功能性踝关节不稳者的静态平衡能力

背景：目前国内对功能性踝关节不稳者平衡能力的研究较少,并且其平衡能力的缺失也可能是导致踝关节反复损伤的一个重要原因,对其研究能有效地降低损伤概率。 目的：分析功能性踝关节不稳者的静态平衡能力特征。 方法：选取10名男性患有单侧功能性踝关节不稳的受试者为实验组,匹配10名无踝关节伤病的受试者作为对照组。采用win-pod平衡功能检测系统对受试者进行双足和单足的静态平衡能力的测试,双足测试30 s,单足测试10 s,获得评价平衡能力各指标的数值。 结果与结论：双足测试时,无论是睁眼还是闭眼状态下,实验组的各项指标与对照组之间差异无显著性意义(P > 0.05),但双足站立时各指标的值明显都小于单足站立时各指标值,说明在双足站立时,功能性踝关节不稳者的静态平衡能力与正常人差异没有显著性意义,而双足的静态平衡能力比单足的要好。而在患侧足单足测试时,观察发现功能性踝关节不稳者的静态平衡能力略差于正常人,尤其在闭眼状态下。再通过组内X轴平均摆幅与Y 轴平均摆幅的对比发现,在维持平衡姿势的过程中,身体重心的摆动方向基本上以前后方向为主。     

中老年人静态平衡能力与认知、焦虑的相关性分析

目的探讨中老年人静态平衡能力与认知、焦虑之间的相关性。方法选择北京市海淀区中老年受试者57例,其中女性28例,男性29例;年龄50~70岁,平均年龄59.70岁;平均身高164.49 cm,平均体质量69.51 kg,平均体质量指数25.63 kg/m~2。受试对象分别在睁眼双足、睁眼单足、闭眼双足、闭眼单足4种站立状态下测试10 s平衡能力。用简单反应时(SRT)和空间记忆广度(VMT)测试受试者的认知功能。用贝克焦虑量表和状态-特质焦虑问卷进行焦虑状态评估。分析平衡能力与认知、焦虑之间的相关性。结果睁眼双足状态下,VMT与线形图总长度(L-SKG)有显著的相关性(r=-0.43,P=0.01)。睁眼单足状态下,SRT与轨迹长度(LFS)有显著的相关性(r=0.44,P=0.01),T-AI与x轴上摆动幅度(SM_x)的平均值呈正相关系(r=0.35,P=0.04)。闭眼双足状态下,VMT与L-SKG有显著的相关性(r=-0.42,P=0.01)。闭眼单足状态下SRT与y轴上摆动幅度(SMy)的平均值有相关性(r=-0.34,P=0.04),BAI与MD呈负相关关系(r=-0.33,P=0.04)。结论对于50~70岁健康中老年人来说,静态平衡能力与认知、焦虑之间有一定的相关性。     

肥胖儿童短时间静态平衡特征

目的 通过比较肥胖和非肥胖儿童6种站立情况下的压力中心（center of pressure, COP）偏移,研究肥胖儿童短时间静态平衡特征。方法 应用Footscan人体平衡系统获取47名肥胖儿童和50名非肥胖儿童分别双足、单足睁眼和闭眼站立10 s时COP摆动参数。结果 在双足闭眼站立时,肥胖儿童前后方向上的最大动摇径显著大于非肥胖儿童。在左足睁眼站立时,肥胖男孩COP摆动速度、左右方向上的最大动摇径显著小于非肥胖男孩,肥胖女孩左右方向上的最大动摇径显著大于非肥胖女孩。在左足闭眼站立时,男孩的COP摆动速度显著大于女孩。结论 短时间内,双足闭眼站立时,肥胖儿童前后方向上的平衡能力比非肥胖儿童差;肥胖对不同性别儿童的静态平衡影响不同。左足睁眼站立时,肥胖男孩平衡能力优于非肥胖男孩,肥胖女孩平衡能力差于非肥胖女孩;左足闭眼站立时,女孩的平衡能力优于男孩,其他情况下男女无显著差异。由于肥胖及性别因素会影响儿童短时静态平衡能力,建议对于不同性别肥胖儿童减重采取不同的运动模式。     

