老年人本体感觉、足底触觉和肌肉力量与姿势稳定性的关系

Relationship of proprioception,cutaneous sensitivity and strength to postural stability among older adults

目的探讨本体感觉、足底触觉以及肌肉力量对动态和静态姿势稳定性的影响。方法2020年6月至11月,共纳入164例老年人。本体感觉测试仪测试右侧膝关节屈伸和踝关节背屈/跖屈的本体感觉阈值;单丝法测量拇趾、第1和第5跖骨、足跟、足弓的足底触觉;等速肌力测试系统测量踝关节跖屈与背屈以及髋关节外展的肌肉力量。采用Berg平衡量表(BBS)评分和足底压力中心(COP)分别测量动态和静态姿势稳定性。采用因子分析和多元线性回归分析来探索每个因子与姿势稳定结果之间的关系。结果本体感觉与BBS评分(r=-0.449,P<0.001)、COP在内外侧方向的均方根(RMS)(r=0.254,P=0.004)明显相关。足底触觉与COP前后方向的RMS明显相关(r=0.281,P=0.002)。肌肉力量与BBS评分显著相关(r=0.493,P<0.001)。结论本体感觉和肌肉力量与动态姿势稳定性相关,本体感觉和足底触觉与静态姿势稳定性相关。

Objective To explore the impacts of proprioception,cutaneous sensitivity and strength on dynamic and static postural stability.Methods From June to November,2020,a total of 164 elderly participated in this study.Independent parameters included proprioception of knee flexion/extension and ankle dorsi/plantar flexion with proprioception measurement;the cutaneous sensitivity of great toe,first and fifth metatarsals,arch,and heel with monofilament;and strength of ankle dorsi/plantar flexion and hip abduction with isokinetic test.The Berg Balance Scale(BBS)and center of pressure(COP)-based postural stability tests were conducted to represent dynamic and static postural stability.Exploratory factor and multivariable linear regression analyses were used to explore the relationship of each generated factor to postural stability outcomes.Results Proprioception was significantly correlated to the score of BBS(r=-0.449,P<0.001)and the root mean square(RMS)of COP in mediolateral direction(r=0.254,P=0.004).Cutaneous sensitivity was significantly correlated to the RMS of COP in the anteroposterior direction(r=0.281,P=0.002).Strength was significantly correlated to the score of BBS(r=0.493,P<0.001).Conclusion Proprioception and strength are related to dynamic postural stability,while proprioception and cutaneous sensitivity are associated with static postural stability.