Hughes M A, Schenkman M L
Center on Aging, University of Kansas Medical Center, Kansas City 66160, USA.
J Rehabil Res Dev. 1996 Oct;33(4):409-12.
Many elderly people have difficulty with the common functional activity of rising from a chair. Previous work has identified different strategies that are used to assist the young, the healthy elderly, and the functionally impaired elderly subjects in this activity. For the young and the healthy elderly, modification of these strategies with decreased chair height has been examined. This study examined the changes in chair rise strategy in 18 moderately functionally impaired elderly as the difficulty with rising was increased. The results show that the functionally impaired elderly, when rising from their lowest successful chair compared to a chair of knee height, significantly increase peak hip flexion velocity (11 degrees/sec, p < 0.01) and time to rise (1.25 sec, p < 0.01), and significantly decreased their mean center of mass/base of support (COM/BOS) separation at lift-off (1.96 cm, p < 0.05). These alterations in strategy suggest that while the functionally impaired elderly attempt to increase their momentum in rising by increasing their hip flexion velocity, they simultaneously attempt to increase their stability by taking more time to rise and shortening the distance between their COM/BOS at lift-off. These changes suggest a more conservative strategy with increased difficulty, resulting in decreased success in rising from a chair.
许多老年人在从椅子上起身这一常见功能活动上存在困难。先前的研究已经确定了不同的策略,用于帮助年轻人、健康的老年人以及功能受损的老年受试者完成这项活动。对于年轻人和健康的老年人,研究了降低椅子高度对这些策略的影响。本研究调查了18名中度功能受损老年人在起身难度增加时,从椅子上起身策略的变化。结果表明,与膝盖高度的椅子相比,功能受损的老年人从最低成功起身高度的椅子上起身时,髋部最大屈曲速度显著增加(11度/秒,p<0.01),起身时间显著延长(1.25秒,p<0.01),并且在离地时平均质心/支撑面(COM/BOS)间距显著减小(1.96厘米,p<0.05)。这些策略上的改变表明,功能受损的老年人在试图通过增加髋部屈曲速度来提高起身动量的同时,也试图通过延长起身时间和缩短离地时COM/BOS之间的距离来增强稳定性。这些变化表明,随着难度增加,策略变得更加保守,导致从椅子上起身的成功率降低。