人体动态稳定性控制理论在老年人防跌倒中的应用

doi:10.3969/j.issn.1006-9771.2017.11.004

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (11): 1254-1257.doi: 10.3969/j.issn.1006-9771.2017.11.004

人体动态稳定性控制理论在老年人防跌倒中的应用

徐欣¹, 温子星²

1.上海师范大学天华学院,上海市 201815;
2.上海杉达学院国际医学技术学院,上海市 201209

收稿日期:2017-06-04 出版日期:2017-11-25 发布日期:2017-12-10
通讯作者: 温子星(1991-),男,汉族,硕士,主要研究方向：运动生物力学,人体平衡控制机制。E-mail: wenzixing@hotmail.com。
作者简介:徐欣(1990-),女,汉族,山东泰安市人,硕士,助教,主要研究方向：人体运动学,康复学基础研究。
基金资助:
1; 上海高校教师产学研践习计划(No; 沪教委人〔2017〕32 号); 2; 上海杉达学院重点学科(护理学) (No; A-021304-17-001)

Concept of Dynamic Stability in Old People for Fall Prevention (review)

XU Xin¹, WEN Zi-xing²

1. Shanghai Normal University Tianhua College, Shanghai 201815, China;
2. Shanghai Sanda University School of International Medical Technology, Shanghai 201209, China

Received:2017-06-04 Published:2017-11-25 Online:2017-12-10
Contact: WEN Zi-xing. E-mail: wenzixing@hotmail.com

摘要/Abstract

摘要： 跌倒与人体稳定性密切相关,在老年人中,稳定性差是跌倒的主要原因。与静态稳定性控制理论相比,动态稳定性控制理论更强调以人体质心位置-速度的交互作用预测人体动态稳定边界,而非简单地以质心与支撑面的位置关系作为评价人体稳定性的指标。利用动态稳定性控制理论可更准确进行跌倒风险评估,在训练中强调应从整体水平促进人体稳定性的提高,促进中枢神经对平衡干扰刺激的适应性改变。但训练方案还需要进一步研究。

关键词: 动态稳定性, 跌倒, 姿势控制, 老年, 康复, 综述

Abstract: Fall down is related to stability of persons, especially in the aged. Poor stability usually results in fall down. Compared with the concept of static stability, dynamic stability theory emphasizes the velocity-position of center of mass (CoM) to predict feasible movements rather than CoM position only. Dynamic stability can help to estimate the risk of fall, and guide the exercise about fall prevention from improvements of adaption to regain balance. The training program still needs more studies.

Key words: dynamic stability, fall, postural control, aged, rehabilitation, review

中图分类号:

R592

徐欣, 温子星. 人体动态稳定性控制理论在老年人防跌倒中的应用[J]. 《中国康复理论与实践》, 2017, 23(11): 1254-1257.

XU Xin, WEN Zi-xing. Concept of Dynamic Stability in Old People for Fall Prevention (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2017, 23(11): 1254-1257.

