Gait variability and the risk of incident mobility disability in community-dwelling older adults
Gait variability and the risk of incident mobility disability in community-dwelling older adults
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DOI：
10.1093/gerona/62.9.983
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发表时间：
2007-09-01
影响因子：
5.1
通讯作者：
Newman, Anne B.
中科院分区：
文献类型：
--
作者：
Brach, Jennifer S.;Studenski, Stephanie A.;Newman, Anne B.
背景步态速度是一个强有力的预测事件步行残疾。目的是确定步态变异性是否增加了独立于步态速度的意外移动性残疾的预测。参与者包括匹兹堡心血管健康研究的379名老年人（平均年龄= 79岁; 78%白人，40%男性）。所有人都能独立行走，行走半英里没有困难。步态特征是从一个4米的电脑走道。对于每个步态参数，变异性定义为两次通过的单个步数的标准差。通过每6个月一次的电话访谈获得54个月的行走残疾事件，并将其定义为新的行走半英里困难或无法行走半英里。在379名参与者中，222名（58.6%）发生意外移动残疾。在未调整的考克斯比例风险模型中，步态速度、平均步长、平均站立时间和站立时间变异性与意外的移动性残疾相关。在调整了步态速度、人口统计学、慢性病、处方药、健康状况和身体活动水平后，只有站立时间变异性仍然是残疾的重要指标。在调整后的模型中，站立时间变异性增加0.01秒与移动性残疾发生率增加13%相关（危险比1.13，95%置信区间，1.01-1.27）。站立时间变异性是未来移动能力障碍的独立预测因子。未来的努力是必要的，以确定是否干预措施，减少立场时间变异性也将推迟行动能力的残疾。
Background. Gait speed is a strong predictor of incident walking disability. The objective was to determine if gait variability adds to the prediction of incident mobility disability independent of gait speed.Methods. Participants included 379 older adults (mean age = 79 years; 78% Caucasian, and 40% men) in the Cardiovascular Health Study at the Pittsburgh site. All could ambulate independently and reported no difficulty walking a half mile. Gait characteristics were determined from a 4-meter computerized walkway. For each gait parameter, variability was defined as the standard deviation from the individual steps from two passes. Incident walking disability was obtained by phone interview every 6 months for 54 months and was defined as new difficulty walking a half mile or inability to walk a half mile.Results. Of the 379 participants, 222 (58.6%) developed incident mobility disability. In unadjusted Cox proportional hazards models gait speed, mean step length, mean stance time, and stance time variability were associated with incident mobility disability. After adjusting for gait speed, demographics, chronic conditions, prescription medications, health status, and physical activity level, only stance time variability remained an important indicator of disability. In the adjusted model, an increase in stance time variability of 0.01 seconds was associated with a 13% higher incidence of mobility disability (hazard ratio 1.13, 95% confidence interval, 1.01-1.27).Conclusions. Stance time variability is an independent predictor of future mobility disability. Future efforts are needed to determine whether interventions that decrease stance time variability will also delay mobility disability.