DOI QR코드

DOI QR Code

Evaluation of the Elderly Gait Stability Using the Center of Mass and Center of Pressure Inclination Angles

전, 후방 기울기각을 이용한 노인의 보행안정성 평가

  • Published : 2007.12.31

Abstract

The gait instability in the elderly has been associated with age-related deterioration in physical strength and reducing the potential for elderly falls requires regular exercise. In 2005, National Center for Injury Prevention and Control(NCIPC) reported that most elderly falls occur during activities in daily living(ADL). To better reveal biomechanic mechanisms underlying age-related degeneration in gait stability, and to enhance the assessment of falls risk, an accurate quantification of a person's balance maintenance during locomotion is needed. Instantaneous orientation of the line connecting COP and COM can characterize whole body position with respect to the supporting foot during gait and the angle between this line and the vertical line passing through the COP known as a good assessment to detect the elderly gait instability. Therefore the purpose of this study was to investigate a 6-month walking exercise effects in reducing elderly fall risk factors by using COP-COM inclination angles. Twenty-two community-dwelling elderly participated this study. The participants performed a walking exercise(3 times/week, 1 hour/visit) for 6 months. Laboratory kinematics during walking was assessed at months 0, 3 and 6. Significant increased in gait velocity was found among periods(p=.011, $1.25{\pm}.03$, $1.32{\pm}.03$, and $1.39{\pm}.04\;m/s$ in 0-, 3-, and 6-month, respectively). Also, significant differences in anterior and posteriror inclination angles were found among the periods(p<.05; posterior inclination angles: $12.8{\pm}2.2$, $11.0{\pm}2.9$, & $10.9{\pm}1.9$; anterior inclination angles: $13.7{\pm}1.7$, $14.6{\pm}3.2$, & $1.46{\pm}.21$ in 0month, 3month, & 6month, respectively). These findings provide evidence of significant reduced fall risk factors of community-living older adults associated with a systematic walking program.

