Maki B E, McIlroy W E
Department of Surgery, School of Physical and Health Education, University of Toronto, Ontario, Canada.
Clin Geriatr Med. 1996 Nov;12(4):635-58.
Age-related changes in the neural, sensory, and musculoskeletal systems can lead to balance impairments that have a tremendous impact on the ability to move about safely. The many complex substrates of the posture control system subserve a common functional goal: regulation of the relationship between the center of mass and the base of support. Traditional approaches, which have focused on the control of the center-of-mass displacement, have documented age-related changes in "feet-in-place" responses: during quiet standing, during volitional movement, or in response to applied perturbation. Recently, increasing attention has been directed toward the control of the base of support, that is, compensatory leg and arm movement, as an important element of the postural repertoire, and early results suggest profound age-related impairment in the control of compensatory stepping movements. For both feet-in-place and stepping responses, control of lateral stability appears to be a major problem associated with increased risk of falling. In view of age-related differences in ability to adapt postural responses under predictable task conditions, future work will likely benefit by mimicking, as much as possible, the varied and unpredictable nature of the events that often precipitate falls in daily life, in order to draw connections between the laboratory or clinic and "real-life" stability.
神经、感觉和肌肉骨骼系统的年龄相关变化会导致平衡受损，这对安全移动能力有巨大影响。姿势控制系统的许多复杂基础结构都服务于一个共同的功能目标：调节重心与支撑面之间的关系。传统方法专注于控制重心位移，记录了在“原地双脚”反应中与年龄相关的变化，如安静站立时、自主运动期间或对施加的扰动做出反应时。最近，越来越多的注意力被导向支撑面的控制，即补偿性腿部和手臂运动，作为姿势动作的一个重要元素，早期结果表明在补偿性跨步运动控制方面存在与年龄相关的严重受损。对于原地双脚反应和跨步反应，横向稳定性的控制似乎是与跌倒风险增加相关的一个主要问题。鉴于在可预测任务条件下姿势反应适应能力的年龄相关差异，未来的研究可能会受益于尽可能模仿日常生活中经常引发跌倒的各种不可预测事件的性质，以便在实验室或临床与“现实生活”稳定性之间建立联系。
