Physiological and psychological predictors of walking speed in older community-dwelling people
Physiological and psychological predictors of walking speed in older community-dwelling people
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DOI：
10.1159/000088703
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发表时间：
2005-01-01
期刊：
影响因子：
3.5
通讯作者：
Lord, SR
中科院分区：
文献类型：
--
作者：
Tiedemann, A;Sherrington, C;Lord, SR
背景：6米步行速度（SMWS）是测量老年人功能表现的常用测试。然而，除了下肢力量，很少有研究探讨了影响这项测试表现的生理和心理因素。目的：在大样本老年人中调查一系列感觉运动、平衡和心理因素对SMWS的相对贡献。研究方法：668名75-98岁（平均年龄80.1岁，SD = 4.4）的社区居民接受了SMWS测试以及视觉、外周感觉、力量、反应时间、平衡、跌倒恐惧、疼痛和活力的定量测试。结果：单因素分析显示，许多生理和心理因素与SMWS显著相关。逐步多元回归分析显示，复合下肢力量测量（膝关节伸展、膝关节屈曲和踝关节背屈肌肉力量评分之和）、姿势摇摆、通过协调稳定性测试评估的倾斜平衡、反应时间、边缘对比敏感度、SF 12身体疼痛和活力评分以及年龄是SMWS的显著和独立预测因素。在这些指标中，组合下肢力量指标的β权重最高，表明其是解释SMWS方差的最重要变量。然而，其他感觉运动，平衡和心理措施提供了重要的独立信息。合并的变量集解释了SMWS中40%的方差（多重r = 0.63）。结论：研究结果表明，在社区居住的老年人中，自我选择的步行速度不仅受到下肢力量的影响，还受到平衡，反应时间，视力，疼痛和情绪健康的影响。
Background: Six-metre walking speed (SMWS) is a commonly used test for measuring functional performance in older people. However, apart from lower limb strength, few studies have examined the range of physiological and psychological factors that influence performance in this test. Objective: To investigate the relative contributions of a range of sensorimotor, balance and psychological factors to SMWS in a large sample of older people. Methods: 668 community-dwelling people aged 75-98 years (mean age 80.1, SD = 4.4) underwent the SMWS test as well as quantitative tests of vision, peripheral sensation, strength, reaction time, balance, fear of falling, pain and vitality. Results: Many physiological and psychological factors were significantly associated with SMWS in univariate analyses. Stepwise multiple regression analyses revealed that a composite lower limb strength measure (sum of knee extension, knee flexion and ankle dorsiflexion muscle strength scores), postural sway, leaning balance as assessed with the coordinated stability test, reaction time, edge contrast sensitivity, SF12 body pain and vitality scores and age were significant and independent predictors of SMWS. Of these measures, the combined lower limb strength measure had the highest beta weight indicating it was the most important variable in explaining the variance in SMWS. However, the other sensorimotor, balance and psychological measures each provided important independent information. The combined set of variables explained 40% of the variance in SMWS (multiple r = 0.63). Conclusions: The findings indicate that in community-dwelling older people, self-selected walking speed is influenced not only by lower limb strength but also by balance, reaction time, vision, pain and emotional well-being.