膝、踝关节运动位置觉对老年女性跌倒风险的影响

Research on Fall Risk Related Kinesthetic Position Sense of Knee and Ankle of Female Elderly

探索老年女性膝、踝关节位置觉衰退,导致跌倒的风险因素及改善手段。方法:根据跌倒史调查对29名65岁及以上的老年女性分组,并进行膝和踝关节运动位置觉、跌倒风险指数和站立行走能力的定量测试与统计分析。结果:与未跌倒者相比,有跌倒史的老年女性,其跌倒风险指数明显较高,膝关节主动、被动和踝关节被动位置觉的准确性显著较低;膝关节主动、踝关节被动位置觉准确性和站立行走测试能力呈显著正相关;此外,关节目标角度的重复练习呈现改善膝关节动作准确性的趋势。结论:老年女性下肢关节本体感觉能力衰退,尤其膝关节主动和被动、以及踝关节被动位置觉下降,是导致跌倒的重要风险因素;积极的适量负荷活动和结果反馈的目标角度关节屈伸练习可能是改善老年人下肢关节运动位置觉的有效手段。

Objective：The present research was to investigate the risk factors related to falls in kinesthetic position sense（KPS） on the knee and ankle,and the related training methods for its improvement.Methods：29 female elderly（age：65 or above） were classified into fallers and non-fallers according to their fall histories,and their KPS in the knee and ankle,Fall Risk Index（FRI） and Time Up and Going（TUG） time were quantitatively measured and statistically analyzed.Results： Compared to non-fallers,female elderly with fall history showed higher fall risk index,lower accuracy in knee＇s active and passive KPS,and ankle＇s passive KPS as well.The accuracy of knee＇s active KPS and ankle＇s passive KPS had a significant positive relation with one＇s ability in TUG measurement.Furthermore,joint angle reproduction under the condition of knowledge of results（KR）tended to increase the accuracy of knee movement.Conclusion： The kinesthetic function deteriorations in the lower joints characterized with lower accuracy in knee＇s active and passive KPS and ankle＇s passive KPS are the important contributors to fall risk of female elderly.Active exercise with appropriate load and goal-oriented repetitive practice could be effective ways to improve the KPS in the lower extremity.