Hausdorff J M, Edelberg H K, Mitchell S L, Goldberger A L, Wei J Y
Gerontology Division, Beth Israel Hospital, Boston, MA 02215, USA.
Arch Phys Med Rehabil. 1997 Mar;78(3):278-83. doi: 10.1016/s0003-9993(97)90034-4.
To test the hypothesis that quantitative measures of gait unsteadiness are increased in community-dwelling elderly fallers.
Retrospective, case-control study.
General community.
Thirty-five community-dwelling elderly subjects older than 70 years of age who were capable of ambulating independently for 6 minutes were categorized as fallers (age, 82.2 +/- 4.9 yrs [mean +/- SD]; n = 18) and nonfallers (age, 76.5 +/- 4.0 yrs; n = 17) based on history; 22 young (age, 24.6 +/- 1.9 yrs), healthy subjects also participated as a second reference group.
Stride-to-stride variability (standard deviation and coefficient of variation) of stride time, stance time, swing time, and percent stance time measured during a 6-minute walk.
All measures of gait variability were significantly greater in the elderly fallers compared with both the elderly nonfallers and the young subjects (p < .0002). In contrast, walking speed of the elderly fallers was similar to that of the nonfallers. There were little or no differences in the variability measures of the elderly nonfallers compared with the young subjects.
Stride-to-stride temporal variations of gait are relatively unchanged in community-dwelling elderly nonfallers, but are significantly increased in elderly fallers. Quantitative measurement of gait unsteadiness may be useful in assessing fall risk in the elderly.
检验社区居住的老年跌倒者步态不稳的定量指标增加这一假设。
回顾性病例对照研究。
普通社区。
35名年龄超过70岁、能够独立行走6分钟的社区居住老年人，根据病史分为跌倒者（年龄82.2±4.9岁[均值±标准差]；n = 18）和非跌倒者（年龄76.5±4.0岁；n = 17）；22名年轻（年龄24.6±1.9岁）健康受试者作为第二参考组也参与研究。
6分钟步行过程中测量的步幅时间、站立时间、摆动时间和站立时间百分比的逐步步态变异性（标准差和变异系数）。
与老年非跌倒者和年轻受试者相比，老年跌倒者的所有步态变异性指标均显著更高（p < .0002）。相比之下，老年跌倒者的步行速度与非跌倒者相似。老年非跌倒者与年轻受试者的变异性指标几乎没有差异。
社区居住的老年非跌倒者步态的逐步时间变化相对不变，但老年跌倒者显著增加。步态不稳的定量测量可能有助于评估老年人的跌倒风险。
