老年人步态稳定性、步态评价与跌倒风险的研究进展

doi:10.3969/j.issn.1006-9771.2019.07.010

《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (7): 793-796.doi: 10.3969/j.issn.1006-9771.2019.07.010

老年人步态稳定性、步态评价与跌倒风险的研究进展

张子华^1,2, 纪仲秋¹, 庞博¹, 李嘉慧¹, 赵盼超¹

1.北京师范大学体育与运动学院，北京市 100875
2.铜仁学院大健康学院，贵州铜仁市 554300

收稿日期:2019-02-05 修回日期:2019-03-26 出版日期:2019-07-25 发布日期:2019-07-23
通讯作者: 纪仲秋 E-mail:jizhongqiu61@bnu.edu.cn
作者简介:张子华(1983-)，男，汉族，辽宁锦州市人，博士研究生，副教授，主要研究方向：运动生物力学及老年平衡与跌倒。
基金资助:
1.北京城市系统工程研究中心项目(No. PXM2018_178215_000001)；2.贵州省科学技术厅联合基金项目(No. 2013黔科和LH7485)

Advance in Gait Stability, Gait Assessment and Fall Risk in Old Adults (review)

ZHANG Zi-hua^1,2, JI Zhong-qiu¹, PANG Bo¹, LI Jia-hui¹, ZHAO Pan-chao¹

1.College of P.E and Sports, Beijing Normal University, Beijing 100875, China
2.School of Sports and Health Science, Tongren University, Tongren, Guizhou 554300, China

Received:2019-02-05 Revised:2019-03-26 Published:2019-07-25 Online:2019-07-23
Contact: JI Zhong-qiu E-mail:jizhongqiu61@bnu.edu.cn
Supported by:
Supported by Foundation:Being Research Center of Urban System Engineering Project (No. PXM2018_178215_000001) and Guizhou Department of Science and Technology Association Fund (No. 2013_LH7485)

摘要/Abstract

摘要： 跌倒风险预测对提高老年人身心健康至关重要，步态和平衡失调被认为能反映老年人跌倒的风险。最大李雅普诺夫指数反映步态稳定性，但在临床环境中需更标准和被普遍接受的算法。步态评价指数间彼此相关，各有优势和局限性，步态偏差指数代表性、可靠性强，计算便利。步幅变异性可预示老年人跌倒的可能性。应综合几方面研究，提高老年人跌倒风险预测的准确性。

关键词: 跌倒, 老年人, 步态, 综述

Abstract: It is important to predict fall risk for the old adults. Gait and imbalance are generally considered as the greatest risk for falls. Largest Lypunov Exponent (LyE) reflects the gait stability, and it needs to improve in standardization and acceptable algorithms for clinical use. Gait indices are correlated with each other, with their own advantages and limitations. Gait Deviation Index is representative and reliable, and easy to calculate. Gait variability can predict the possibility of falls in the old adults. The combination of all the indices may improve the accuracy of falls risk prediction for the old adults.

Key words: fall, aged, gait, review

中图分类号:

R493

张子华, 纪仲秋, 庞博, 李嘉慧, 赵盼超. 老年人步态稳定性、步态评价与跌倒风险的研究进展[J]. 《中国康复理论与实践》, 2019, 25(7): 793-796.

ZHANG Zi-hua, JI Zhong-qiu, PANG Bo, LI Jia-hui, ZHAO Pan-chao. Advance in Gait Stability, Gait Assessment and Fall Risk in Old Adults (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(7): 793-796.

