老年男性与青年男性静态平衡能力的差异性研究
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摘要
目的:探讨相同BMI、身高的老年男性与青年男性站立于硬地和软垫时,前庭、视觉和本体感觉在维持静态平衡中的作用,对提早预防老年男性跌倒提供一定参考依据。方法:使用Biodex平衡仪测试对老年男性43例和在校普通男性大学生40例进行姿势稳定度测试30s、睁眼硬地双脚站立30s、闭眼双脚硬地站立30s、睁眼双脚软垫站立30s、闭眼双脚软垫站立30s及跌倒风险测试。记录不同平衡感觉器官作用下静态平衡能力的变化,并分析前庭、视觉和本体感觉在维持平衡时的作用效果,并分析不同BMI、不同身高和不同年龄段老年人静态平衡能力的特点。结果:①个体在维持平衡的过程中不同平衡感受器作用的差异较大,老年男性与青年男性在不同测试条件中前庭觉作用变化相同,前庭觉在不同年龄段受试者中无明显差异,视觉和本体感觉的退化是引起老年男性平衡能力下降的主要原因。②T1和T2测试中,老年男性的本体感觉占比分别为:30.14%、38.06%,青年男性的本体感觉占比为23.28%、33.83%,老年男性本体感觉占比始终大于青年男性,说明在调节人体平衡过程中,本体感觉对老年男性的作用大于青年男性。③维持人体平衡主要因素是前庭觉,不同测试条件下最低占比58.40%。④老年男性更易发生前后跌倒,跌倒风险随年龄增长具有显著性差异(P<0.05)。⑤身高<165cm的老年男性表现出更好的平衡能力。老年男性年龄的增长引起视觉的退化会对T3、T4及跌倒风险有较大影响(P<0.05)。结论:前庭觉是影响人体平衡能力的重要因素,老年男性与青年男性在不同测试条件中前庭觉作用变化相同,前庭觉在不同年龄段受试者中无明显差异。影响老年男性平衡能力下降的原因为老年男性本体感觉和视觉的下降。老年男性更易发生前后跌倒,且发生可能性随年龄的增长而增加。身高越高的老年男性越容易发生跌倒风险。
Objective: To explore the effect of vestibular, vision and proprioceptive sensibility when the elderly male and young male keep their balance with same BMI,height standing on the firm and foam ground, respectively, and provide the basis for preventing the elderly falls.Method: 43 elderly male and 40 young male were tested for their 30 seconds stand with two feet using the Biodex balance measuring equipment under different circumstances, including open eyes and firm ground, close eyes and firm ground, open eyes and foam ground, close eyes and foam ground. Recording the static balance ability change under different balance sense and analysing the effects of vestibular, vision and proprioceptive sensibility in the process of balance, concluding the characters of elderly male balance with different BMI,height and age.Result: The different balance sense differs among individuals in the process of maintaining balance,and the vestibular function in the elderly men and the young men under the different test conditions showed the same change. The vestibular sensation had no significant statistical difference among the subjects of different ages. Visual is the main reason for the declined balance of in elderly men.The proprioceptive sense proportion in the T1 and T2 test for elderly men were 30.14% and 38.06%, for young men were 23.28% and 33.83%.The proportion of proprioception in elderly male was greater than in young male, indicating that proprioception weighs more in older male than young male in the regulation body balance process. The main factor to maintain the balance of the human body is the vestibule, the lowest scale under different test conditions, accounting for58.40%.The elderly males were more prone to fall back and forth, and the risk of falling had statistical increase with age(P<0.05). The elderly male less than 165 cm height showed a better balance. The age-related visual deterioration may have a greater impact on T3, T4 and the risk of falling(P<0.05).Conclusion: Vestibular sensation is the most important factor influencing the balance ability of the human body and has the same change under different test circumstances for both elderly and young man. The reason for the decline of the balance ability for the elderly men is the decline of the ontological sensation and vision of the elderly men. The elderly males were more prone to fall back and forth. For older men,the higher height suggested the higher fall risk.
