Can use of walkers or canes impede lateral compensatory stepping movements?
Can use of walkers or canes impede lateral compensatory stepping movements?
复制标题
DOI：
10.1016/s0966-6362(03)00098-5
复制
发表时间：
2004-08-01
期刊：
影响因子：
2.4
通讯作者：
Maki, BE
中科院分区：
文献类型：
--
作者：
Bateni, H;Heung, E;Maki, BE
虽然像助行器和拐杖这样的辅助设备经常被用来帮助平衡控制，但最近的研究表明，这些设备实际上可能会增加跌倒的风险。在这项研究中，我们调查了一种可能的机制：步行者或手杖可能干扰或限制足部的横向运动，从而阻碍在横向失去平衡时代偿性步进反应的执行。在10名健康青年（22-27岁）中，通过突然不可预测的中-外侧支持面平移，引起了侧步反应。受试者在手持和装载标准助行车或单尖手杖或不使用辅助设备（双手解放或手持物体）的情况下进行测试。结果支持了使用助行器或手杖会干扰代偿行走的假设。在使用助行器时，摆动脚和助行器之间的碰撞非常频繁（60%的步进反应），在手杖试验中也发生过（11%的步进反应）。此外，这种碰撞与侧步长显著减少（26-37%）有关。研究表明，受试者有时能够通过增加摆动脚向前或向后的位移或移动手杖来避免碰撞；然而，试图将助行器抬出的情况很少发生，通常由于对侧助行器立柱和站立脚之间的碰撞而受阻。在这样一个健康的队列中，代偿性步进行为发生了显著改变，这一事实清楚地表明，目前设计的这些辅助装置固有的一些安全局限性。(C) 2003 Elsevier B.V.版权所有
Although assistive devices, such as walkers and canes are often prescribed to aid in balance control, recent studies have suggested that such devices may actually increase risk of falling. In this study, we investigated one possible mechanism: the potential for walkers or canes to interfere with, or constrain, lateral movement of the feet and thereby impede execution of compensatory stepping reactions during lateral loss of balance. Lateral stepping reactions were evoked, in 10 healthy young adults (ages 22-27 years), by means of sudden unpredictable medio-lateral support surface translation. Subjects were tested while holding and loading a standard pickup walker or single-tip cane or while using no assistive device (hands free or holding an object). Results supported the hypothesis that using a walker or cane can interfere with compensatory stepping. Collisions between the swing-foot and mobility aid were remarkably frequent when using the walker (60% of stepping reactions) and also occurred in cane trials (11% of stepping reactions). Furthermore, such collisions were associated with a significant reduction (26-37%) in lateral step length. It appeared that subjects were sometimes able to avoid collision by increasing the forward or backward displacement of the swing-foot or by moving the cane; however, attempts to lift the walker out of the way occurred rarely and were usually impeded due to collision between the contralateral walker post and stance foot. The fact that compensatory stepping behavior was altered significantly in such a healthy cohort clearly demonstrates some of the safety limitations inherent to these assistive devices, as currently designed. (C) 2003 Elsevier B.V. All rights reserved.