慢性非特异性腰痛患者的静态平衡和稳定极限

背景：平衡能力是影响慢性非特异性腰痛患者姿势控制的重要因素和引发跌倒、骨折、残疾的主要原因。现有研究大多仅从双足站位下分析比较,却鲜见在辨别优势腿和非优势腿带来混杂因素等影响的前提下去探讨单、双足静态平衡和稳定极限的特征报道。目的：分析慢性非特异性腰痛患者的静态平衡和稳定极限特征。方法：2020年4月至2021年12月在广州市番禺区中心医院实习生中招募慢性非特异性腰痛患者20例(腰痛组),健康者20例(健康组)。选择Pro-kin平衡仪,进行单/双足站立静态平衡和稳定极限测试,并记录相应测试的指标数值,例如：双足站立时的足底压力中心和稳定极限,以及单双足站立下的前后和左右摆动幅度标准差、前后和左右平均运动速度、运动面积、运动长度等。结果与结论：(1)睁/闭眼状态下,健康组的足底压力中心呈轴心处集中分布,腰痛组相较呈更大离散分布,并以非优势腿上分布为主;(2)比较双足站立静态平衡：睁眼状态下两组间无显著差异(P> 0.05),闭眼状态下腰痛组各静态平衡指标数值大于健康组(P <0.05);(3)比较单足站立静态平衡：腰痛组优势腿各静态平衡指标数值大于非优势腿(P <0....     

视觉因素对前交叉韧带重建患者足底压力中心的影响

目的 分析患者前交叉韧带重建(anterior cruciate ligament reconstruction, ACLR)术后早期与术后 1 年在视觉因素影响下足底压力中心面积(center of pressure area, COPA)和压力中心速度(center of pressure speed, COPS)等参数的变化。 方法 纳入 ACLR 患者 17 例,于术后早期和术后 1 年测试足底 COPA 和 COPS 等数据;匹配 17 例健康受试者作为对照组。 进行睁、闭眼不同视觉状态站立平衡测试,对各测量状态进行相关性分析。 结果 双足站立测试时,短期组 COPA 和 COPS 在睁眼和闭眼对比均有统计学差异(P<0. 05);长期组 COPS 睁眼和闭眼对比有统计学差异(P<0. 001)。 健侧站立时,各组间差异具有统计学意义(P<0. 05),伤侧站立时各组间差异无统计学意义(P>0. 05)。 健侧站立睁眼条件下,长期组 COPA 高于短期组和对照组,对照组 COPS 低于短期组和长期组(P<0. 01)。 健侧站立闭眼条件下,对照组 COPA 低于短期组和长期组,对照组 COPS 低于长期组(P<0. 01)。 双足睁眼与双足闭眼之间、双足睁眼与伤侧睁眼之间、健侧睁眼和伤侧睁眼之间、健侧闭眼和伤侧闭眼之间在 COPA 和COPS 上均呈正相关。 结论 通过对 ACLR 患者站立位压力中心相关数据的分析,发现视觉对姿势稳定控制有重要影响。 术后 1 年患者双足和单足站立时对比正常人稳定性波动较大,提示在临床上要加强术后长期训练以巩固康复效果,并对开展长期评估和制定精准训练计划具有一定的指导作用,以防止术后长时间功能退化和降低再次损伤的风险。     