Objective: To explore the effect of vestibular, vision and proprioceptive sensibility when the elderly male and young male keep their balance with same BMI,height standing on the firm and foam ground, respectively, and provide the basis for preventing the elderly falls.Method: 43 elderly male and 40 young male were tested for their 30 seconds stand with two feet using the Biodex balance measuring equipment under different circumstances, including open eyes and firm ground, close eyes and firm ground, open eyes and foam ground, close eyes and foam ground. Recording the static balance ability change under different balance sense and analysing the effects of vestibular, vision and proprioceptive sensibility in the process of balance, concluding the characters of elderly male balance with different BMI,height and age.Result: The different balance sense differs among individuals in the process of maintaining balance,and the vestibular function in the elderly men and the young men under the different test conditions showed the same change. The vestibular sensation had no significant statistical difference among the subjects of different ages. Visual is the main reason for the declined balance of in elderly men.The proprioceptive sense proportion in the T1 and T2 test for elderly men were 30.14% and 38.06%, for young men were 23.28% and 33.83%.The proportion of proprioception in elderly male was greater than in young male, indicating that proprioception weighs more in older male than young male in the regulation body balance process. The main factor to maintain the balance of the human body is the vestibule, the lowest scale under different test conditions, accounting for58.40%.The elderly males were more prone to fall back and forth, and the risk of falling had statistical increase with age(P<0.05). The elderly male less than 165 cm height showed a better balance. The age-related visual deterioration may have a greater impact on T3, T4 and the risk of falling(P<0.05).Conclusion: Vestibular sensation is the most important factor influencing the balance ability of the human body and has the same change under different test circumstances for both elderly and young man. The reason for the decline of the balance ability for the elderly men is the decline of the ontological sensation and vision of the elderly men. The elderly males were more prone to fall back and forth. For older men,the higher height suggested the higher fall risk.
引文
[1]王国祥,马胜.骨骼肌神经调控与表面肌电图技术应用[M].北京:北京体育大学出版社,2016.168—169.
[2] Borel L, Alescio LB.Posture and cognition in the elderly interaction and contribution to the rehabilitation strategies[J].Neurophysiologie Clinique, 2014, 44(1):95—107.
[3] Choy NL, Brauer S, Nitz J. Changes in postural stability in women aged 20 to 80 years[J]. Journal of Gerontology,2003, 58(A)525—530.
[4] Akhbari B, Takamjani IE, Salavati M, et al. A 4-week biodex stability exercise program improved ankle musculature onset, peak latency and balance measures in functionally unstable ankles[J]. Physical Therapy in Sport, 2007,8(3):117—129.
[5] Albertsen IM, Temprado JJ, Berton E,et al.Effect of haptic supplementation on postural control of younger and older adults in an unstable sitting task[J].Journal of Electromyography and Kinesiology, 2014, 24(03):572—578.
[6] Sarabon N, Rosker J.Ability of different balance tests to discriminate between young and elderly subjects[J].Measurement, 2015, 68(1):42—48.
[7] Scheicher ME, Fonseca LCS, Bortolloto TB,et al.A patellar bandage improves mobility but not static balance in elderly female fallers[J].Journal of Bodywork&Movement Therapies, 2017, 21(4):1—5.
[8] Hill MW, Duncan MJ,Oxford SW, et al.Effects of external loads on postural sway during quiet stance in adults aged20-80 years[J].Applied Ergonomics, 2018, 66:64—69.
[9] Melzer L, Benjuya, Kaolanski J, et al.Postural stability in the elderly:falls versus non-fallers[J].Aging Ageing, 2004, 33(6):602—607.
[10]谭思洁,徐冬青.肌肉适能评定理论与方法[M].北京:知识产权出版社,2016.025—027.
[11] Sherafat S, Salavati M, Ebrahimi Takamjani I, et al. Intersession and interssion reliability of postural control in participants with and without nonpecific low back pain using the biodex balance system[J].Journal of Manipulative and Physiological Therapeutics, 2013, 36(2):111—118.
[12] Almeida GPL, Monteiro IO, Marizeiro DF, et al. Y balance test has no correlation with the stability index of the Biodex Balance System[J].Musculoskeletal Science and Practice, 2017, 27(1):1—6.
