Age-related differences in reactive balance control and fall-risk in people with chronic stroke.
Age-related differences in reactive balance control and fall-risk in people with chronic stroke.
复制标题
慢性中风患者反应性平衡控制和跌倒风险与年龄相关的差异。
DOI：
10.1016/j.gaitpost.2023.03.011
复制
发表时间：
2023
期刊：
影响因子：
2.4
通讯作者：
Bhatt,Tanvi
中科院分区：
文献类型：
--
作者：
Purohit,Rudri;Wang,Shuaijie;Dusane,Shamali;Bhatt,Tanvi
背景对突发环境扰动的反应性受损导致健康老龄化和神经功能受损人群跌倒风险增加。先前的研究已经证明了不同程度运动障碍的中风患者的偏瘫侧和非偏瘫侧对跌倒风险的个体贡献。然而，老龄化和单侧皮质病变对反应性平衡控制的综合影响尚不清楚。因此，我们的目的是研究年龄相关的差异反应性平衡控制和跌倒风险在实验室诱导的步态滑移的人与可比的中风相关的运动障碍。（45.61 ± 4.61岁）和13岁以上（71.92 ± 6.50岁）有类似卒中相关损害的成人（根据Fugl-Meyer下肢功能评估）在每侧肢体（轻瘫和非轻瘫）下暴露于一次地上步态滑移。计算了质心状态稳定性和滑移运动学（滑移位移和速度）。临床平衡和流动性也assessed.ResultsOn非轻瘫滑，老年人慢性中风表现出更大的福尔斯和较低的质量中心的稳定性（其位置和速度）在后滑触地相比，年轻的成年人慢性中风（p < 0.01）。这伴随着更大的峰值滑移位移和更快的峰值滑移速度（p < 0.01）。然而，有没有这样的组间差异注意到轻瘫slip（p > 0.01）。在控制滑动强度（滑动位移和速度）方面的非麻痹性缺陷可加重慢性卒中老年人的跌倒风险。进一步的调查是必要的，以确定其他因素归因于老年人慢性中风跌倒的风险增加。
BackgroundImpaired reactive responses to sudden environmental perturbations contribute to heightened fall-risk in healthy aging and neurologically impaired populations. Previous studies have demonstrated individual contributions of paretic and non-paretic sides to fall-risk in people with stroke with variable levels of motor impairment. However, the combined effect of aging and unilateral cortical lesion on reactive balance control is not clearly understood. We therefore aimed to examine age-related differences in reactive balance control and fall-risk during laboratory-induced gait-slips in people with comparable stroke-related motor impairments.MethodsThirteen younger(45.61 ± 4.61 years)and thirteen older(71.92 ± 6.50 years)adults with similar stroke-related impairment (on Fugl-Meyer Lower Extremity Assessment) were exposed to one overground gait-slip under each limb (paretic and non-paretic). Center of mass state stability and slipping kinematics (slip displacement and velocity) were computed. Clinical balance and mobility were also assessed.ResultsOn non-paretic slips, older adults with chronic stroke demonstrated greater falls and lower center of mass stability (its position and velocity) at post-slip touchdown compared to younger adults with chronic stroke(p < 0.01). This was accompanied with a greater peak slip displacement and faster peak slip velocity(p < 0.01). However, there were no such group differences noted on the paretic slips(p > 0.01).ConclusionAging may have an independent, detrimental effect on reactive balance control in people with chronic stroke. Non-paretic deficits in controlling slip intensities (slip displacement and velocity) can accentuate fall-risk in older adults with chronic stroke. Further investigation is necessary to identify additional factors attributing to heightened fall-risk in older adults with chronic stroke.