Differences Between Gait on Stairs and Flat Surfaces in Relation to Fall Risk and Future Falls
Differences Between Gait on Stairs and Flat Surfaces in Relation to Fall Risk and Future Falls
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DOI：
10.1109/jbhi.2017.2677901
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发表时间：
2017-03
影响因子：
7.7
通讯作者：
Kejia Wang;K. Delbaere;M. Brodie;N. Lovell;L. Kark;S. Lord;S. Redmond
中科院分区：
文献类型：
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作者：
Kejia Wang;K. Delbaere;M. Brodie;N. Lovell;L. Kark;S. Lord;S. Redmond
我们使用身体佩戴的惯性传感器来量化老年人在楼梯和正常平地上的半自由生活步态的差异，并研究了评估这些地形上的步态用于预测多个福尔斯发生的效用。82名居住在社区的老年人在休息和日常生活活动之间的几次平坦表面上和上下楼梯的行走中，在下背部和右脚踝上佩戴了两个惯性传感器。步速由下背部的垂直加速度推导而来，并根据信号的基本频率计算得出。步进率变异性是信号功率谱密度中该基频峰值的宽度。从信号方差计算两个身体位置处的运动活力。在控制年龄和性别的同时，计算步态参数和生理跌倒风险因素（生理特征评估的组成部分）之间的部分斯皮尔曼相关性。总的来说，反应时间较长的受试者在下楼梯时下背部的前后活力较低。老年人在楼梯上走得更慢，但在平坦的表面上并不明显慢。使用逻辑回归分析，下楼梯时更快的步速与12个月内多次预期福尔斯跌倒相关。在上楼或在平坦表面上行走时获得的步态参数没有显示出显著的相关性。这些结果表明，下楼梯步态可能比常规步行和上楼梯更能洞察跌倒风险，并且进一步基于传感器的研究在不同地形上的无监督步态将是有价值的。
We used body-worn inertial sensors to quantify differences in semi-free-living gait between stairs and on normal flat ground in older adults, and investigated the utility of assessing gait on these terrains for predicting the occurrence of multiple falls. Eighty-two community-dwelling older adults wore two inertial sensors, on the lower back and the right ankle, during several bouts of walking on flat surfaces and up and down stairs, in between rests and activities of daily living. Derived from the vertical acceleration at the lower back, step rate was calculated from the signal's fundamental frequency. Step rate variability was the width of this fundamental frequency peak from the signal's power spectral density. Movement vigor was calculated at both body locations from the signal variance. Partial Spearman correlations between gait parameters and physiological fall risk factors (components from the Physiological Profile Assessment) were calculated while controlling for age and gender. Overall, anteroposterior vigor at the lower back in stair descent was lower in subjects with longer reaction times. Older adults walked more slowly on stairs, but they were not significantly slower on flat surfaces. Using logistic regression, faster step rate in stair descent was associated with multiple prospective falls over 12 months. No significant associations were shown from gait parameters derived during walking upstairs or on flat surfaces. These results suggest that stair descent gait may provide more insight into fall risk than regular walking and stair ascent, and that further sensor-based investigation into unsupervised gait on different terrains would be valuable.