支撑面稳定度在不同视觉输入条件下对轻度认知障碍老年人平衡能力的影响

背景：支撑面稳定度与视觉输入是影响静态平衡的重要因素，但目前对轻度认知障碍老年人平衡能力的研究大多集中在稳定的硬支撑面，对其在不同视觉输入条件下不稳定支撑面上的静态平衡控制尚未可知。目的：探讨轻度认知障碍老年人不同视觉输入条件下在软、硬支撑面上的静态平衡能力。方法：选择21名轻度认知障碍老年人和19名认知正常老年人为研究对象，使用Kistler三维测力台分别对其进行睁眼双脚硬支撑面站立、睁眼双脚软支撑面站立、闭眼双脚硬支撑面站立、闭眼双脚软支撑面站立4种测试，每次测试站立持续时间为30 s，采集2组人群不同视觉条件下在软、硬支撑面站立时的足底压力中心数据，并进行对比。结果与结论：(1)有视觉输入条件下，轻度认知障碍老年人在软、硬支撑面上足底压力中心的总摇摆路径(软支撑面：P=0.003)、内外总摇摆路径(软支撑面：P=0.001，硬支撑面：P <0.001)和95%椭圆置信面积(软支撑面：P=0.001，硬支撑面：P <0.001)显著高于认知正常老年人；(2)无视觉输入条件下，轻度认知障碍老年人在软支撑面上足底压力中心的均方根距离(P=0.014)、内外均方根距离(P=0...     

精神分裂症患者平衡功能特点

目的:探讨精神分裂症患者平衡功能特点及与临床症状的关系。方法:本研究采用横断面研究设计。选取35例符合《ICD-10精神与行为障碍分类临床描述与诊断要点》中精神分裂症诊断标准,目前药物治疗处于稳定期的门诊患者,及35例年龄、性别与病例组相匹配的健康对照。采用人体动静态姿势控制测试仪测试病例组和对照组的动静态平衡能力,包括感觉组织能力测试、单腿站立测试、走直线测试。用阳性与阴性症状量表(PANSS)、个人和社会表现量表(PSP)对病例组进行评定。结果:感觉组织能力测试中,病例组在6种状态下的平衡分及平均平衡分、视觉感觉分、前庭感觉分均低于对照组(均P0.05)。单腿站立测试中,病例组在左侧及右侧单腿站立闭眼情况晃动速度大于对照组,维持平衡持续时间短于对照组(均P0.05)。走直线测试中,病例组速度低于对照组(P0.05)。病例组平衡功能各项测试指标与PANSS各项评分及PSP评分未发现明显相关(r0.24,P0.05)。结论:本研究结果显示,精神分裂症患者动静态平衡功能明显差于正常对照。     

中国人重心平衡动摇检查的正常值测定

目的：检查正常人平衡能力的各项指标，以做为临床正常参考值与诊断标准。方法：使用日本阿尼玛公司生产的G-5500型重心平衡动摇仪，对140例不同年龄的正常男女进行多指标检测。结果：多数指标值在睁眼时小于闭眼，随年龄增长指标值趋小，随年龄老化指标值增大。20～29岁组指标值最小，与60～80岁组之间有显著差异（P＜0．05），但与10～19岁组无显著差异。重心动摇的轨迹形态以球心型居首位，其次为弥漫型，再次为前后型。结论：人体平衡的维持与视觉协调有重要关系；人体平衡能力随年龄老化逐渐衰退，尤以60岁以后明显。     

儿童下肢生物力学特征在视觉剥夺及双重任务时的变化

背景:人体平衡与控制有赖于内耳前庭系统、本体感受器及视觉系统的协调及中枢神经系统等共同配合才能完成,但人在视觉剥夺或双重认知任务时会引发神经控制与感觉统合的变化,进而改变下肢平衡控制能力及动作控制策略。目的:探讨儿童在不同视觉输入及执行不同认知任务时下阶梯时下肢生物力学特征的变化规律,从而揭示其作用机制,为预防及减少儿童下阶梯时的跌倒伤害提供一些有益参考。方法:共招募20名西南大学附属小学3-6年级的小学生志愿者,每个年级5名。运用运动学(JVC9800高速摄像机)、动力学(BIOFORCEN动态平衡训练评估系统)及肌电(JE-TB0810八通道肌电测试仪)等测试工具,同步采集受试者在不同视觉输入及执行不同认知任务时下阶梯动作的生物力学参数。结果与结论:(1)闭眼及双重任务下阶梯着阶瞬间的膝、踝关节角度显著大于睁眼及单一任务时的角度(P <0.05),但在身体重心处于最低瞬间时仅踝关节角度展现出闭眼及双重任务下显著大于睁眼及单一任务(P <0.05);(2)睁眼及双重任务下的压力中心前后方向位移均方根、左右方向位移均方根、摆动的轨迹总长及轨迹包络面积皆显著小于闭眼时(P &...     

