摘要
目的研究衰弱状态和步行速度对老年人步行时下肢关节运动学特征的影响。方法招募59名60岁及以上老年人,根据衰弱指数清单将受试者分为非衰弱组、衰弱前组和衰弱组,采用Xsens MVN运动捕捉惯性传感器采集3组老年人慢速、习惯速度、快速行走时的运动学数据,应用双因素重复测量方差分析比较不同衰弱状态和步速下老年人行走时的下肢关节运动学特征差异。结果衰弱组老年人的年龄显著高于非衰弱组(P<0.01),膝关节最大屈角、膝关节和踝关节活动范围(range of motion,ROM)显著低于非衰弱组和衰弱前组(P<0.05);同时,衰弱组老年人踝关节最大跖屈角显著低于非衰弱组(P<0.05);随着步速增加,衰弱组老年人的单支撑相时间显著增加(P<0.05),3组老年人髋关节矢状面最大角及其ROM、膝关节最大屈角、踝关节最大跖屈角及其ROM显著增加(P<0.05),双支撑相时间、踝关节最大背屈角度和膝关节ROM显著减小(P<0.05);所有关节角度中只有髋关节最大伸角及其ROM、膝关节最大屈角在慢速与习惯速度之间出现显著差异(P<0.05)。相关性分析显示,衰弱前组和衰弱组老年人不同速度步行时髋、膝关节ROM均显著正相关(P<0.01),衰弱组老年人在习惯速度和快速行走时膝、踝关节ROM显著正相关(P<0.05)。结论随着衰弱程度的进展,老年人下肢关节矢状面角度持续降低,主要集中于膝、踝关节。在行走时两个关节间同步性增强,自由度降低,但在提高步行速度时,衰弱状态基本不影响老年人的步行策略。研究结果有助于对衰弱老年人群进行筛查及康复指导。
Objective To observe the effects of frailty state and walking speed on kinematic characteristics of lower limb joints in older adults.Methods A total of 59 old people aged 60 and above participated in this study.The subjects were divided into non⁃frailty,pre⁃frailty,and frailty groups by the Kihon Checklist.The Xsens MVN motion capture inertial sensor was used to collect kinematic data from three groups of older adults during walking at slow,customary and fast speeds,and two⁃way repeated⁃measures analysis of variance was performed to determine the difference of kinematic characteristics between three groups of older adults walking under different frailty states and at different speeds.Results The age of frailty group was significantly older than that of non⁃frailty group(P<0.01).The maximum knee flexion angle and range of motion(ROM)of knee and ankle joints in frailty group were significantly smaller than those in non⁃frailty group and pre⁃frailty group(P<0.05),and the maximum plantar⁃flexion angle of the ankle joint in frailty group was significantly smaller than that in non⁃frailty group(P<0.05).With walking speed increasing,the single support time of frailty group increased significantly(P<0.05),the maximum hip flexion and extension angle,the maximum knee flexion angle,the maximum ankle plantar⁃flexion angle,the hip and ankle ROMs in three groups were significantly increased(P<0.05),the double support time,the maximum ankle dorsiflexion angle,the knee ROM were significantly decreased(P<0.05),and only the maximum hip extension angle,the hip ROM and the maximum knee flexion angle showed significant differences between slow speed and customary speed(P<0.05).Correlation analysis showed that the hip and knee ROMs were significantly positively correlated in pre⁃frailty group and frailty group at different walking speeds(P<0.01),the knee and ankle ROMs were significantly positively correlated in frailty group at customary and fast walking speeds(P<0.05).Conclusions With the change of frailty sta
作者
张红倩
王巍
代新年
王立端
许湘苹
ZHANG Hongqian;WANG Wei;DAI Xinnian;WANG Liduan;XU Xiangping(School of Rehabilitation Medicine,Weifang Medical University,Weifang 261053,Shandong,China;School of Basic Medicine,Weifang Medical University,Weifang 261053,Shandong,China;Rehabilitation Medical Center,Qingdao Fuwai Hospital,Qingdao 266034,Shandong,China)
出处
《医用生物力学》
CAS
CSCD
北大核心
2022年第5期832-838,共7页
Journal of Medical Biomechanics
