健康與具跌倒風險高齡者執行座椅起身與坐下的動作分析

Abstract

目的：本研究的目的為比較健康與具跌倒風險高齡者執行起立和坐下動作的策略差異，以及起立與坐下動作的下肢運動學、動力學與肌肉活化特徵差異。方法：招募10名健康與10名過去一年內具跌倒經歷之男性高齡者。使用8台Vicon紅外線攝影機(200 Hz)、2塊Kistler測力板(1000 Hz)與6顆Delsys無線肌電(2000 Hz)同步收集動作的生物力學參數。參與者在高度等同小腿長、深度等同大腿長一半的木箱上，執行起立和坐下動作各3次。計算動作過程的執行時間；軀幹、髖、膝、踝關節矢狀面活動度；髖、膝關節伸直力矩峰值；質心左右及前後總晃動範圍，以及下肢6條肌肉：臀大肌、股二頭肌、股外側肌、股直肌、股內側肌、外側腓腸肌的肌肉活化。統計方法以獨立樣本t檢定進行組別分析，以及成對樣本t檢定分析動作的比較(α =.05)。結果：具跌倒風險高齡者在關節活動度、下肢力矩峰值、下肢肌肉活化以及質心左右晃動範圍皆顯著與健康高齡者有差異，並且起立和坐下動作在執行時間和上述參數皆有顯著差異。結論： 具跌倒風險高齡者在起立和坐下時，額狀面會有更多晃動，並採用屈曲更多軀幹、髖、膝關節，肌肉活化更高或週邊肌肉協同完成，以補償下肢力矩不足和身體的晃動。另外，起立和坐下不完全為單純相反方向的運動。Objective: The purpose of this study was to compare the differences in lower extremity kinematics and electromyogram between healthy and faller elderly when performing Sit-to-Stand (SitTS) and Stand-to-Sit (StandTS) movements. Methods: Ten healthy male elderly and ten male elderly who had fall history at least once in the past year were recruited for this study. Kinematics data were collected synchronously with 8 VICON cameras (200 Hz) and 2 Kistler force plates (1000 Hz). Participants were asked to perform SitTS and StandTS movements for 3 trials. Calculate the duration; sagittal range of motion (ROM) of lower extremities; lower extremities peak extension moment; center of mass (COM) total trajectory, and the 6 muscle activation of the lower extremities. Independent Sample t test and Paired Sample t test were used for statistical analysis. Alpha was set at 0.05. Result: When compare to healthy elderly, elderly fallers have significant differences in joint ROM, lower extremities peak extension moment, lower extremities muscle activation, and total COM sway distance, and there are significant differences in theduration of above parameters as well as SitTS and StandTS movements. Conclusion: Elderly fallers use more flexion of the trunk, hip and knee joints and higher muscle activation and coordination of peripheral muscles to compensate for insufficient lower extremities moment and body sway.