长期太极拳和慢跑锻炼对侧向突发干扰下老年男性神经肌肉反应时和肌电达峰值时间影响

目的比较长期太极拳和慢跑锻炼对老年男性突发侧向姿势干扰下神经肌肉反应时和肌电达峰值时间的差异,探索提高老年男性侧向姿势挑战下神经肌肉反应和肌肉收缩效率的有效锻炼方式。方法利用足底水平干扰触发平台对年轻男性、无规律锻炼的老年男性、长期慢跑锻炼的老年男性、长期太极拳锻炼的老年男性进行突发侧向姿势干扰。表面肌电测试和分析系统用于收集腓骨长肌、胫骨前肌、臀中肌和竖脊肌的肌电信号。结果突发侧向干扰下,无规律锻炼老年男性腓骨长肌、胫骨前肌和臀中肌的神经肌肉反应时明显地慢于年轻男性,长期太极拳锻炼老年男性胫骨前肌和竖脊肌的神经肌肉反应明显地快于老年对照组;年轻男性腓骨长肌、胫骨前肌和臀中肌的收缩速度明显地快于3组老年人。结论长期太极拳锻炼可以使老年男性踝关节和躯干肌的神经肌肉反应更加迅速以应对侧向的姿势挑战,而对于提高老年男性肌肉收缩效率的效果不明显。     

Analysis of static and dynamic balance in healthy elderly practitioners of Tai Chi Chuan versus ballroom dancing

OBJECTIVE:

To determine whether Tai Chi Chuan or ballroom dancing promotes better performance with respect to postural balance, gait, and postural transfer among elderly people.

METHODS:

We evaluated 76 elderly individuals who were divided into two groups: the Tai Chi Chuan Group and the Dance Group. The subjects were tested using the NeuroCom Balance Master® force platform system with the following protocols: static balance tests (the Modified Clinical Tests of Sensory Interaction on Balance and Unilateral Stance) and dynamic balance tests (the Walk Across Test and Sit-to-stand Transfer Test).

RESULTS:

In the Modified Clinical Test of Sensory Interaction on Balance, the Tai Chi Chuan Group presented a lower sway velocity on a firm surface with open and closed eyes, as well as on a foam surface with closed eyes. In the Modified Clinical Test of Sensory Interaction on Unilateral Stance, the Tai Chi Chuan Group presented a lower sway velocity with open eyes, whereas the Dance Group presented a lower sway velocity with closed eyes. In the Walk Across Test, the Tai Chi Chuan Group presented faster walking speeds than those of the Dance Group. In the Sit-to-stand Transfer Test, the Tai Chi Chuan Group presented shorter transfer times from the sitting to the standing position, with less sway in the final standing position.

CONCLUSION:

The elderly individuals who practiced Tai Chi Chuan had better bilateral balance with eyes open on both types of surfaces compared with the Dance Group. The Dance Group had better unilateral postural balance with eyes closed. The Tai Chi Chuan Group had faster walking speeds, shorter transfer times, and better postural balance in the final standing position during the Sit-to-stand Test.     

