摘要
目的 探究有跌倒史老年人在不同步速下跨越障碍物时,下肢关节力矩峰值特征、下肢关节贡献率和代偿机制。方法 招募健康老年人和有跌倒史老年人各30名,使用红外Qualisys高速动作捕捉系统和Kistler三维测力台,采集老年人在3种步速(1.05、1.41、1.74 m/s)下跨越高度为其身高15%障碍物时的生物力学数据,通过Visual 3D软件进行建模与分析。结果 随着步速增加,伸膝力矩峰值、踝跖屈力矩峰值以及健康组屈髋力矩双峰值均呈显著性增加(P<0.05);与健康组相比,跌倒组屈髋力矩双峰值均显著小于健康组(P<0.05);在中速行走过程中,跌倒组左侧髋关节贡献率显著高于健康组(P=0.025),而踝关节贡献率则显著低于健康组(P=0.044);支撑腿和跨越腿触地时刻前后方向动态稳度随着步速增加而增加(P=0.007,P=0.002)。结论 与健康老年人相比,有跌倒史老年人力矩峰值、地面反作用力峰值以及前后方向动态稳度较低;随着步速增加,老年人下肢力学参数和动态稳度显著增加,行走稳定性得到改善;相较于健康老年人,有跌倒史老年人通常更依赖髋关节的动作贡献,并减少踝关节的参与度。建议将快速步行锻炼纳入老年人日常防跌倒锻炼计划,并结合髋、膝、踝关节进行协同训练。
Objective To explore the peak moment characteristics of lower limb joints,as well as the contribution rate and compensation mechanism of lower limb joints when older adults with a history of falls cross obstacles at different paces.Methods Thirty healthy older adults and 30 eldely fallers were recruited.The Qualisys infrared high-speed motion capture system and the Kistler three-dimensional force platform were used to collect the biomechanical data of the older adults when they crossed an obstacle with a height of 15%of their height at three walking speeds(1.05,1.41,1.74 m/s).The data were then modeled and analyzed using Visual 3D software.Results As walking speed increased,the peak knee extension moment,peak ankle plantar flexion moment,and double peak value of hip flexion moment in healthy group all increased significantly(P<0.05).Compared with healthy group,the double peak values of hip flexion moment in faller group were significantly smaller than those in healthy group(P<0.05).During walking at moderate speed,the contribution rate of the left hip joint in faller group was significantly higher than that of healthy group(P=0.025),while the contribution rate of the ankle joint was significantly lower(P=0.044).The margin of stability in the anterior-posterior direction at the moment of ground contact of the stance leg and the stride leg increased with walking speed(P=0.007,P=0.002).Conclusions Compared with healthy older adults,the elderly fallers have lower peak torque,peak ground reaction force,and dynamic stability in the anterior-posterior direction.As the walking speed increases,the mechanical parameters and the margin of stability of older adults increase significantly,and walking stability is improved.Compared with healthy older adults,elderly fallers usually rely more on the contribution of hip joint movements and reduce the involvement of ankle joints.It is recommended to incorporate fast walking exercises into the daily fall prevention exercise program for older adults,with combination of coordinated training of the hip,knee,and ankle joints.
作者
董杨梅
张庆来
李瑞宁
孟站领
周雯馨
许创业
宋凤莹
DONG Yangmei;ZHANG Qinglai;LI Ruining;MENG Zhanling;ZHOU Wenxin;XU Chuangye;SONG Fengying(School of Management,Zhengzhou University,Zhengzhou 450053,China;Henan Institute of Physical Education,Zhengzhou 450040,China;School of Physical Education(Main Campus),Zhengzhou University,Zhengzhou 450053,China)
出处
《医用生物力学》
北大核心
2025年第4期971-979,共9页
Journal of Medical Biomechanics
基金
国家社科基金项目(22BTY074)。
关键词
跌倒
老年人
下肢关节
功能补偿
力矩峰值
功率峰值
地面反作用力
fall
old adult
lower limb joints
functional compensation
peak torque
peak power
ground reaction force
