Gait Speed and Dynamic Stability Decline Accelerates Only in Late Life: A Cross-sectional Study in Community-Dwelling Older Adults.
Gait Speed and Dynamic Stability Decline Accelerates Only in Late Life: A Cross-sectional Study in Community-Dwelling Older Adults.
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DOI：
10.1519/jpt.0000000000000171
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Pai YC
中科院分区：
文献类型：
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作者：
Lee A;Bhatt T;Smith-Ray RL;Wang E;Pai YC
福尔斯的发生率随着年龄的增长而增加，而步态速度下降。本研究的目的是检查1）在社区居住的老年人中，步态速度和质心（COM）速度是否以线性方式随年龄稳步下降，以及2）这种下降是否对应于动态稳定性的类似下降，这取决于对COM位置和COM速度相对于支撑基础（BOS）的控制。184名社区老年人（≥ 65岁）参加了横断面研究。参与者被分为5个年龄组：65-69岁，70-74岁，75-79岁，80-84岁和85岁以上，并被要求以他们喜欢的步行速度在7米的人行道上行走。他们的速度，步态模式，相对COM位置，和相对COM速度进行了测量。临床步态速度测量和COM速度之间的关系非常密切（R2 = 0.875，p < 0.05），这使得我们能够互换使用这两个术语。65 ~ 84岁时步态速度下降不明显（p > 0.05），85岁以后加速下降。这种下降很可能受到步长（p < 0.05）和节奏（p < 0.05）减少的影响。同样，65岁至84岁之间的动态稳定性对向后失去平衡的影响也很小（p > 0.05）。然而，在85岁之后，它显著下降（p < 0.05），主要受到COM相对于BOS的速度降低的影响，其中COM相对于BOS的位置在他们行走期间保持恒定。无法证实步态速度和步态稳定性控制的预期稳定下降。相反，我们发现，这两种情况只有在85岁以后才急剧下降，而85岁以后，福尔斯跌倒的风险可能相应地增加。
Incidence of falls increases with age while gait speed declines. The purposes of this study were to examine 1) whether gait speed and center of mass (COM) velocity declined steadily across ages in a linear fashion among community-dwelling older adults, and 2) whether such decline corresponded to the similar decline in dynamic stability, which is governed by the control of their COM position and COM velocity relative to base of support (BOS). 184 community-dwelling older adults (≥ 65 yr) participated in the cross-sectional study. The participants were categorized into 5 age groups: 65–69 years, 70–74 years, 75–79 years, 80–84 years, and 85+ years and were asked to walk on the 7-m walkway at their preferred walking speed. Their speed, gait pattern, the relative COM position, and the relative COM velocity were measured. Very close relationship was confirmed between a clinical gait speed measurement and the COM velocity (R2 = 0.875, p < 0.05), which enabled us to use the 2 terms interchangeably. Gait speed decline was not noticeable from 65 to 84 years old (p > 0.05), but it accelerated after age 85. This decline was most likely influenced by a reduction in both step length (p < 0.05) and cadence (p < 0.05). Similarly, dynamic stability against backward loss of balance changed little between 65 and 84 years old (p > 0.05). Yet, it declined significantly after 85 years old (p < 0.05), primarily affected by the reduction in the COM velocity relative to the BOS, whereby the COM position relative to the BOS remained constant during their walking. Expected steady decline in gait speed and in the control of gait stability cannot be confirmed. Rather, we found that both declined precipitously only after age 85, when the risk of falls is likely to increase correspondingly.