DYNAMIC BALANCE IN OLDER PERSONS - EFFECTS OF REDUCED VISUAL AND PROPRIOCEPTIVE INPUT
DYNAMIC BALANCE IN OLDER PERSONS - EFFECTS OF REDUCED VISUAL AND PROPRIOCEPTIVE INPUT
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DOI：
10.1093/gerona/50a.5.m263
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发表时间：
1995-09-01
影响因子：
5.1
通讯作者：
WOLFSON, LI
中科院分区：
文献类型：
--
作者：
JUDGE, JO;KING, MB;WOLFSON, LI
背景了解运动和感觉对老年人平衡功能的贡献对于设计有效的干预措施以预防福尔斯和丧失活动能力非常重要。我们在110名无神经系统疾病临床证据的受试者（平均年龄80岁）中测试了视觉和本体感受输入、肌肉力量和年龄对平衡性能的贡献。EquiTest感觉组织测试用于呈现在2（触觉/本体感受输入）x 3（视觉输入）设计中改变感觉输入的顺序条件。从平台记录力中心和剪切力数据;主要结局是平衡丧失（LOB）和前后力中心（COF）位移占足长的比例（COFD）。受试者在测试期间有3.5 +/- 2.7 LOB。在不稳定的表面条件下，视觉输入的减少使LOB的比值比增加了5.7倍（3.9，8.4，95%CI），但重复试验的适应性很大。与第一项试验相比，第二项和第三项试验中LOB的调整优势比分别为0.65和0.45。肌力和年龄是LOB的独立预测因子。步态速度，单站平衡，和报道的步行困难，移动性和日常生活的工具活动也与LOB相关。临床力量、平衡和步态测试的表现与挑战性平衡测试的表现相关，该测试减少了感觉输入和运动反应的有效性。在这组老年受试者中，对挑战性平衡条件的适应是实质性的，但在年龄最大的受试者中减少。
Background. Understanding the motor and sensory contributions to balance function in older persons is important in order to design effective interventions to prevent falls and loss of mobility. We tested the contributions of visual and proprioceptive input, muscle strength, and age to balance performance in 110 subjects free of clinical evidence of neurologic disease (mean age 80 years).Methods. The EquiTest Sensory Organization Test was used to present sequential conditions that altered sensory input in a 2 (tactile/proprioceptive input) x 3 (visual input) design. Center of force and shear force data were recorded from the platform; the primary outcomes were loss of balance (LOB) and anterior-posterior center of force (COF) displacement as a proportion of foot length (COFD).Results. Subjects had 3.5 +/- 2.7 LOB during testing. Reduction of vision input increased the odds ratio of a LOB 5.7 fold (3.9, 8.4, 95% CI) in unstable surface conditions, but adaptation with repeated trials was substantial. The adjusted odds ratio of a LOB was 0.65 and 0.45 in the second and third trials, respectively, compared to the first. Muscle strength and age were independent predictors of LOB. Gait velocity, single stance balance, and reported difficulty with ambulation, mobility, and instrumental activities of daily living were also associated with LOB.Conclusions. Performance on clinical tests of strength, balance, and gait was associated with performance on a challenging balance test which reduced sensory input and effectiveness of motor responses. Adaptation to challenging balance conditions was substantial in this group of older subjects, but was diminished in the oldest subjects.