外周动脉疾病对步态运动学和动力学的影响大于年龄。

Q Medicine
Sara A Myers, Bryon C Applequist, Jessie M Huisinga, Iraklis I Pipinos, Jason M Johanning
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引用次数: 16

摘要

外周动脉疾病(PAD)产生异常步态和不成比例地影响老年人。目前的研究调查了年轻(65岁)受试者的PAD步态生物力学。该研究包括61例PAD患者(31例年轻人,年龄:57.4 +/- 5.3岁,30例老年人,年龄:71.9 +/- 5.2岁)和52例非残疾年龄匹配的对照组。PAD患者在无痛行走时进行测试,并与对照组进行比较。采用2 × 2方差分析比较关节运动学和动力学(扭矩)(组:PAD患者与对照组,年龄:年轻人与老年人)。与对照组相比,PAD患者在站立阶段的踝关节活动范围明显增加,髋关节活动范围明显减少,踝关节背屈肌扭矩明显减少。老年人的步态变化很大程度上受时间-距离参数的限制。PAD患者在无痛行走时关节运动学和动力学显著改变。通过先进的生物力学分析,有症状的PAD在不同年龄产生一致的活动障碍。当前研究最重要的发现是,基于先进的生物力学分析,在没有PAD和其他运动合并症的情况下,步态不会随着年龄的增长而显著下降。因此,之前的研究必须在人群中存在潜在PAD患者的背景下进行检查,未来的门诊研究必须将PAD作为评估老年人步态功能的混杂因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Gait kinematics and kinetics are affected more by peripheral arterial disease than by age.

Gait kinematics and kinetics are affected more by peripheral arterial disease than by age.

Gait kinematics and kinetics are affected more by peripheral arterial disease than by age.

Peripheral arterial disease (PAD) produces abnormal gait and disproportionately affects older individuals. The current study investigated PAD gait biomechanics in younger (<65 yr) and older (>/=65 yr) subjects. The study included 61 patients with PAD (31 younger, age: 57.4 +/- 5.3 yr, and 30 older, age: 71.9 +/- 5.2 yr) and 52 nondisabled age-matched control subjects. Patients with PAD were tested during pain-free walking and compared with control subjects. Joint kinematics and kinetics (torques) were compared using a 2 x 2 analysis of variance (groups: patients with PAD vs control subjects, age: younger vs older). Patients with PAD had significantly increased ankle and decreased hip range of motion during the stance phase as well as decreased ankle dorsiflexor torque compared with control subjects. Gait changes in older individuals are largely constrained to time-distance parameters. Joint kinematics and kinetics are significantly altered in patients with PAD during pain-free walking. Symptomatic PAD produces a consistent ambulatory deficit across ages definable by advanced biomechanical analysis. The most important finding of the current study is that gait, in the absence of PAD and other ambulatory comorbidities, does not decline significantly with age based on advanced biomechanical analysis. Therefore, previous studies must be examined in the context of patients with potential PAD being present in the population, and future ambulatory studies must include PAD as a confounding factor when assessing the gait function of elderly individuals.

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