Influence of lower extremity strength of healthy older adults on the outcome of an induced trip
Influence of lower extremity strength of healthy older adults on the outcome of an induced trip
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DOI：
10.1046/j.1532-5415.2002.50056.x
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发表时间：
2002-02-01
影响因子：
6.3
通讯作者：
Grabiner, MD
中科院分区：
文献类型：
--
作者：
Pavol, MJ;Owings, TM;Grabiner, MD
目的：确定下肢力量下降是否会导致老年人绊倒相关跌倒。设计：老年人的横截面样本在使用隐藏的机械障碍物行走时被安全带绊倒。比较行程结果组之间的下肢力量。地点：生物力学研究实验室。参与者：79 名 65 岁及以上的健康社区居民（50 名女性）。测量：通过等长和等速测量踝、膝和髋的屈伸力量。对测量的强度进行因子分析。比较了从旅途中恢复过来的人和因之前确定的三种机制跌倒的人的力量因子得分：步中、步后；结果：七个公共因素，其中一个与每个关节的每个用力方向相关，另一个与力矩增加的时间率相关，解释了测量力量的 88% 的差异。与使用类似降低策略成功恢复的人 (n = 26) 相比，步中 (n = 5) 的踉跄在踝关节伸展（跖屈）、膝关节屈曲、整体伸展和总力量因子方面明显更强。与大多数使用类似的抬高策略恢复的跌倒者 (n = 11) 相比，进行抬升反应的跌倒者 (n = 1) 在跖屈和整体伸展因子方面更强。三名后跌倒者中的两名是测试中最弱的受试者之一。结论：虚弱的老年人和最强壮的老年人可能有更大的跌倒风险，尽管机制不同。高强度可能会增加迈步或提升反应时跌倒的可能性；力量下降可能会增加步后跌倒的可能性。
OBJECTIVES: To determine whether decreased lower extremity strength contributes to trip-related falls in older adults.DESIGN: A cross-sectional sample of older adults were safety-harnessed and tripped while walking using a concealed, mechanical obstacle. Lower extremity strength was compared between trip outcome groups.SETTING: A biomechanics research laboratory.PARTICIPANTS: Seventy-nine healthy, community-dwelling adults aged 65 and older (50 women).MEASUREMENTS: Ankle, knee, and hip flexion and extension strength were measured isometrically and isokinetically. Measured strengths were subjected to a factor analysis. Strength factor scores were compared between those who recovered from the trip and those who fell by three previously identified mechanisms: during-step, after-step; and elevating-response falls.RESULTS: Seven common factors, one associated with each direction of exertion at each joint and one with the time rate of moment increase, explained 88% of the variance in measured strength. The during-step (n = 5) falters were significantly stronger in the ankle extension (plantarflexion), knee flexion, overall extension, and total strength factors than those who successfully recovered using a similar, lowering strategy (n = 26). The elevating-response faller (n = 1) was stronger in the plantarflexion and overall extension factors than most of those who recovered using a similar, elevating strategy (n = 11). Two of three after-step fallers were among the weakest subjects tested.CONCLUSION: Weak older adults and the strongest older adults may be at greater risk of falling from a trip, although by different mechanisms. High strength may increase the likelihood of a during-step or elevating-response fall; decreased strength may increase the likelihood of an after-step fall.