下肢蹲起蹬伸肌力衰退导致老年女性跌倒风险的研究  

Extension Force Deficiency of the Lower Extremity in Squat Contributing to Increased Fall Risk in the Female Elderly

作　　者：李宗涛[1] 赖勤[2] 孙晋海[3] 葛新发[4] 

机构地区：[1]曲阜师范大学,山东日照276826 [2]韦恩州立大学,MI,U.S.A48202 [3]山东大学体育学院,济南250014 [4]山东体育学院,济南250102

出　　处：《中国运动医学杂志》2017年第8期700-705,679,共7页Chinese Journal of Sports Medicine

基　　金：中国博士后科学基金资助项目(编号:2016M592153);教育部人文社会科学研究规划青年基金(编号:15YJC890018)

摘　　要：目的:探索下肢蹲起蹬伸肌力衰退与老年女性跌倒风险的关系,明确其中潜在的风险因素。方法:40名65岁以上社区居住老年女性,根据跌倒史调查和跌倒风险指数(fall risk index,FRI)分为跌倒组(24名)和无跌倒组(16名),通过测力台测试下肢蹲起蹬伸峰值肌力,并进行静态平衡、动态平衡和3米站立行走(3m-TUG)测试。结果:与无跌倒组相比,跌倒组快速蹲起时左腿蹬伸峰值肌力/体重较低,左、右腿蹬伸峰值肌力差值和左、右腿蹬伸峰值肌力/体重差值较高,差异具有统计学意义(P<0.05);相关分析表明老年女性动态平衡指数与左腿蹲起蹬伸峰值肌力/体重呈密切负相关,与左、右腿蹲起蹬伸峰值肌力差异呈显著正相关;3m-TUG时间与所有体重标准化的下肢蹲起蹬伸峰值肌力指标呈显著负相关,其中与左腿蹲起蹬伸峰值肌力/体重关系非常密切;静态平衡身体压力中心(center of presuure,COP)晃动速度矩与所有下肢蹲起蹬伸峰值肌力指标无关;下肢蹲起蹬伸峰值肌力/体重随年龄增长呈逐渐下降的趋势,左腿尤其明显,且两腿肌力差异逐渐变大。结论:蹲起蹬伸肌力测试是预测老年人跌倒风险的下肢肌力评价有效手段;左腿承负自身体重的蹲起蹬伸肌力衰退是老年女性动态平衡能力下降,跌倒风险升高的重要潜在因素;左、右腿蹲起蹬伸肌力不均衡,可能是下肢肌力衰退导致老年女性跌倒的又一潜在因素。Objectives To explore the relationship between the extension force deficiency of the low- er extremity and fall risks among the senior female, so as to reveal the potential factors contributing to fall. Methods Forty community-dwelling senior females aged 65 and older were assigned to the group of fallers or non-fallers according to their reported fall history and measured fall risk index （FRI）. Ex- tension force of the lower extremity was measured through 3-consecutive fast squats on a force plat- form. The time for 3m-time up and going （TUG）,as well as static and dynamic balance were also measured. Results Compared to the non-fallers,the fallers showed lower peak extension force per body weight （PEF/BW） of the left leg and larger asymmetry of the peak extension force per body weight be- tween the two legs in squats. Correlation analysis showed that FRI had a strong negative relation with PEF/BW of the left leg and a strong positive relation with extension force asymmetry/body weight. Also time for 3m-TUG was positively related to all the force variables standardized by the body weight ,espe- cially for the left leg. However, the analysis failed to find a relationship between the velocity of the center of pressure （COP） sway on static balance and any force variables. In addition,PEF/BW of the left leg decreased and force asymmetry/body weight between the two legs increased with aging. Conclu- sion Extension force measurement in squat is an effective way to assess the muscle strength deficiency related to the increased fall risk. The extension force of the lower extremity to support the body weight in squat had a strong relation to the function decline in the dynamic balance,which contributes greatly to fall risk. The extensive force asymmetry in squat between the two legs is another important fall risk factor for the senior females.

关 键 词：蹲起蹬伸肌力 跌倒风险 平衡控制 老年女性 

分 类 号：R87[医药卫生—运动医学]