[13]郭丽敏,迟放鲁.姿势平衡中的感觉相互作用[J].上海:上海医学,2003,26(4):258—261.
[14] Borel L, Alescio LB.Posture and cognition in the elderly interaction and contibution to the rehabition strategies[J].Clinical Neurophysiology, 2014, 44(1):95—107.
[15] Yeh JR, Lo MT, Chang FL,et al.Complexity of human postural control in subjects with unilateral perpheral vestibular.Hypofunction[J].Gait&Posture, 2014, 40(4):581—586.
[16] Thomas KWG, Kwan RLC, Lo SK, et al. A tailor-made exercise program for improving balance and mobility in older adults with type2 diabetes[J].Journal of Gerontological nursing, 2018,44(2):41—48.
[17] Masui T, Hasegawa Y, Matsuyama Y, et al.Gender differences in platform measures of balance in rural communitydwelling elders[J].Archives of Gerontology and Geriatrics,2005, 41(2):201—209.
[18] Ricci NA, de Faria Figueiredo Gon?alves D, Coimbra AM,et al. Sensory interaction on static balance:A comparison concerning the history of falls of community-dwelling elderly[J]. Geriatrics Gerontology, 2009, 9(2):165—171.
[19] Vitório R, Pieruccini-Faria F, Stella F, et al.Effects of obstacle height on obstacle crossing in mild Parkinson’s disease[J].Gait&Posture, 2010, 31(1):143—146.
[20]刘波,孔维佳,邹宇.应用海绵垫干扰本体觉分析正常人姿势平衡中的感觉整合作用[J].临床耳鼻咽喉头颈外科杂志,2007,21(4):162—165.
[21] Kunimune S, Okada S. The effects of object height and visual information on the control of obstacle crossing during locomotion in healthy older adults[J].Gait&Posture, 2017,55:126—130.
[22] Villegas GD,Parodi JF, Merino TA, et al.Calf circumference and risk of falls among Peruvian older adults[J].European Grriatric Medicine, 2016, 7(6):543—546.
[23] Pereira HM, de Campos TF, Santos MB, et al. Influence of knee position on the postural stability index registered by the Biodex Stability System[J]. Gait&Posture, 2008, 28(4):688—672.
[24] Wingert JR, Welder C, Foo P. Age-related hip propriception declines:effects on postural sway and dynamic balance[J]. Archives of Physical Medicine and Rehabitation, 2014,95:253—261.
[25] Relph N, Herrington L. The effects of knee direction, physical activity and age on knee joint position sense[J]. The Knee,2016,23:393—398.
[26] Miura K, Ishibashi Y, Tsuda E, et al. The effect of local and general fatigue on knee proprioception[J]. Arthroscopy,2004,20(4):14—18.
[27] Choi YK, Nam CW, Lee JH,et al. The effects of taping prior to PNF treatment on lower extremity proprioception of heiplegic patients[J].Journal of Physical Therapy Science,2013,25(9):1119—1122.
[2] Borel L, Alescio LB.Posture and cognition in the elderly interaction and contribution to the rehabilitation strategies[J].Neurophysiologie Clinique, 2014, 44(1):95—107.
[3] Choy NL, Brauer S, Nitz J. Changes in postural stability in women aged 20 to 80 years[J]. Journal of Gerontology,2003, 58(A)525—530.
[4] Akhbari B, Takamjani IE, Salavati M, et al. A 4-week biodex stability exercise program improved ankle musculature onset, peak latency and balance measures in functionally unstable ankles[J]. Physical Therapy in Sport, 2007,8(3):117—129.
[5] Albertsen IM, Temprado JJ, Berton E,et al.Effect of haptic supplementation on postural control of younger and older adults in an unstable sitting task[J].Journal of Electromyography and Kinesiology, 2014, 24(03):572—578.
[6] Sarabon N, Rosker J.Ability of different balance tests to discriminate between young and elderly subjects[J].Measurement, 2015, 68(1):42—48.
