Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention
Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention
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DOI：
10.1093/ageing/afl078
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发表时间：
2006-09-01
期刊：
影响因子：
6.7
通讯作者：
McIlroy, William E.
中科院分区：
文献类型：
--
作者：
Maki, Brian E.;McIlroy, William E.
背景：平衡反应，包括快速踏步或达到运动是至关重要的，以防止球迷。这些代偿反应比自主肢体运动快得多，并且可以非常有效地减缓突然不可预测的平衡扰动引起的质心运动;然而，与年龄相关的神经、感觉和/或肌肉骨骼系统的退化可能会阻碍有效执行这些反应的能力。目的：本文总结了最近的研究，关于年龄相关的变化，代偿性步进和达到反应和实际意义，这些发现风扇预防方案。结果：即使是健康的老年人也会遇到明显的困难。对于踏步反应，主要问题涉及横向稳定性的控制-阻止在向前和向后踏步期间发生的横向身体运动，以及控制横向脚运动以避免在横向踏步期间与站立肢体碰撞。老年人似乎更依赖于手臂的反应比年轻人，但不太能够执行达到把握reactions.Conclusions：这是很重要的临床医生评估补偿步进和达到，以确定个人谁是在跌倒的风险，并查明具体的控制问题，以目标为平衡或力量训练或其他干预。可以通过改进设计和适当使用感官辅助设备、助行器、鞋、扶手和抓杆来促进更有效地利用踏步和伸手反应。解决与侧向稳定性控制相关的问题尤其重要，因为侧向福尔斯跌倒最有可能导致髋部骨折。
Background: balancing reactions that involve rapid stepping or reaching movements are critical for preventing fans. These compensatory reactions are much more rapid than volitional limb movements and can be very effective in decelerating the centre-of-mass motion induced by sudden unpredictable balance perturbation; however, age-related deterioration in the neural, sensory and/or musculoskeletal systems may impede the ability to execute these reactions effectively.Objective: this paper summarises recent research regarding age-related changes in compensatory stepping and reaching reactions and the practical implications of these findings for fan prevention programmes.Results: even healthy older adults experience pronounced difficulties. For stepping reactions, the main problems pertain to control of lateral stability-arresting the lateral body motion that occurs during forward and backward steps, and controlling lateral foot movement so as to avoid collision with the stance limb during lateral steps. Older adults appear to be more reliant on arm reactions than young adults but are less able to execute reach-to-grasp reactions rapidly.Conclusions: it is important for clinicians to assess compensatory stepping and reaching, in order to identify individuals who are at risk of falling and to pinpoint specific control problems to target for balance or strength training or other intervention. More effective use of stepping and reaching reactions can be promoted through improved design and appropriate use of sensory aids, mobility aids, footwear, handrails and grab-bars. It is particularly important to address the problems associated with the control of lateral stability because it is the lateral falls that are most likely to result in hip fracture.