Postural Responses to a Suddenly Released Pulling Force in Older Adults with Chronic Low Back Pain: An Experimental Study
Postural Responses to a Suddenly Released Pulling Force in Older Adults with Chronic Low Back Pain: An Experimental Study
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DOI：
10.1371/journal.pone.0162187
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发表时间：
2016-09-13
期刊：
影响因子：
3.7
通讯作者：
Tsai, Yi-Ju
中科院分区：
文献类型：
--
作者：
Lee, Pei-Yun;Lin, Sang-I;Tsai, Yi-Ju
慢性下腰痛(CLBP)是老年人最常见的肌肉骨骼疾病之一，可能会影响平衡和功能独立性。本研究的目的是研究戴和不戴CLBP的老年人对突然释放的拉力的体位反应。30名患有CLBP的社区老年人和26名没有CLBP的自愿对照被纳入研究。参与者被要求站在力量平台上，同时，他们用一只手以随机顺序拉着一根绳子，绳子的另一端系在相反方向的2公斤或4公斤的力量上。记录受试者突然松开绳子时失去平衡的次数和压力中心(COP)的运动。结果表明，尽管不同拉力状态下的失平衡率在不同组之间没有差异，但患有CLBP的老年人的姿势反应较差：与老年对照组相比，反应迟缓，位移更大，速度更快，路径更长，COP摇摆面积更大。此外，在4公斤的拉力条件下，两组都表现出更大的姿势反应。尽管衰老通常被认为与平衡和姿势控制能力下降有关，但这些发现强调了CLBP在对老年人群中外部产生的力量做出反应时对反应性平衡的影响。这项研究还建议，对于患有CLBP的老年人，除了治疗他们的疼痛和残疾外，还应该在他们的干预措施中包括反应性平衡评估和训练，如反应和运动策略训练。临床医生和老年CLBP患者需要意识到反应性平衡受损的重要性，以及遇到意外干扰时摔倒的风险增加。
Chronic low back pain (CLBP), one of the most common musculoskeletal conditions in older adults, might affect balance and functional independence. The purpose of this study was to investigate the postural responses to a suddenly released pulling force in older adults with and without CLBP. Thirty community-dwelling older adults with CLBP and 26 voluntary controls without CLBP were enrolled. Participants were required to stand on a force platform while, with one hand, they pulled a string that was fastened at the other end to a 2-kg or to a 4-kg force in the opposite direction at a random order. The number of times the participants lost their balance and motions of center of pressure (COP) when the string was suddenly released were recorded. The results demonstrated that although the loss of balance rates for each pulling force condition did not differ between groups, older adults with CLBP had poorer postural responses: delayed reaction, larger displacement, higher velocity, longer path length, and greater COP sway area compared to the older controls. Furthermore, both groups showed larger postural responses in the 4-kg pulling force condition. Although aging is generally believed to be associated with declining balance and postural control, these findings highlight the effect of CLBP on reactive balance when responding to an externally generated force in an older population. This study also suggests that, for older adults with CLBP, in addition to treating them for pain and disability, reactive balance evaluation and training, such as reaction and movement strategy training should be included in their interventions. Clinicians and older patients with CLBP need to be made aware of the significance of impaired reactive balance and the increased risk of falls when encountering unexpected perturbations.