[7] Scheicher ME, Fonseca LCS, Bortolloto TB,et al.A patellar bandage improves mobility but not static balance in elderly female fallers[J].Journal of Bodywork&Movement Therapies, 2017, 21(4):1—5.
[8] Hill MW, Duncan MJ,Oxford SW, et al.Effects of external loads on postural sway during quiet stance in adults aged20-80 years[J].Applied Ergonomics, 2018, 66:64—69.
[9] Melzer L, Benjuya, Kaolanski J, et al.Postural stability in the elderly:falls versus non-fallers[J].Aging Ageing, 2004, 33(6):602—607.
[10]谭思洁,徐冬青.肌肉适能评定理论与方法[M].北京:知识产权出版社,2016.025—027.
[11] Sherafat S, Salavati M, Ebrahimi Takamjani I, et al. Intersession and interssion reliability of postural control in participants with and without nonpecific low back pain using the biodex balance system[J].Journal of Manipulative and Physiological Therapeutics, 2013, 36(2):111—118.
[12] Almeida GPL, Monteiro IO, Marizeiro DF, et al. Y balance test has no correlation with the stability index of the Biodex Balance System[J].Musculoskeletal Science and Practice, 2017, 27(1):1—6.
[13]郭丽敏,迟放鲁.姿势平衡中的感觉相互作用[J].上海:上海医学,2003,26(4):258—261.
[14] Borel L, Alescio LB.Posture and cognition in the elderly interaction and contibution to the rehabition strategies[J].Clinical Neurophysiology, 2014, 44(1):95—107.
[15] Yeh JR, Lo MT, Chang FL,et al.Complexity of human postural control in subjects with unilateral perpheral vestibular.Hypofunction[J].Gait&Posture, 2014, 40(4):581—586.
[16] Thomas KWG, Kwan RLC, Lo SK, et al. A tailor-made exercise program for improving balance and mobility in older adults with type2 diabetes[J].Journal of Gerontological nursing, 2018,44(2):41—48.
[17] Masui T, Hasegawa Y, Matsuyama Y, et al.Gender differences in platform measures of balance in rural communitydwelling elders[J].Archives of Gerontology and Geriatrics,2005, 41(2):201—209.
[18] Ricci NA, de Faria Figueiredo Gon?alves D, Coimbra AM,et al. Sensory interaction on static balance:A comparison concerning the history of falls of community-dwelling elderly[J]. Geriatrics Gerontology, 2009, 9(2):165—171.
[19] Vitório R, Pieruccini-Faria F, Stella F, et al.Effects of obstacle height on obstacle crossing in mild Parkinson’s disease[J].Gait&Posture, 2010, 31(1):143—146.
[20]刘波,孔维佳,邹宇.应用海绵垫干扰本体觉分析正常人姿势平衡中的感觉整合作用[J].临床耳鼻咽喉头颈外科杂志,2007,21(4):162—165.
[21] Kunimune S, Okada S. The effects of object height and visual information on the control of obstacle crossing during locomotion in healthy older adults[J].Gait&Posture, 2017,55:126—130.
[22] Villegas GD,Parodi JF, Merino TA, et al.Calf circumference and risk of falls among Peruvian older adults[J].European Grriatric Medicine, 2016, 7(6):543—546.
[23] Pereira HM, de Campos TF, Santos MB, et al. Influence of knee position on the postural stability index registered by the Biodex Stability System[J]. Gait&Posture, 2008, 28(4):688—672.
[24] Wingert JR, Welder C, Foo P. Age-related hip propriception declines:effects on postural sway and dynamic balance[J]. Archives of Physical Medicine and Rehabitation, 2014,95:253—261.
[25] Relph N, Herrington L. The effects of knee direction, physical activity and age on knee joint position sense[J]. The Knee,2016,23:393—398.
[26] Miura K, Ishibashi Y, Tsuda E, et al. The effect of local and general fatigue on knee proprioception[J]. Arthroscopy,2004,20(4):14—18.
[27] Choi YK, Nam CW, Lee JH,et al. The effects of taping prior to PNF treatment on lower extremity proprioception of heiplegic patients[J].Journal of Physical Therapy Science,2013,25(9):1119—1122.