参考文献

1 LamontR M, MorrisM E, MenzH B, et al. Falls in people with Parkinson’s disease: a prospective comparison of community and home-based falls [J]. Gait Posture, 2017, 55(5): 62-67.
2 Wong-YuI S, MakM K. Task- and context-specific balance training program enhances dynamic balance and functional performance in Parkinsonian nonfallers: a randomized controlled trial with six-month follow-up [J]. Arch Phys Med Rehabil, 2015, 96(12): 2103-2111.
3 DahodwalaN, NwadiogbuC, FittsW, et al. Parkinsonian signs are a risk factor for falls [J]. Gait Posture, 2017, 55(1): 1-7.
4 Montero-OdassoM, Muir-HunterS W, Oteng-AmoakoA, et al. Donepezil improves gait performance in older adults with mild Alzheimer’s disease: a phase II clinical trial [J]. J Alzheimers Dis, 2015, 43(3): 193-199.
5 屈莎. 预测中老年人跌倒敏感指标和风险评价等级的研究[D]. 北京:北京体育大学, 2015.
6 韩佳琳. 老年人群跌倒现况、风险评估及康复干预的研究[D]. 青岛:青岛大学, 2017.
7 SparrowD, DeAngelisT R, HendronK, et al. Highly challenging balance program reduces fall rate in Parkinson disease [J]. J Neurol Phys Ther, 2016, 40(1): 24-30.
8 OsobaM Y, RaoA K, AgrawalS K, et al. Balance and gait in the elderly: a contemporary review [J]. Laryngoscope Investig Otolaryngol, 2019, 4(1): 143-153.
9 CampbellG, WolfeR A, KlemM L. Risk factors for falls in adult cancer survivors: an integrative review [J]. Rehabil Nurs, 2018, 43(4): 201-213.
10 GrimmerM, RienerR, WalshC J, et al. Mobility related physical and functional losses due to aging and disease－a motivation for lowerlimb exoskeletons [J]. J Neuroeng Rehabil, 2019, 16(1): 2.
11 KoS U, JeromeG J, SimonsickE M, et al. Differential associations between dual-task walking abilities and usual gait patterns in healthy older adults－results from the Baltimore Longitudinal Study of Aging [J]. Gait Posture, 2018, 63(6): 63-67.
12 AljehaniM, MadaraK, Snyder-MacklerL, et al. The contralateral knee may not be a valid control for biomechanical outcomes after unilateral total knee arthroplasty [J]. Gait Posture, 2019, 70(3): 179-184.
13 ParkS H. Tools for assessing fall risk in the elderly: a systematic review and meta-analysis [J]. Aging Clin Exp Res, 2018, 30(1): 1-16.
14 NakamuraT, MeguroK, SasakiH. Relationship between type [J]. Gerontology, 1996, 42(2): 108-113.
15 HouW H, KangC M, HoM H, et al. Evaluation of an inpatient fall risk screening tool to identify the most critical fall risk factors in inpatients [J]. J Clin Nurs, 2017, 26(5): 698-706.
16 VergheseJ, AmbroseA F, LiptonR B, et al. Neurological gait abnormalities and risk of falls in older adults [J]. J Neurol, 2010, 257(3): 392-398.
17 HoltzerR, VergheseJ, AllaliG. Neurological gait abnormalities moderate the functional brain signature of the posture first hypothesis [J]. Brain Topogr, 2016, 29(2): 334-343.
18 MehdizadehS. The largest Lyapunov exponent of gait in young and elderly individuals: a systematic review [J]. Gait Posture, 2018, 60(2): 241-250.
19 ElbazA, MorA, SegalG, et al. Lower extremity kinematic profile of gait of patients after ankle fracture: a case control study [J]. J Foot Ankle Surg, 2016, 55(5): 918-921.
20 KimM, LeeD. Development of an IMU based foot-ground contact detection (FGCD) algorithm [J]. Ergonomics, 2017, 60(3): 1-23.
21 MehdizadehS, SanjariM A. Effect of noise and filtering on largest Lyapunov exponent of time series associated with human walking [J]. J Biomech, 2017, 64(11): 236-239.
22 HamacherD, SinghN B, Van Die?nJ H, et al. Kinematic measures for assessing gait stability in elderly individuals: a systematic review [J]. J R Soc Interface, 2011, 65(8): 1682-1698.
23 BruijnS M, BregmanD J, MeijerO G, et al. Maximum Lyapunov exponents as predictors of global gait stability: a modelling approach [J]. Med Eng Phys, 2012, 34(4): 428-436.
24 RispensS M, PijnappelsM, van Die?nJ H, et al. A benchmark test of accuracy and precision in estimating dynamical systems characteristics from a time series [J]. J Biomech, 2014, 47(2): 470-475.
25 BeaudetteS M, HowarthS J, GrahamR B. On the use of a Euclidean norm function for the estimation of local dynamic stability from 3D kinematics using time-delayed Lyapunov analyses [J]. Med Eng Phys, 2016, 38(10): 1139-1145.
26 ToebesM J, HoozemansM J, FurrerR, et al. Local dynamic stability and variability of gait are associated with fall history in elderly subjects [J]. Gait Posture, 2012, 36(3): 527-531.
27 CignettiF, DeckerL M, StergiouN. Sensitivity of the Wolf’s and Rosenstein’s algorithms to evaluate local dynamic stability from small gait data sets [J]. Ann Biomed Eng, 2012, 40(5): 1122-1130.
28 SimsD T, BurdenA, PaytonC, et al. A quantitative description of self-selected walking in adults with achondroplasia using the gait profile score [J]. Gait Posture, 2019, 68(2): 150-154.
29 FukuchiC A, DuarteM. Gait profile score in able-bodied and post-stroke individuals adjusted for the effect of gait speed [J]. Gait Posture, 2019, 69(3): 40-45.
30 CorreaK P, DevetakG F, MartelloS K, et al. Reliability and minimum detectable change of the Gait Deviation Index (GDI) in post-stroke patients [J]. Gait Posture, 2017, 53(3): 29-34.
31 MatsunagaN, ItoT, NoritakeK, et al. Correlation between the Gait Deviation Index and skeletal muscle mass in children with spastic cerebral palsy [J]. J Phys Ther Sci, 2018, 30(9): 1176-1179
32 CimolinV, CondoluciC, CosticiP F, et al. A proposal for a kinetic summary measure: the Gait Kinetic Index [J]. Comput Methods Biomech Biomed Engin, 2018, 16(11): 1-6.
33 BarakY, WagenaarR C, HoltK G. Gait characteristics of elderly people with a history of falls: a dynamic approach [J]. Phys Ther, 2006, 86(11): 1501-1510.
34 SrygleyJ M, HermanT, GiladiN, et al. Self-report of missteps in older adults: a valid proxy of fall risk? [J]. Arch Phys Med Rehabil, 2009, 90(5): 786-792.
35 MansfiendA, MochizukiG, InnessE L, et al. Clinical correlates of between-limb synchronization of standing balance control and falls during inpatient stroke rehabilitation [J]. Neurorehabil Neural Repair, 2012, 26(6): 627-635.
36 Di RosaM, HausdorffJ M, StaraV, et al. Concurrent validation of an index to estimate fall risk in community dwelling seniors through a wireless sensor insole system: a pilot study [J]. Gait Posture, 2017, 55(5): 6-11.
37 DanielsenA, OlofsenH, BremdalB A. Increasing fall risk awareness using wearables: a fall risk awareness protocol [J]. J Biomed Inform, 2016, 63(5): 184-194.
38 WashabaughE P, KalyanaramanT, AdamczykP G, et al. Validity and repeatability of inertial measurement units for measuring gait parameters [J]. Gait Posture, 2017, 55(5): 87-93.