体感游戏与有氧健身舞改善老年人健康体适能与平衡能力的效果对比研究

目的 研究体感游戏与有氧健身舞对老年人健康体适能与平衡能力改善的效果。方法 40名老年人随机分配为体感组或舞蹈组。分别进行12周中高强度的运动训练,干预前后进行健康体适能与动静态平衡能力指标测量。结果 与舞蹈组相比,体感组肺活量(P<0.05,d=0.85)、舒张压(P<0.05,d=-0.24)显著改善;静态平衡测试前后摇摆面积改善效果较好(d=-0.57),动态平衡测试后(d=-0.70)、右前方向上(d=-0.67)的运动控制能力改善效果较好。与体感组相比,舞蹈组闭眼单脚站立(d=-0.61),动态平衡测试左方向上(d=1.14)的运动控制能力改善效果较好。结论 体感游戏运动比有氧健身舞在提高老年人健康体适能、身体平衡能力方面更具优势,可作为老年人体育锻炼的重要方式,进一步提高健康水平,预防跌倒损伤现象发生。     

Effects of Tai Chi on pre-landing muscle response latency during stepping down while performing a concurrent mental task in older adults

To investigate whether elderly Tai Chi practitioners are better able to descend a step while performing a concurrent mental task than non-practitioners. The design includes cross-sectional study. The setting includes university-based rehabilitation center. The subjects were 16 young women, 29 elderly women, and 31 elderly women who had been practicing Tai Chi regularly for at least half a year. Pre-landing muscle response latencies in their tibialis anterior (TA) and medial gastrocnemius (MG) muscles were measured during stepping down (single task) and stepping down while performing a concurrent mental activity (dual tasking). The non-practitioners had earlier onset of muscle activity in the TA in preparation for landing than the other subjects. The response latency of the Tai Chi practitioners was not significantly different from that of the young controls. When the cognitive task was added, the pre-landing response in the TA was significantly altered in both elderly groups. Response was significantly delayed among the non-practitioners, but significantly earlier among the Tai Chi subjects. The average change in response latency was significantly greater in the non-Tai Chi group compared with the young subjects and the Tai Chi practitioners (p = 0.006). Such findings suggest that practicing Tai Chi helps the elderly maintain the same strategy as much as younger subjects during stepping down. Tai Chi practitioners seem to have a greater capacity to shift attention between mental and physical tasks than other elderly women.     

闭眼单脚站立方法在体质测试中的应用

背景：闭眼单脚站立是反应肌力与平衡能力的测试方法,在中国被作为评价成年人和老年人平衡能力的重要素质指标, 以往有大量的测试工作,但深入的研究报道较少。 目的：总结闭眼单脚站立方法的国内外研究现状,分析闭眼单脚站立在体质测试中存在的问题,并展望研究方向。 方法：通过计算机检索CNKI 和Elsevier数据库中相关文献,关键词为“闭眼单脚站立,平衡能力,体质测试”。对资料进行初审,选取符合研究要求的文献。 结果与结论：中国男性闭眼单脚站立评分标准高于女性;测试中出现部分老年人站立时间很短,很难评定其平衡能力;老年人平衡能力明显低于中、青年人,成年人与老年人采用相同的测试方法是否具有科学性;在简单平衡能力测试方法中,闭眼单脚站立的各项指标相关系数较低。鉴于以上原因,闭眼单脚站立作为国民体质平衡能力评价的测试方法尚待进一步研究。     

太极拳搂膝拗步动作的踝关节生物力学分析

本文旨在分析太极拳搂膝拗步中踝关节软骨和主要韧带的生物力学响应。采集1名太极拳练习者搂膝拗步及正常行走时的运动学和动力学数据,作为有限元分析的载荷和边界条件,计算关节接触应力和韧带受力。研究结果表明,搂膝拗步动作时踝关节接触应力普遍小于步行时接触应力。但是,在搂膝拗步动作中距腓前韧带、跟腓韧带和距腓后韧带的最大拉力分别为130、169、89 N,对应在步态中仅分别为57、119、48 N。因此,踝关节炎的患者可以适当练习太极拳,但是踝关节外侧韧带扭伤的练习者在搂膝拗步时应适当减小足踝动作幅度。     

Neuromuscular responses of elderly women to tasks of increasing complexity imposed during walking

