背向行走训练对老年人静态平衡能力及步态的影响

Effect of Backward-Walking on the Static Balance Ability and Gait of the Aged People

目的：研究老年人背向行走训练对其平衡能力及步态控制能力的影响。方法：30名健康老年女性分为实验组（18人）和对照组（12人）,实验组受试者进行为期12周、每周3次、每次40分钟、训练强度控制在心率110-120次/分之间的背向行走训练。运用红外自动示踪运动分析系统（Motion Analysis）、测力台（KistlerForce Plate）、DJ2L-Ⅱ型电子单脚站立测试仪对受试者实验前后静态平衡能力、正常行走的步态特征进行了测量。结果：（1）实验组训练后左、右侧单脚站立时间较训练前显著延长（P〈0.05）,较之对照组也明显延长;静态闭目站立时前后方向上的身体压力中心波动,实验组较之训练前和对照组均显著减小（P〈0.05）。（2）步态运动学测试：实验组训练后躯干最大扭转幅度明显增大（P〈0.05）、躯干左右晃动幅度明显减小（P〈0.05）;各项指标组间比较均未表现出统计学差异。实验组正常行走时摆动腿抬膝高度、脚前部离地高度均显著提高（P〈0.05）;组间比较,实验组左侧抬膝高度较对照组显著增加（P〈0.05）。（3）步态动力学测试：实验组训练后正常行走缓冲时相的最大地面约束力明显降低、蹬伸时相的最大地面约束力显著增加（P〈0.05）,最大制动力与推进力较实验前也显著增加（P〈0.05）。对照组的两次测试无明显变化,组间比较各项动力学指标未表现出统计学差异。结论：背向行走训练能够提高老年人的静态平衡与运动控制能力,提高老年人行走中的下肢蹬伸力量及缓冲控制能力,改善双侧步长的均衡性。

Objective To study the effect of backward-walking training on the balance ability and gait control of the aged people. Methods Thirty healthy aged females were divided into experimental group （E,n= 18）, and control group （C,n= 12）. The group E underwent backward-walking training three times a week for 12 weeks, 40 minutes per day with intensity of heart rate between 110 and 120. Their static balance ability and features of gait before and after the experiment were tested with infrared automatic tracing system of motion analysis （Motion Analysis）, force plate （Kistler force plate） and electronic apparatus for single-leg-standing test （DJ2L- Ⅱ ）. Results （1） As compared with those of pre-experiment and those of the group C, the single-leg （left or right） standing duration after training in the group E increased （P〈0.05） and the fluctuation of gravity center of static standing with close-eyes decreased （P〈0. 05）. （2） The truncal twist amplitude after training in group E increased obviously （P〈0.05）, but reduced in the left-right sways （P〈0.05）. The intergroup comparison showed no statistical difference. Meanwhile, the knee and front-foot lifting height during normally walking increased in the group E （P〈0.05）. The left-knee lifting height in group E also remarkably increased as compared with that in the group C. （3） The maximal constraint force of buffer phase during normal walking after training diminished significantly, while the maximal braking, propulsion force and the maximal force of extending phase increased in the group E （P〈0.05）. The data of the two testing in group C before and after experiment showed no statistical difference. Conclusion The backward-walking training could increase not only aged people＇ s static balance and motor control ability, but also their lower-limb extending force and their buffer controllability. The backward-walking training could also improve their symmetry of bilateral stride.