Lower Limb Muscle Weakness Predicts Use of a Multiple- Versus Single-Step Strategy to Recover From Forward Loss of Balance in Older Adults
Lower Limb Muscle Weakness Predicts Use of a Multiple- Versus Single-Step Strategy to Recover From Forward Loss of Balance in Older Adults
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DOI：
10.1093/gerona/gls149
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发表时间：
2012-11-01
影响因子：
5.1
通讯作者：
Mills, Peter M.
中科院分区：
文献类型：
--
作者：
Carty, Christopher P.;Barrett, Rod S.;Mills, Peter M.
与年轻人相比，老年人的力量和平衡恢复能力都有所降低。本研究的目的是调查年龄、性别和/或下肢力量是否可以预测用于从向前失去平衡中恢复的踏步策略。95名居住在社区的6590岁的老年人参与了这项研究。平衡的丧失是通过让参与者从静态的前倾中释放出来的。参与者在三个初始倾斜程度下进行了四个试验，随后被归类为使用单步或多步策略。单因素Logistic回归分析表明，踝关节足底屈曲、膝关节伸展或髋关节屈曲力量降低一个单位(即，体重高度的1%)与采用多步策略的几率增加1.72.5倍。在最瘦的两个阶段，女性也有更大的几率需要多步恢复策略。前向逐步Logistic回归分析显示，髋屈肌力量尤其有影响，因为它是体重在20%和25%BW的Logistic回归模型中的主要预测因子。与单步行走相比，下肢肌肉无力，尤其是髋屈肌和膝关节伸肌的无力，与单步行走相比，需要多步行走才能从初始倾斜幅度范围内的向前平衡中恢复过来的几率增加。通过在预防跌倒的计划中针对这些肌肉群，可以提高平衡恢复能力。
Older adults compared with young adults have reduced strength and balance recovery ability. The purpose of the present study was to investigate whether age, sex, and/or lower limb strength predicted the stepping strategy used to recover from a forward loss of balance.Ninety-five, community-dwelling, older adults, aged 6590 years, participated in the study. Loss of balance was induced by releasing participants from a static forward lean. Participants performed four trials at three initial lean magnitudes and were subsequently classified as using a single- or multiple-step strategy. Isometric strength of the ankle, knee, and hip joint flexors and extensors was assessed using a dynamometer.Univariate logistic regression revealed that a unit (ie, 1% body weight [BW] height) decrease in ankle plantar flexion, knee extension, or hip flexion strength was associated with 1.72.5 times increased odds of adopting a multiple-step strategy. Women also had greater odds of requiring a multiple-step recovery strategy at the two greatest lean magnitudes. Forward stepwise logistic regression revealed that hip flexor strength in particular was influential as it was the primary predictor included in the logistic regression models at 20% and 25% BW lean magnitudes.Lower limb muscle weakness, especially of the hip flexors and knee extensors, was associated with increased odds of requiring multiple steps compared with single steps to recover from forward loss of balance across a range of initial lean magnitudes. Improved balance recovery ability might be achieved by targeting these muscle groups in falls prevention programs.