背景:衰老和糖尿病会损害老年人和糖尿病患者的平衡功能,并增加他们的跌倒风险。这项研究旨在评估静态站立过程中压力中心(CoP)的振动幅度,分析衰老和糖尿病对平衡控制的影响。
方法:这项横断面观察研究,比较20名健康年轻成年人(27.65±5.60岁)的平衡表现,16名健康的老年人(58.88±3.54岁)和15名糖尿病患者(58.33±5.33岁)在四个静态站立条件下在一个力板上:水平,前后(AP),左右斜面(AP上的5°角,左右方向,分别)。记录CoP随时间的轨迹坐标,并通过主成分分析进行分析,以获得95%置信度椭圆及其参数:角度,长轴和短轴长度,和面积。采用单因素方差分析(ANOVA)比较三组间的平衡指标,Brown-Forsythe试验或Kruskal-WallisH试验,取决于方差假设的正态和同质性。
结果:糖尿病组在水平面上的置信椭圆面积明显大于健康的年轻成年人(P=0.032)和在水平面上的健康老年人(P=0.036)。AP斜率(P=0.023),和右ML斜率(P=0.037)平面。三组之间的置信椭圆的长轴长度没有显着差异。在AP斜率上,糖尿病组的短轴长度明显长于健康的年轻成年人(P=0.039),左侧ML斜率(P=0.045)和右侧ML斜率(P=0.016)平面和健康老年人在AP斜率(P=0.007),左侧ML斜率(P=0.035)和右侧ML斜率(P=0.012)。
结论:与健康的年轻人和老年人相比,糖尿病患者的平衡控制下降,在静态站立过程中,身体摆动幅度主要在置信椭圆的短轴方向上增加,而长轴方向的摆动幅度没有明显变化。评估糖尿病患者的平衡功能可以帮助临床医生早期识别有跌倒风险的人群并进行早期干预,从而减少该人群中跌倒事件的发生。
BACKGROUND: Aging and diabetes can impair the balance function of the elderly and diabetic patients and increase their fall risk. This study aimed to assess the shaking amplitude of the center-of-pressure (CoP) during static standing, to analyze the effects of aging and diabetes on the balance control.
METHODS: This cross-sectional observational study, compared the balance performance of 20 healthy younger adults (27.65 ± 5.60 years), 16 healthy older adults (58.88 ± 3.54 years) and 15 diabetic patients (58.33 ± 5.33 years) in four static standing conditions on a force plate: horizontal, anteroposterior (AP), left and right slope planes (5° angles on AP, left and right directions, respectively). The trajectory coordinates of the CoP over time were recorded and analyzed by principal components analysis to obtain the 95% confidence ellipse and its parameters: angle, major and minor axes lengths, and area. The balance indicators were compared among the three groups using one-way analysis of variance (ANOVA), Brown-Forsythe test or Kruskal-Wallis H test, depending on the normality and homogeneity of variance assumptions.
RESULTS: The diabetic group had a significantly larger confidence ellipse area than the healthy younger adults on the horizontal plane (P = 0.032) and than the healthy older adults on the horizontal (P = 0.036), AP slope (P = 0.023), and right ML slope (P = 0.037) planes. There were no significant differences in the major axis length of the confidence ellipse among the three groups. The diabetic group had a significantly longer minor axis length than the healthy younger adults on the AP slope (P = 0.039), left ML slope (P = 0.045) and right ML slope (P = 0.016) planes and than the healthy older adults on the AP slope (P = 0.007), left ML slope (P = 0.035) and right ML slope (P = 0.012) planes.
CONCLUSIONS: The balance control of diabetic patients is decreased compared with healthy younger and older people, and the body swing amplitude increases mainly in the direction of minor axis of confidence ellipse during static standing, while the swing amplitude in the direction of the major axis has no significant change. Evaluating the balance function of diabetic patients can help clinicians identify people with fall risk early and intervene early, thereby reducing the occurrence of fall events in this population.