参考文献

[1] 刘翠鲜,沈志祥. 老年跌倒的特点与预防策略[J]. 中国老年学, 2013, 33(2): 459-461.
[2] Pai YC, Rogers MW, Patton J, et al. Static versus dynamic predictions of protective stepping following waist-pull perturbations in young and older adults [J]. J Biomech, 1998, 31(12): 1111-1118.
[3] Takeuchi Y. Sagittal plane spinal mobility is associated with dynamic balance ability of community-dwelling elderly people [J]. J Phys Ther Sci, 2017, 29(1): 112-114.
[4] Campbell C, Kress J, Schroeder J, et al. The relationship between pedometer-determined ambulatory activity and balance variables within an older adult population [J]. Gerontol Geriatr Med, 2016, 2: 1-10.
[5] World Health Organization. WHO Global Report on Falls Prevention in Older Age [R]. World Health Organization (WHO), 2008.
[6] Zijlstra GA, van Haastregt JC, Van RE, et al. Interventions to reduce fear of falling in community-living older people: a systematic review [J]. J Am Geriatr Soc, 2007, 55(4): 603-615.
[7] Houry D, Florence C, Baldwin G, et al. The CDC Injury Center's response to the growing public health problem of falls among older adults [J]. Am J Lifestyle Med, 2016, 10(1): 74-77.
[8] Stenhagen M, Ekström H, Nordell E, et al. Accidental falls, health-related quality of life and life satisfaction: a prospective study of the general elderly population [J]. Arch Gerontol Geriatr, 2014, 58(1): 95-100.
[9] Thiem U, Klaaßenmielke R, Trampisch U, et al. Falls and EQ-5D rated quality of life in community-dwelling seniors with concurrent chronic diseases: a cross-sectional study [J]. Health Qual Life Outcomes, 2014, 12(1): 1-7.
[10] Pai YC. Movement termination and stability in standing [J]. Exerc Sport Sci Rev, 2003, 31(1): 19-25.
[11] Kuo AD. An optimal control model for analyzing human postural balance [J]. IEEE Trans Biomed Eng, 1995, 42(1): 87-101.
[12] Shumway-Cook A, Woollacott MH. Motor Control: Translating Research into Clinical Practice [M]. Williams & Wilkins, 1995: 161-194.
[13] Hof AL, Gazendam MG, Sinke WE. The condition for dynamic stability [J]. J Biomech, 2005, 38(1): 1-8.
[14] Pai YC, Patton J. Center of mass velocity-position predictions for balance control [J]. J Biomech, 1997, 30(4): 347-354.
[15] Pai YC, Maki BE, Iqbal K, et al. Thresholds for step initiation induced by support-surface translation: a dynamic center-of-mass model provides much better prediction than a static model [J]. J Biomech, 2000, 33(3): 387-392.
[16] 武明,季林红,金德闻,等. 基于能量的人体动力学平衡评价指标的仿真研究[J]. 清华大学学报(自然科学版), 2002, 42(2): 168-171.
[17] 李世明, Pai YC, Yang F, 等. 人体动态稳定性理论及防跌倒扰动性训练进展[J]. 体育科学, 2011, 31(4): 67-74.
[18] 渡部和彦, 王芸. 老年人的身体平衡能力与“外部干扰适应理论”[J]. 体育科学, 2014, 34(2): 54-59.
[19] Belen'kiĭ VE, Gurfinkel' VS, Pal'tsev EI. Control elements of voluntary movements [J]. Biofizika, 1967, 12(1): 135-141.
[20] 温子星,徐欣,潘景文,等. 预测性姿势调节对人体站立受扰后姿势响应影响的研究[J]. 中国康复医学杂志, 2016, 31(10): 1104-1110.
[21] Pavol MJ, Pai YC. Feedforward adaptations are used to compensate for a potential loss of balance [J]. Exp Brain Res, 2002, 145(4): 528-538.
[22] Horak FB, Nashner LM. Central programming of postural movements: adaptation to altered support-surface configurations [J]. J Neurophysiol, 1986, 55(6): 1369-1381.
[23] Maki BE, McIlroy WE. The role of limb movements in maintaining upright stance: the "change-in-support" strategy [J]. Phys Ther, 1997, 77(5): 488-507.
[24] Wang Y, Asaka T, Watanabe K. Multi-muscle synergies in elderly individuals: preparation to a step made under the self-paced and reaction time instructions [J]. Exp Brain Res, 2013, 226(4): 463-472.
[25] Kahle N, Tevald MA. Core muscle strengthening's improvement of balance performance in community-dwelling older adults: a pilot study [J]. J Aging Phys Act, 2014, 22(1): 65-73.
[26] Gonzalez AM, Mangine GT, Fragala MS, et al. Resistance training improves single leg stance performance in older adults [J]. Aging Clin Exp Res, 2014, 26(1): 89-92.
[27] Wang S, Liu X, Lee A, et al. Can recovery foot placement affect older adults' slip-fall severity? [J]. Ann Biomed Eng, 2017, 45(8): 1941-1948.
[28] Sawers A, Pai YC, Bhatt T, et al. Neuromuscular responses differ between slip-induced falls and recoveries in older adults [J]. J Neurophysiol, 2017, 117(2): 509-522.
[29] Arampatzis A, Peper A, Bierbaum S. Exercise of mechanisms for dynamic stability control increases stability performance in the elderly [J]. J Biomech, 2011, 44(1): 52-58.
[30] Parijat P, Lockhart TE. Effects of moveable platform training in preventing slip-induced falls in older adults [J]. Ann Biomed Eng, 2012, 40(5): 1111-1121.
[31] Pai YC, Bhatt T, Yang F, et al. Perturbation training can reduce community-dwelling older adults' annual fall risk: a randomized controlled trial [J]. J Gerontol A Biol Sci Med Sci, 2014, 69(12): 1586-1594.
[32] Pai YC, Yang F, Bhatt T, et al. Learning from laboratory-induced falling: long-term motor retention among older adults [J]. Age (Dordr), 2014, 36(3): 1367-1376.
[33] Liu X, Bhatt T, Wang S, et al. Retention of the "first-trial effect" in gait-slip among community-living older adults [J]. Geroscience, 2017, 39(1): 93-102.
[34] Lockhart TE. An integrated approach towards identifying age-related mechanisms of slip initiated falls [J]. J Electromyogr Kinesiol, 2008, 18(2): 205-217.
[35] Yang F, Bhatt T, Pai YC. Generalization of treadmill-slip training to prevent a fall following a sudden (novel) slip in over-ground walking [J]. J Biomech, 2013, 46(1): 63-69.
[36] Wang TY, Bhatt T, Yang F, et al. Generalization of motor adaptation to repeated-slip perturbation across tasks [J]. Neuroscience, 2011, 180(2): 85-95.
[37] Pai YC, Wening JD, Runtz EF, et al. Role of movement stability in reducing slip-related balance loss and falls among older adults [J]. J Neurophysiol, 2003, 90(2): 755-762.
[38] Pai YC. Role of cognition and priming in interlimb generalization of adaptive control of gait stability [J]. J Mot Behav, 2009, 41(6): 479-493.
[39] Bhatt T, Pai YC. Immediate and latent interlimb transfer of gait stability adaptation following repeated exposure to slips [J]. J Mot Behav, 2008, 40(5): 380-390.
[40] Bhatt T, Pai YC. Generalization of gait adaptation for fall prevention: from moveable platform to slippery floor [J]. J Neurophysiol, 2009, 101(2): 948-957.