Keywords

References

  1. 통계청(2007). 장래인구추계.
  2. 윤석훈(2007). 24주간 보행운동이 여성노인의 장애물 극복보행의 운동학적 변인에 미치는 영향. 한국체육학회지, 46(4), 485-493
  3. 황옥남(1998). 노인의 안전사고와 관련된 요인에 대한 조사연구. 성인간호학회지, 10(2), 337-352.
  4. Allum, J.H., Adkin, A.L., Carpenter, M.G., Held-Ziolkowaska, M., Honegger, F., & Pierchala, K. (2001). Trunk sway measures of postural stability during clinical balance tests: effects of a unilateral vestibular deficit. Gait and Posture, 14, 227-37. https://doi.org/10.1016/S0966-6362(01)00132-1
  5. Allum, J.H., Zamani, F., Adkin, A.L., & Ernst A. (2002). A differences between trunk sway characteristics on a foam support surface and on the Equitest ankle-sway-referenced support surface. Gait and Posture, 16, 264-70. https://doi.org/10.1016/S0966-6362(02)00011-5
  6. Charette, S., McEnvoy, L., Pyka, G., Snow-Harter, C., Guido, D., Wiswell, R.(1991). Muscle hypertrophy response to resistance training in older women. Journal of Applied Physiology, 70, 1912-6.
  7. Chou L.S., Kaufman, K.R., Hahn, M.E. & Brey, R.H. (2003). Medio-lateral motion of the center of mass during obstacle crossing distinguishes elderly individuals with imbalance. Gait and Posture, 18, 125-33.
  8. Duncan, P.W., Weiner, D.K., Chandler, J., & Studenstki, S. (1990). Functional reach: a new clinical measure of balance. Journal of Gerontology, 45, 192-7.
  9. Gross, M., Stevenson P., Charette S., Pyka, G., & Marcus R. (1998). Effect of muscle strength and movement speed on the biomechanics of rising from a chair in healthy elderly and young women. Gait and Posture, 8, 175- 85. https://doi.org/10.1016/S0966-6362(98)00033-2
  10. Hess, J.A. & Woollacott, M. (2005). Effect of high-intensity strength-training on functional measures of balance ability in balance-impaired older adults. Journal Of Manipulative And Physiological Therapeutics, 28, 582-590. https://doi.org/10.1016/j.jmpt.2005.08.013
  11. Hindmarsh, J.J., & Estes, E.H. (1989). Falls in older persons. Causes and interventions. Archives of Internal Medicine, 149, 2217-22. https://doi.org/10.1001/archinte.149.10.2217
  12. Hausdorff, J.M., Rios, D.A., & Edelber, H.K. (2001) Gait variability and fall risk in community -living older adults: a 1-year prospective study. Archives of Physical Medicine and Rehabilitation, 82(8), 1050–6. https://doi.org/10.1053/apmr.2001.24893
  13. Judge, J.O. Lindsey, C. Underwood, M. & Winsemius, D. (1993). Balance improvements in older women: effects of exercise training. Physical Therapy, 73, 254-262.
  14. Kaya, B.K., Krebs, D.E., & Riley, P.O. (1998). Dynamic stability in elders: momentum control in locomotor ADL. Journal of Gerontology, 53, 126-34
  15. Krebs, D.E., Gill-Body, K.M., Riley, P.O., & Parker, S.W. (1993). Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: preliminary report. Otolaryngology - Head and Neck Surgery, 109, 735-41.
  16. Krebs, D.E., McGibbon, C.A., & Goldvasser, D. (2001). Analysis of postural perturbation responses. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 9, 76-80. https://doi.org/10.1109/7333.918279
  17. Lee, H.J., & Chou, L.S. (2006). Detection of Gait Instability Using the Center of Mass and Center of Pressure Inclination Angles. Archives of physical medicine and rehabilitation, 87, 569-575. https://doi.org/10.1016/j.apmr.2005.11.033
  18. Leibson, C.L., Toteson, A,, Gabriel, S.E., Ransom, J.E., & Melton, J.L. (2002). Mortality, disability, and nursing home use for persons with and without hip fracture: a population-based study. Journal of the American Geriatrics Society, 50, 1644–50. https://doi.org/10.1046/j.1532-5415.2002.50455.x
  19. Liu-Ambrose, T., Khan, K. M., Eng, J.J., Janssen, P. A., Lord, S.R., & McKay, H.A. (2004). Resistance and agility training reduce fall risk in women aged 75 to 85 with low bone mass: a 6-month randomized, controlled trial. Journal of the American Geriatrics Society, 525, 657-665.
  20. MacRae, O., Lacourse, M., & Modavon, R. (1992). Physical performance measures that predict faller status in community-dwelling older adults. Journal of Orthopaedic & Sports Physical Theraphy, 16, 123-8. https://doi.org/10.2519/jospt.1992.16.3.123
  21. MacKinnon, C.D., & Winter, D.A. (1993). Control of whole body balance in the frontal plane during human walking. Journal of Biomechanics, 26, 633-44. https://doi.org/10.1016/0021-9290(93)90027-C
  22. NCIPC. (2004). Costs of Falls Among Older Adults. Retrieved March 1, 2006, from http://www.cdc.gov/ncipc/factsheets/fallco st.htm.
  23. NCIPC. (2005). Falls Among Older Adults: An Overview. Retrieved March 1, 2006, from http://www .cdc.gov/ncipc/factsheets/adul tfalls.htm.
  24. Overstall, P.W., Exton-Smith, A.N., Imms, F.J., & Johnson, A.L. (1977). Fall in the elderly related to postural imbalance. British Medical Journal, 1, 261-4. https://doi.org/10.1136/bmj.1.6056.261
  25. Ostrosky, K.M., VanSwearingen, J.M., Burdett, R.G., & Gee, Z. (1994). A comparison of gait characteristics in young and old subjects. Physical Therapy, 74, 637.
  26. Patla, A., & Rietdyk, S. (1993). Visual control of limb trajectory during locomotion: effect of obstacle height and width. Gait and Posture, 1, 45-60. https://doi.org/10.1016/0966-6362(93)90042-Y
  27. Rogers, M.E., Fernandeze, J.E., & Bohlken, R. M.(2001). Training to reduce postural sway and increase functional reach in the elderly. Journal of Occupational Rehabilitation, 11, 291-298. https://doi.org/10.1023/A:1013300725964
  28. Roman, W., Fleckenstein, J., Stray-Gundersen, J., Alway, S., Peshok, R., & Gonyea, W. (1993). Adaptations to the elbow flexors of elderly males after heavy-resistance training . Journal of Applied Physiology, 72, 750-4.
  29. Schlicht, J., Camaionea, C.N., & Owen, S.V. (2001). Effect of intense strength training on standing balance, walking speed, and Sit-to-Stand performance in older adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56, M281-M286. https://doi.org/10.1093/gerona/56.5.M281
  30. Tinetti, M., Doucette, J., Claus, E., & Marottoli, R. (1995). Risk factors for serious injury during falls by older persons in the community. Journal of the American Geriatrics Society, 43, 1214-21.
  31. Yoon, S.H. (2007). Biomechanical analysis of obstacle avoidance in walking with Telescope-Style poles in the elderly. Unpublished Doctoral Dissertation, Texas Woman's University.

Cited by

  1. Kinematic Difference between the Lower Limb Joints and the Lower Extremities Given Elderly Women's Walking through the Lower-limb Resistance Exercises vol.9, pp.12, 2009, https://doi.org/10.5392/JKCA.2009.9.12.364
  2. Changes of Walking Pattern for Young Adults dur ing Level Walking under Low Illumination vol.20, pp.4, 2010, https://doi.org/10.5103/KJSB.2010.20.4.381
  3. Evaluation of Gait Stability using Medio-Lateral Inclination Angle in Male Adults vol.20, pp.3, 2010, https://doi.org/10.5103/KJSB.2010.20.3.261