Rhythmic Interlimb Coordination Impairments and the Risk for Developing Mobility Limitations
Rhythmic Interlimb Coordination Impairments and the Risk for Developing Mobility Limitations
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DOI：
10.1093/gerona/glw236
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发表时间：
2017-08-01
影响因子：
5.1
通讯作者：
Bean, Jonathan F.
中科院分区：
文献类型：
--
作者：
James, Eric G.;Leveille, Suzanne G.;Bean, Jonathan F.
背景：识别新的康复障碍是活动受限的危险因素可能会改善老年人对其的预防和治疗。我们测试了这一假设，即肢体间节律性、踝关节和肩部协调性受损是老年人随后活动受限的危险因素。方法：我们对67岁及以上的社区老年人(N=99)进行了一项为期一年的前瞻性队列研究，他们在基线时没有活动受限(短身体表现电池评分>；9)。受试者在听觉节拍器的引导下，进行左右脚踝或肩部的反相协调。结果：根据踝关节(OR=1.88；95%可信区间：1.16~3.05)和肩部(OR=1.96；95%CI：1.17~3.29)协调性差异，在调整了年龄、性别、体重指数、Mini-Mini State检查分数、慢性病次数和基线短体能电池评分后，OR值对活动受限的发生有显著意义。ORS对肩关节不对称(OR=2.11；95%CI：1.25~3.57)有显著影响，但对踝关节协调性(OR=0.95；95%CI：0.59~1.55)无显著影响。在未经调整的分析中也发现了类似的结果。结论：该结果支持我们的假设，即肢体间、踝关节和肩部协调性受损是活动受限发生的危险因素。未来还需要进一步研究这种关系背后的外围和中央机制，并测试加强协调是否改变了行动限制。
Background: The identification of novel rehabilitative impairments that are risk factors for mobility limitations may improve their prevention and treatment among older adults. We tested the hypothesis that impaired rhythmic interlimb ankle and shoulder coordination are risk factors for subsequent mobility limitations among older adults.Methods: We conducted a 1-year prospective cohort study of community-dwelling older adults (N = 99) aged 67 years and older who did not have mobility limitations (Short Physical Performance Battery score >9) at baseline. Participants performed antiphase coordination of the right and left ankles or shoulders while paced by an auditory metronome. Using multivariable logistic regression, we determined odds ratios (ORs) for mobility limitations at 1-year follow-up as a function of coordination variability and asymmetry.Results: After adjusting for age, sex, body mass index, Mini-Mental State Examination score, number of chronic conditions, and baseline Short Physical Performance Battery score, ORs were significant for developing mobility limitations based on a 1 SD difference in the variability of ankle (OR = 1.88; 95% confidence interval [CI]: 1.16-3.05) and shoulder (OR = 1.96; 95% CI: 1.17-3.29) coordination. ORs were significant for asymmetry of shoulder (OR = 2.11; 95% CI: 1.25-3.57), but not ankle (OR = 0.95; 95% CI: 0.59-1.55) coordination. Similar results were found in unadjusted analyses.Conclusions: The results support our hypothesis that impaired interlimb ankle and shoulder coordination are risk factors for the development of mobility limitations. Future work is needed to further examine the peripheral and central mechanisms underlying this relationship and to test whether enhancing coordination alters mobility limitations.