Wolfson L, Whipple R, Derby C A, Amerman P, Nashner L
Department of Neurology, University of Connecticut Health Center.
J Gerontol. 1994 Jul;49(4):M160-7. doi: 10.1093/geronj/49.4.m160.
Prior studies indicate that older women fall more often than men although there is no evidence of gender-based balance differences. Using a force platform, we measured the effects of restricted sensory input and support surface movement to detect gender differences in balance.
Healthy, elderly community dwellers (N = 234, mean age = 76 +/- 5 years, 52% female) were administered the following perturbations on the balance platform: The platform and/or visual surround were fixed or tilted proportionally to the subject's sway with the eyes open or closed, forward or backward horizontal translations, and toes-up and toes-down rotations.
Gender-based balance differences were not present during quiet standing, or when the support surface or visual input were manipulated separately. Women swayed and lost their balance more than men when the surface was sway-referenced while vision was compromised, but by the third trial their sway control was comparable to the men. Women also initially lost their balance more frequently than men during toes-up and -down rotations, and compared to men continued to lose their balance more often during repeated toes-up rotations. Finally, women developed less angular momentum than men in response to forward platform rotations.
Elderly women show impairments of balance when simultaneously deprived of visual and somatosensory inputs or during a backwards destabilization. Since there is little evidence for a CNS source for such gender differences, biomechanical origins (e.g., dorsiflexion strength and range of motion) are a more likely cause. Limited postural control of women under conditions stressing balance may explain their greater frequency of falling.
先前的研究表明，老年女性比男性更容易跌倒，尽管没有证据表明存在基于性别的平衡差异。我们使用测力平台测量了受限感觉输入和支撑面移动对平衡中性别差异的影响。
对健康的老年社区居民（N = 234，平均年龄 = 76 ± 5岁，52%为女性）在平衡平台上施加以下干扰：平台和/或视觉环境固定或与受试者的摇摆成比例倾斜，眼睛睁开或闭合，向前或向后水平平移，以及足尖上抬和足尖下压旋转。
在安静站立时，或分别操纵支撑面或视觉输入时，不存在基于性别的平衡差异。当视觉受损且支撑面以摇摆为参考时，女性比男性摇摆得更多且更容易失去平衡，但到第三次试验时，她们的摇摆控制与男性相当。在足尖上抬和下压旋转过程中，女性最初也比男性更频繁地失去平衡，并且与男性相比，在重复的足尖上抬旋转过程中继续更频繁地失去平衡。最后，在平台向前旋转时，女性产生的角动量比男性少。
老年女性在同时被剥夺视觉和躯体感觉输入时或在向后失稳期间表现出平衡受损。由于几乎没有证据表明这种性别差异源于中枢神经系统，生物力学起源（例如背屈力量和运动范围）更可能是原因。在强调平衡的条件下，女性有限的姿势控制可能解释了她们更高的跌倒频率。
