Tashiro Hideyuki, Hirosaki Sota, Sato Yui, Ihira Hikaru, Toki Megumi, Kozuka Naoki
Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, S-1, W-17, Chuo-ku, Sapporo, Hokkaido 060-8556, Japan.
Department of Health Promotion Science, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo 192-0397, Japan.
Clin Biomech (Bristol). 2025 May;125:106536. doi: 10.1016/j.clinbiomech.2025.106536. Epub 2025 Apr 24.
We investigated whether reactive stepping during dual tasking is associated with falls in community-dwelling older adults.
In 78 healthy community-dwelling older adults, we evaluated quiet standing stability, limits of stability, and reactive stepping performance during single and dual tasking. Participants were suspended in a forward-leaning position using a lean control cable with a load of 12 % of their body weight and were instructed to regain balance upon release by taking steps forward. Reactive stepping was induced under two conditions: (1) simple front-fixed gaze (single-task condition) and (2) reading color names written in different colors (dual-task condition). Reactive stepping performance was measured using the onset latency of the medial gastrocnemius of the stepping limb and the number of steps required to recover balance after forward balance loss. Participants were classified as fallers or non-fallers based on fall history during the past 12 months.
Twenty-two participants were classified as fallers. Both fallers and non-fallers exhibited a significantly increased number of steps during dual-tasking compared to the single-task condition. An interaction between group and condition was observed. The increased number of steps to balance recovery from forward balance loss during dual-tasking was significantly associated with falls after controlling for age, sex, body mass, cognitive function, and concerns about falling.
The number of steps taken to recover balance during dual-tasking was independently related to fall history in community-dwelling older adults. Fall prevention strategies for older adults should include measuring and improving their response to balance loss while dual tasking.
我们研究了在执行双重任务时的反应性跨步是否与社区居住的老年人跌倒有关。
在78名健康的社区居住老年人中，我们评估了单任务和双重任务期间的安静站立稳定性、稳定性极限和反应性跨步表现。参与者使用倾斜控制电缆以其体重12%的负荷被悬吊在前倾位置，并被指示在释放后通过向前迈步来恢复平衡。在两种条件下诱发反应性跨步：（1）简单的前方固定注视（单任务条件）和（2）阅读用不同颜色书写的颜色名称（双重任务条件）。使用跨步肢体腓肠肌内侧的起始潜伏期和向前平衡丧失后恢复平衡所需的步数来测量反应性跨步表现。根据过去12个月的跌倒史将参与者分为跌倒者或非跌倒者。
22名参与者被分类为跌倒者。与单任务条件相比，跌倒者和非跌倒者在双重任务期间的步数均显著增加。观察到组和条件之间的相互作用。在控制了年龄、性别、体重、认知功能和跌倒担忧后，双重任务期间从向前平衡丧失恢复平衡所需的步数增加与跌倒显著相关。
在双重任务期间恢复平衡所采取的步数与社区居住老年人的跌倒史独立相关。老年人的跌倒预防策略应包括测量和改善他们在双重任务时对平衡丧失的反应。