Summary The purpose of this electromyographic study was to examine the effects of age on lower limb muscle response characteristics during reaction tasks of varying complexity when standing and walking. Ten young (mean age 22 years) and ten elderly (mean age 68 years) women participated in the investigation. No differences between groups were recorded in muscle activation times (MAT) in response to a visual light directional stimulus (LDS) during all standing reaction tasks. All the women required a longer period of time to respond to LDS when walking than standing. Completion of complex walking reaction tasks produced significantly longer (P<0.001) MAT in all subjects than the more simple walking reaction tasks. Delays in neuromuscular response were significantly greater (P<0.05) in the older women as the complexity of the walking reaction task increased. Movement behaviour of subjects during the walking reaction trials suggested that relatively greater demands were placed on the neuromuscular systems of the elderly during those tasks of greatest complexity. It was postulated that these movements were directed more at compensating for a reduced neuromuscular ability to control efficiently balance homeostasis. The results of this study provide further support for the hypothesis that delays in the central processing of information during reaction tasks may occur with ageing.     

搂膝拗步膝踝关节预激活与共收缩的表面肌电分析

目的 分析长期太极拳练习者进行搂膝拗步和正常行走时下肢膝、踝关节肌群预激活与共收缩的表面肌电（surface electromyography, sEMG）特征,探讨太极预防跌倒的神经肌肉控制策略。方法 采用Vicon运动捕捉系统、Kistler测力板和Noraxon表面肌电图系统同步采集搂膝拗步和正常行走时股直肌、股二头肌、胫骨前肌、外侧腓肠肌的sEMG信号和体位信息。通过股直肌和股二头肌、胫骨前肌和外侧腓肠肌两对肌肉的积分肌电分别计算膝、踝关节预激活和共收缩。结果 与正常行走相比,搂膝拗步在4个阶段的平均用时显著增加;搂膝拗步在4个阶段内时间百分比存在显著性差异;搂膝拗步膝关节共收缩水平和预激活水平降低,踝关节共收缩水平和预激活水平升高。结论 长期的太极拳练习可能使膝关节周围肌肉的激活水平提高,增强肌肉群之间的协同作用,以帮助稳定关节。研究结果为神经肌肉控制障碍疾病的康复评估和训练提供参考。     

太极运动对脑卒中患者运动、情绪及生活质量影响的系统评价和Meta分析

BACKGROUND: Tai Chi exercise can relax the affected muscle of patients, increase muscle flexibility and strength, promote normal movement patterns of stroke patients, inhibit abnormal posture and spasm patterns, improve patient motion control and balance function. OBJECTIVE: To systematically assess the effectiveness of Tai Chi on the movement, emotional disorder and quality of life in patients with stroke. METHODS: All extracted data from databases of PubMed, EMbase, Web of Science, EBSCO, Google Scholar, CNKI, VIP and Wangfang were obtained, which were the randomized controlled trials addressing the effects of Tai Chi on the movement, emotional disorder and quality of life in patients with stroke. The retrieval time was from database establishment to July 1st, 2015. According to the inclusion and exclusion criteria, two reviewers independently screened, extracted data and assessed the methodological quality of the included literatures. Then the meta-analysis was conducted using RevMan 5.3 software. RESULTS AND CONCLUSION: A total of 15 randomized controlled trials involving 1016 patients were included. The results of Meta-analysis suggested that: Tai Chi was superior to the conventional rehabilitation in improvement of balance function [mean difference (MD)=7.87, 95% confidence interval (CI) (4.56, 11.18), P < 0.000 01], gait speed [MD=0.27, 95%CI (0.04, 3.94), P=0.02], anxiety [standardized mean difference (SMD)=-0.47, 95%CI (-0.89, -0.04), P=0.03] and quality of life [SMD=0.65, 95%CI (0.10, 1.19), P=0.02], and there were statistical differences. But there was no statistically significant difference in the improvement of depression and functional walking ability. These findings indicate that Tai Chi is superior to the conventional rehabilitation in the improvement of balance function, gait speed, anxiety and quality of life. However, large-sample, high-quality randomized controlled trials are needed to provide more reliable evidence for the effect of Tai Chi in depression and functional walking ability.