老年人手提重物时不同停止方式对步态稳定性的影响
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天津市科技支撑计划项目(14ZCDSY00010),天津市应用基础与前沿技术研究计划(16JCZDJC35900)


Influences of Different Stop Modes on Gait Stability of the Elderly Carrying Heavy Objects
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    摘要:

    目的 分析老年人手提重物及不同步态停止方式时下肢肌肉活动特性及相应关节运动参数的变化,探究手部负重及步态停止方式对老年人步态稳定性以及身体平衡的影响。方法 以0 kg、双手各2.5 kg和右手5 kg的负重方式,分别在急停和有计划停止条件下,采集双侧下肢踝、膝、髋关节角度以及表面肌电信号。结果 在不同的负重方式下,双侧下肢踝、髋关节角度均有显著差异(P<0.05),而膝关节角度无显著变化,不同停止方式显著影响各关节角度的变化(P<0.001);制动腿胫骨前肌、股外侧肌、股二头肌平均肌电均表现为急停时肌肉活动水平更高。结论 老年人为应对负重和急停带来的不稳定性,下肢会产生相应的平衡机制。急停时,制动腿胫骨前肌需要更高的肌肉活动水平来控制踝关节的跖屈角度,从而减小踝关节波动幅度。而单手负重会增大制动腿和尾随腿肌肉做功的差异,导致侧向的不稳定性。

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    Objective To analyze characteristics of muscle activity and changes of corresponding kinematic parameters of the lower limbs for the elderly carrying heavy objects under synchronous stop modes, and explore the effects of hand weight-bearing and stop modes on gait stability and body balance of the elderly. Methods The ankle, knee, hip joint angles and surface electromyography (EMG) signals of bilateral lower limbs were collected under the condition of emergency stop and planned stop by loading 0 kg, 2.5 kg on both hands and 5 kg on right hand. Results Under different weight-bearing modes, the ankle and hip angles of bilateral lower limbs were significantly different (P<0.05), while the knee angles did not change significantly, and different stop modes significantly affected the angle changes in each joint (P <0.001); the average EMG of tibia anterior muscle, lateral femoral muscle, and biceps femoris in braking leg showed higher muscle activity during emergency stop. Conclusions In order to cope with the instability caused by weight-bearing and emergency stop, the elderly will have a corresponding balance mechanism in the lower limbs. During an emergency stop, braking the tibialis anterior muscle of the leg requires a higher muscle activity level to control flexion angle of the ankle joint, thereby reducing amplitude of the ankle joint fluctuation. The single-handed load increases the muscle performance differences between the braking leg and trailing leg, resulting in the lateral instability.

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王新亭,吴永红,王鸥,徐聃弟,王琪.老年人手提重物时不同停止方式对步态稳定性的影响[J].医用生物力学,2021,36(2):297-303

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  • 收稿日期:2020-02-24
  • 最后修改日期:2020-04-12
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  • 在线发布日期: 2021-04-25
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