Good Lateral Harmonic Stability Combined with Adequate Gait Speed Is Required for Low Fall Risk in Older People
Good Lateral Harmonic Stability Combined with Adequate Gait Speed Is Required for Low Fall Risk in Older People
复制标题
DOI：
10.1159/000362836
复制
发表时间：
2015-01-01
期刊：
影响因子：
3.5
通讯作者：
Lord, Stephen R.
中科院分区：
文献类型：
--
作者：
Brodie, Matthew A. D.;Menz, Hylton B.;Lord, Stephen R.
背景资料：步态中良好的横向谐波稳定性对于最大限度地降低老年人跌倒风险可能很重要，因为许多福尔斯发生在步行过程中，当支撑基础在中外侧（ML）方向上偏西时。然而，由于频率分辨率不足，传统的ML谐波比（MLHR）可能是步态质量的次优度量。目的：主要目的是调查一种新的横向谐波稳定性测量方法，即8步MLHR，是否可以在考虑不同步行速度的同时区分老年跌倒者和非跌倒者。研究方法：96名老年人（平均年龄80岁，SD 4岁）完成了20米以上的重复步行; 35名参与者在过去一年中有一次或多次福尔斯跌倒史。传统的MLHR和8步MLHR是从连接到骶骨的加速度计获得的。结果如下：与传统MLHR相比，8步MLHR显示出相似的单变量能力，可识别基于年龄、步行速度和生理学的跌倒风险的显著差异（p = 0.05）。当考虑到步行速度的差异时，我们观察到步行速度高于平均水平且横向谐波稳定性高于平均水平（通过8步MLHR）的参与者跌倒的可能性比所有其他参与者低5.3倍（相对风险：0.19，95%置信区间：0.06-0.57）。然而，对于传统的MLHR，坠落者和非坠落者之间没有显著差异。结论：研究结果表明，良好的横向谐波稳定性与足够的步态速度相互作用，并且当两者重合时，与老年人跌倒风险降低相关。未来的研究可能会研究专注于提高步态速度和横向稳定性的干预措施是否可以降低跌倒风险，以及这些综合步态措施是否可以使用可穿戴技术远程预测健康状况恶化。(C)2014 S. Karger AG，巴塞尔
Background: Good lateral harmonic stability in gait may be important for minimising fall risk in older people because many falls occur during walking when the base of support is narrowest in the mediolateral (ML) direction. However, the traditional ML harmonic ratio (MLHR) may be a sub-optimal measure of gait quality because of insufficient frequency resolution. Objective: The primary objective was to investigate if a new measure of lateral harmonic stability, the 8-step MLHR, could discriminate older fallers from non-fallers while taking different walking speeds into account. Methods: Repeat walks over 20 m were completed by 96 older people (mean age 80, SD 4 years); 35 participants had a history of one or more falls in the past year. The traditional MLHR and the 8-step MLHR were obtained from an accelerometer attached to the sacrum. Results: Compared to the traditional MLHR, the 8-step MLHR demonstrated similar univariate ability to identify significant differences in fall risk based on age, walking speed and physiology (p = 0.05). When differences in walking speed were taken into account, we observed that participants who walked both faster than average and had above-average lateral harmonic stability (by the 8-step MLHR) were 5.3 times less likely to be fallers than all other participants (relative risk: 0.19, 95% confidence interval: 0.06-0.57). For the traditional MLHR, however, no significant differences between the fallers and non-fallers were evident. Conclusions: The findings indicate that good lateral harmonic stability interacts with adequate gait speed and, when coincident, are associated with reduced fall risk in older people. Future research could examine whether interventions focusing on enhancing both gait speed and lateral stability can reduce fall risk and whether these combined gait measures can remotely predict deteriorating health using wearable technology. (C) 2014 S. Karger AG, Basel