Biomechanical Causes of Slow Gait in the Elderly

老年人步态缓慢的生物力学原因

• 批准号: 7234544
• 负责人: DARRYL G THELEN
• 金额: $ 1.47万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7234544
• 关键词: aerobic exercise; ankle; biomechanics; clinical research; data collection methodology /evaluation; electromyography; exercise; frail elderly; functional ability; gait; health; hip; human old age (65+); human subject; joint stiffness; limb movement; model design /development; muscle function; muscle strength; neuromuscular disorder; posture; statistics /biometry

DESCRIPTION (provided by applicant): The goal of this research is to establish a scientific basis for developing targeted interventions that can improve gait function in the elderly. Walking speed is a common clinical measure of gait function. Slow preferred walking speed has been associated with falls, can contribute to physical disability and is one of the primary criteria used to describe the clinical syndrome of frailty. Reduced strength and diminished aerobic capacity are commonly proposed causes for slow walking. Frail elderly adults can often make significant improvements in muscle strength and endurance through exercise. However, such gains have not consistently translated to improved gait performance. These findings are indicative of the complexities of gait performance and indicate the need for a more fundamental understanding of the neuromuscular factors that limit gait speed. This study will employ musculoskeletal models and forward dynamic simulations to describe the causal relationship between muscle actions and movement during gait. These novel analyses will be used to identify limiting factors, describe compensatory mechanisms and predict the affects of specific interventions. Aim 1 will rigorously examine the contributions of muscle coordination, strength, posture and passive joint stiffness to reduced gait speed in healthy old adults. We will test the hypothesis that age-associated reductions in gait speed arise primarily due to increased passive stiffness at the hip and only secondarily due to diminished muscle power at the ankle. Aim 2 will identify the subject-specific factors that limit gait speed in elderly who exhibit intermediate frailty. We hypothesize that identifiable subject-specific limitations in either passive hip flexion stiffness, ankle plantarflexor power capacity or hip abduction weakness will be the primary factors limiting gait speed in elderly who walk slowly. The development of forward dynamic simulations that elucidate how muscles contribute to both normal and impaired movement, as proposed here, is an important step to understanding the causes of slow walking among frail elderly. The results of this study are fundamental to the development of effective interventions that can improve gait function and thereby contribute to the maintenance of mobility in elderly adults

描述(申请人提供)：这项研究的目标是为开发能够改善老年人步态功能的有针对性的干预措施建立科学基础。步行速度是临床上常用的步态功能指标。较慢的首选步行速度与跌倒有关，可能导致身体残疾，是描述虚弱临床综合征的主要标准之一。力量减弱和有氧能力减弱通常被认为是导致缓慢行走的原因。虚弱的老年人经常可以通过锻炼在肌肉力量和耐力方面取得显著改善。然而，这样的进步并没有持续地转化为步态表现的改善。这些发现表明了步态表现的复杂性，并表明需要对限制步态速度的神经肌肉因素有更基本的了解。 这项研究将使用肌肉骨骼模型和正向动力学模拟来描述步态中肌肉动作和运动之间的因果关系。这些新颖的分析将用于确定限制因素、描述补偿机制和预测特定干预措施的影响。目的1将严格检查肌肉协调性、力量、姿势和被动关节僵硬对健康老年人步态速度减慢的影响。我们将检验这一假设，即与年龄相关的步态速度降低主要是由于髋部被动僵硬的增加，其次是脚踝肌肉力量的减弱。目标2将确定在表现出中度虚弱的老年人中限制步速的特定受试者因素。我们假设，在被动髋关节屈曲僵硬、踝趾屈肌力量能力或髋关节外展无力方面，可识别的特定受试者的限制将是限制步态缓慢的老年人步态速度的主要因素。 正向动态模拟的发展，阐明了肌肉如何对正常和受损的运动做出贡献，这是理解虚弱老年人行走缓慢的原因的重要一步。这项研究的结果是开发有效的干预措施的基础，可以改善步态功能，从而有助于维持老年人的行动能力

项目成果

A simple mass-spring model with roller feet can induce the ground reactions observed in human walking.

• DOI: 10.1115/1.3005147
• 发表时间: 2009-01
• 期刊: Journal of biomechanical engineering
• 作者: Whittington BR;Thelen DG
• 通讯作者: Thelen DG

Differences in lower-extremity muscular activation during walking between healthy older and young adults.

在健康的老年人和年轻人之间行走过程中，低超级性肌肉激活的差异。

• DOI: 10.1016/j.jelekin.2008.10.008
• 发表时间: 2009-12
• 期刊: JOURNAL OF ELECTROMYOGRAPHY AND KINESIOLOGY
• 影响因子: 2.5
• 作者: Schmitz, Anne;Silder, Amy;Heiderscheit, Bryan;Mahoney, Jane;Thelen, Darryl G.
• 通讯作者: Thelen, Darryl G.

Effect of age on center of mass motion during human walking.

• DOI: 10.1016/j.gaitpost.2009.05.006
• 发表时间: 2009-08
• 期刊: GAIT & POSTURE
• 影响因子: 2.4
• 作者: Hernandez, Antonio;Silder, Amy;Heiderscheit, Bryan C.;Thelen, Darryl G.
• 通讯作者: Thelen, Darryl G.