control group were enrolled in this study. Inpatients wore tri-axial accelerometers for a 10m walk before discharge. Gait variability was assessed by the coefficient of variation (CV) based on five consecutive stride times. Clinical assessment of muscle strength, joint mobility, balance, pain, and activities of daily living were also evaluated. Results The CV in inpatients was higher than that in healthy elderly. Quadriceps muscle strength, ankle dorsiflexion range of motion, and balance described the CV. When model 2 (adjusted R = 0.473) was compared with model 1 (adjusted R = 0.293), the quadriceps muscle strength and ankle dorsiflexion range of motion had a major effect on CV, while balance had not a greater influence than these two factors when compared with model 3 (adjusted R = 0.537). Conclusions Poor knee extension strength, balance, and restriction of ankle dorsiflexion mobility have influenced gait variability in older inpatients.
目的 老年住院患者出院回家后身体功能和行走能力下降，跌倒风险更高。步态变异性可评估步行情况，且与跌倒风险密切相关。然而，尚未确定影响住院患者步态变异性的临床因素。本研究的目的是调查影响老年住院患者步态变异性的预测因素。方法 本研究共纳入42例髋部、脊柱和其他部位骨折的老年骨科住院患者以及18名健康志愿者作为对照组。住院患者在出院前佩戴三轴加速度计进行10米步行测试。基于连续五个步幅时间，通过变异系数（CV）评估步态变异性。还对肌肉力量、关节活动度、平衡、疼痛和日常生活活动进行了临床评估。结果 住院患者的CV高于健康老年人。股四头肌力量、踝关节背屈活动范围和平衡可描述CV。当将模型2（调整后R = 0.473）与模型1（调整后R = 0.293）进行比较时，股四头肌力量和踝关节背屈活动范围对CV有主要影响，而与模型3（调整后R = 0.537）相比，平衡对CV的影响不如这两个因素大。结论 膝关节伸展力量差、平衡能力差以及踝关节背屈活动受限影响了老年住院患者的步态变异性。