人体动态稳定性控制理论在老年人防跌倒中的应用

Concept of Dynamic Stability in Old People for Fall Prevention (review)

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	邵伟婷, 雷江华. 反应中断再定向干预孤独症谱系障碍儿童刻板语言的效果：Scoping综述[J]. 《中国康复理论与实践》, 2024, 30(1): 10-20.
[2]	罗丽华, 王雨生, 李剑锋, 董继革. 术后早期综合康复对儿童青少年肱骨髁上骨折伴尺神经损伤的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 105-110.
[3]	王子豪, 李昕华, 蒋慧萍, 郭赛男, 梁秋曼, 史婷奇. 全膝关节置换术后短期膝关节功能及其影响因素[J]. 《中国康复理论与实践》, 2024, 30(1): 111-118.
[4]	周治宁, 周容, 肖燕文, 王博文, 吕娇娇, 刘宇. 多靶区经颅直流电刺激对健康成年人工作记忆-姿势控制双任务表现的影响[J]. 《中国康复理论与实践》, 2024, 30(1): 21-28.
[5]	王航宇, 葛可可, 范永红, 都丽露, 邹敏, 封磊. 基于ICD-11和ICF主动式音乐疗法改善认知障碍老年人认知功能的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 36-43.
[6]	闻嘉宁, 金秋艳, 张琦, 李杰, 司琦. 认知参与型身体活动对发展儿童青少年执行功能的效果：基于ICF的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 44-53.
[7]	葛可可, 范永红, 王航宇, 都丽露, 李长江, 邹敏. 失眠老年人正念干预健康效益的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 54-60.
[8]	陈珺雯, 陈谦, 陈程, 李淑月, 刘玲玲, 吴存书, 龚翔, 鲁俊, 许光旭. 改良八段锦身体活动对脑卒中患者心肺功能、运动功能和日常生活活动能力的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 74-80.
[9]	张婧雅, 邹敏, 孙宏伟, 孙昌隆, 朱峻同. 听障儿童青少年焦虑或抑郁情绪心理干预效果的系统综述[J]. 《中国康复理论与实践》, 2023, 29(9): 1004-1011.
[10]	王俊宇, 杨永, 袁逊, 谢婷, 庄洁. 高强度间歇训练对健康儿童青少年执行功能效果的系统综述[J]. 《中国康复理论与实践》, 2023, 29(9): 1012-1020.
[11]	魏晓微, 杨剑, 魏春艳. 特殊教育学校孤独症谱系障碍儿童参与适应性瑜伽活动的心理与行为效益的系统综述[J]. 《中国康复理论与实践》, 2023, 29(9): 1021-1028.
[12]	杨亚茹, 杨剑. 基于WHO-HPS架构学校身体活动相关健康服务及其健康效益：系统综述的系统综述[J]. 《中国康复理论与实践》, 2023, 29(9): 1040-1047.
[13]	史佳伟, 李凌宇, 杨浩杰, 王琴潞, 邹海欧. 预康复对全膝关节置换术后患者的有效性：系统综述的系统综述[J]. 《中国康复理论与实践》, 2023, 29(9): 1057-1064.
[14]	蔡华年, 费思先, 张忆晨, 孙青, 郭帅, 宋韬. 基于导纳控制的双边康复机器人运动辅助分析[J]. 《中国康复理论与实践》, 2023, 29(9): 1104-1109.
[15]	杨雅楠, 穆丽萍, 邢凤梅, 薛新宏, 王晓光, 陶徉聿, 孙竹梅, 张小丽. 基于计划行为理论的干预对肌少症老年人肌肉衰减状况及平衡能力的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 869-874.