有无跌倒史老年人步态生物力学特征对比分析
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郑州大学体育学院

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Comparative Analysis of Biomechanical Characteristics of Gaitin Elderly People With or Without Falling History
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    摘要:

    目的:通过对有、无跌倒史老年人进行步态运动学和动力学同步测量分析,探讨有跌倒史老年人的步态参数特征,为老年人跌倒防控及功能锻炼提供理论及实践依据。方法:在居民社区及老年公寓招募284名60岁以上的老年人作为研究对象,将样本按照既往12个月跌倒史分为F组(有跌倒史)和NF组(无跌倒史)。通过问卷收集受试者跌倒史、病史以及锻炼习惯等基本信息,采用三维录像解析和动态足底压力测量获取受试者自然行走步态的运动学和动力学参数。测试数据采用独立样本t检验进行组间各因素差异性对照分析。结果:F组老年人自然行走步态过程中左足第1跖骨峰值力(1.50±1.25)N、双足足跟外侧冲量(L=1.10±0.62,R= 1.12±0.64)Ns、右足大拇趾冲量(1.10±0.62)Ns等动力学参数与NF组相比,差异均有统计学意义(P<0.05);F组老年人自然行走步态过程中右足第2跖骨受力面积(11.00±2.37)cm2左足缓冲期接触时间(394.91±199.73)ms、右足前脚掌触地时间(108.69±61.69)ms、右足横向COP(压力中心)轨迹(35.61±7.26)mm、左足触地髋角(170.31±5.52)0双足峰值压力点COM(身体重心)位移(L=210.53±11.78,R=220.66±11.89)mm等运动学参数与NF组相比,差异均有统计学意义(P<0.05)。结论:有跌倒史老年人与无跌倒史老年人相比,行走过程中足底触地时间延长,过渡期支撑稳定性下降,压力中心横向位移增大,行进方向重心位移减小,可能意味着老年人下肢肌力下降,足侧向摆动增大,步行推进力减小,可导致姿势控制策略发生代偿性改变,潜在跌倒风险增大。

    Abstract:

    Objective To explore the characteristics of gait parameters of the elderly with and without a history of falls through the simultaneous measurement and analysis of gait kinematics and dynamics of the elderly with and without a history of falls, so as to provide theoretical and practical basis for fall prevention and control and functional exercise of the elderly. Methods: 284 elderly people over 60 years old were recruited in residential communities and apartments for the elderly as the study subjects, and the samples were divided into F group (with a fall history) and NF group (without a fall history) according to the fall history in the past 12 months. The basic information of subjects" fall history, medical history and exercise habits were collected through questionnaires, and the kinematics and dynamics parameters of subjects" natural walking gait were obtained by 3D video analysis and dynamic plantar pressure measurement. The test data were analyzed by independent sample t-test for the differences of various factors between groups. Results: The dynamic parameters of left foot first metatarsal peak force (1.50 ± 1.25) N, lateral heel impulse (L=1.10 ± 0.62, R=1.12 ± 0.64) Ns, right toe impulse (1.10 ± 0.62) Ns in group F were significantly different from those in group NF (P<0.05); The force bearing area of the second metatarsal of the right foot (11.00 ± 2.37) cm2, the contact time of the left foot in the buffer period (394.91 ± 199.73) ms, the contact time of the right foot in the front foot (108.69 ± 61.69) ms, the right foot transverse COP (pressure center) track (35.61 ± 7.26) mm, the left foot contact hip angle (170.31 ± 5.52) 0 The kinematic parameters such as the displacement of the peak pressure point COM (body center of gravity) of both feet (L=210.53 ± 11.78, R=220.66 ± 11.89) mm were significantly different from those of the NF group (P<0.05). Conclusion: Compared with the elderly without a history of falls, the elderly with a history of falls have longer foot contact time, lower stability of support during the transition period, increased lateral displacement of pressure center, and decreased displacement of center of gravity in the direction of travel, which may mean that the lower limb muscle strength of the elderly is decreased, the lateral swing of foot is increased, and the walking propulsion is reduced, which may lead to compensatory changes in posture control strategies and increase potential fall risk.

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  • 收稿日期:2023-03-09
  • 最后修改日期:2023-04-05
  • 录用日期:2023-04-13
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