背景:绊倒是老年人跌倒的主要原因之一,并且与最小脚趾间隙(MTC)有重要关联。执行交替(ADT)或并发(CDT)双任务活动时的MTC变异性可能是有用的步态参数,可将仅跌倒的人与非跌倒的老年人区分开。
目的:仅有一次跌倒的社区居住老年人的MTC变异性是否受到ADT和CDT的影响?
方法:将22名社区居住老年人在过去12个月中自我报告跌倒一次的老年人分配给跌倒组,将38名非跌倒组。步态数据由两个脚部惯性传感器(Physilog®5,GaitUp,洛桑,瑞士)。MTC平均大小和变异性,以及跨步变化,跨步时间和长度,下肢峰值角速度,和在MTC瞬间的脚向前线性速度,使用GaitUpAnalyzer软件(GaitUp,洛桑,瑞士)。统计分析在社会科学统计软件包(SPSS)中进行,V.22.0,使用广义混合线性模型,采用5%的alpha。
结论:未观察到交互作用;然而,下降的参与者降低了MTC变异性(标准偏差)[(平均差,MD=-0.099cm;置信区间,95CI=-0.183至-0.015)],不管条件如何。与单个任务(仅步态)相比,CDT降低了脚向前线速度的平均幅度(MD=-0.264m/s;95CI=-0.462至-0.067),峰值角速度(MD=-25.205度/秒;95CI=-45.507至-4.904),和步态速度(MD=-0.104m/s;95CI=-0.179至-0.029),不管是哪个群体。这些结果表明MTC变异性,不管条件如何,可能是一个有希望的步态参数,可以区分仅有的跌倒社区居住的老年人和非跌倒的老年人。
Tripping is one of the main causes of falls in older adults and has an important association with minimum toe clearance (MTC). MTC variability while performing alternating (ADT) or concurrent (CDT) dual-task activities may be a useful gait parameter to differentiate once-only fallers from non-
faller older adults.
Is the MTC variability influenced by ADT and CDT in once-only
faller community-dwelling older adults?
Twenty-two community-dwelling older adults with a self-report of up to one fall in the last 12 months were allocated to the fallers group and 38 to the non-fallers group. Gait data were collected by two foot-worn inertial sensors (Physilog® 5, GaitUp, Lausanne, Switzerland). MTC mean magnitude and variability, as well as the stride-to-stride variability, stride time and length, lower limb peak angular velocity, and foot forward linear speed at the MTC instant, were calculated across approximately 50 gait cycles for each participant and condition using the GaitUp Analyzer software (GaitUp, Lausanne, Switzerland). The statistical analyzes were performed in the Statistical Package for the Social Sciences (SPSS), v.22.0, using generalized mixed linear models, adopting an alpha of 5%.
No interaction effect was observed; however,
faller participants reduced the MTC variability (standard deviation) [(mean difference, MD = -0.099 cm; confidence interval, 95%CI = -0.183 to -0.015)], regardless of the condition. CDT compared to a single task (only gait) reduced the mean magnitude of the foot forward linear speed (MD=-0.264 m/s; 95%CI=-0.462 to -0.067), peak angular velocity (MD = -25.205 degrees/s; 95%CI = -45.507 to -4.904), and gait speed (MD = -0.104 m/s; 95%CI = -0.179 to -0.029), regardless of the group. These results suggest that MTC variability, regardless of condition, may be a promising gait parameter to differentiate once-only
faller community-dwelling older adults from non-fallers.