[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]	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.
[3]	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.
[4]	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.
[5]	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.
[6]	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.
[7]	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.
[8]	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.
[9]	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.
[10]	赵盼超, 纪仲秋, 姜桂萍, 文蕊香. 不同任务干扰对儿童早期步态特征和任务成本的影响[J]. 《中国康复理论与实践》, 2023, 29(9): 1072-1082.
[11]	胡晓诗, 张琦, 岳青, 梁艳华, 李晓松, 冯啊美, 张燕庆. 矫形弹力绷带对痉挛性偏瘫脑性瘫痪患儿步态对称性和步行能力的效果[J]. 《中国康复理论与实践》, 2023, 29(9): 1083-1089.
[12]	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.
[13]	张意彬, 吕杰, 喻洪流. 基于模糊逻辑算法的智能膝关节假肢步态相位识别[J]. 《中国康复理论与实践》, 2023, 29(8): 896-902.
[14]	蒋长好, 黄辰, 高晓妍, 戴元富, 赵国明. 神经反馈训练对老年人认知功能效果的系统综述[J]. 《中国康复理论与实践》, 2023, 29(8): 903-909.
[15]	魏晓微, 杨剑, 魏春艳, 贺启令. 学校环境下适应性体育课程促进智力与发展性残疾儿童心理运动发展的系统综述[J]. 《中国康复理论与实践》, 2023, 29(8): 910-918.

老年人步态稳定性、步态评价与跌倒风险的研究进展

Advance in Gait Stability, Gait Assessment and Fall Risk in Old Adults (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