研究生: |
林銀秋 Yin Chiu, Lin |
---|---|
論文名稱: |
由重心動量分析老年人前傾動作之平衡 Based on Forward Leaning Momentum of Center of Mass to Analyze the Limit of Stability for the Elderly Age |
指導教授: |
林德嘉
Lin, Der-Chia 黃長福 Huang, Chen-Fu |
學位類別: |
碩士 Master |
系所名稱: |
體育學系 Department of Physical Education |
論文出版年: | 2004 |
畢業學年度: | 92 |
語文別: | 中文 |
論文頁數: | 83 |
中文關鍵詞: | 重心線動量 、重心角動量 、老人 、前傾動作 、穩定限度 |
英文關鍵詞: | linear momentum of center of mass, angular momentum of center of mass, elderly, forward leaning, limit of stability |
論文種類: | 學術論文 |
相關次數: | 點閱:282 下載:29 |
分享至: |
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老人跌倒的盛行率極高,且影響其健康及獨立生活極大,平衡能力較差為造成老
人跌倒的主要因素之一,對平衡控制的退化及如何量化平衡狀態是許多學者與醫護人員希望了解的主題。有越來越多學者以動量研究平衡,但利用動量探討老人穩定限度研究仍付諸闕如,吾人有必要針對此參數詳加研究。本研究目的有三:(一)前傾動作時,老人與年輕人於不同支撐底面積下,重心線動量是否顯著不同。(二)在不同的支撐底面積下,老人與年輕人在前傾動作中,重心角動量是否顯著不同。(三)重心線動量及重心角動量與壓力中心穩定限度參數及重心穩定限度參數間的相關性為何。本研究受試者為十名社區老人(年齡: 70.4 士3.6 歲,身高: 158.9 士7.6 公分,體重: 60.4 士7.8 公斤)及十名年輕人(年齡:25.6 士3.4 歲,身高:167.7 士8.6 公分,體重: 55.8 士8.1 公斤),男女各半。受試者站立於測力板(AMTI, 600Hz)上,隨機進行自然站立與雙腳併攏的前傾動作十次。並以五台紅外線攝影機(VICON, 120Hz)同步紀錄受試者之動作,利用所得之資料,以LabVIEW 6.1 版軟體撰寫程式計算重心線動量與角動量,並以SPSS 軟體進行混合設計二因子變異數分析及Pearson’s 積差相關考驗(α=.05)。本研究結果:(一) 前傾的動態平衡能力上,老人與年輕人於不同支撐底面積下,重心線動量顯著不同。(二) 在不同的支撐底面積下,老人與年輕人在前傾動作中,重心角動量亦顯著不同。(三)重心線動量及重心角動量與壓力中心及重心極限參數顯著相關。在未來相關動態極限的研究,可利用動量此參數做深入探討,此外,本研究亦可作為老人平衡訓練之參考。
There is high prevalence for the elderly falling and it would affect their
health and independent activities very much. The poor balance is one of the reasons for the elderly falling. Many researchers and clinicians are very much concern about the mechanism of the balance system and how to use the knowledge with respect to the mechanism to improve patients’performance of balance. There are more and more studies related to the momentum for analyzing the performance of balance, however, referred the momentum of center of mass to limit of stability for elderly are still not much to be found.There were three purposes for this study. First, to determine whether the linear momentum of the center of mass significant different between the elderly and the young people or not for forward leaning in two different base of support. Second, to determine whether the angular momentum of the center of mass significant different between the elderly and the young people or not for forward
leaning in two different base of support. Third, to determine the relationship between the linear momentum and the angular momentum of the center of mass, and the parameters for the limit of stability.
The subjects were 10 elderly and 10 young healthy persons. They were asked to standing on the AMTI force plate (600Hz), then measurements were taken repeatedly for forward leaning in natural stance and in Romberg stance randomly, with a short break of 10 minutes between sessions. Five ultrahigh resolution infrared cameras (VICON, 120Hz) were synchronized to collect the 3-D data. Linear momentum and angular momentum were calculated by
LabVIEW 6.1. GLM for repeated measurement and the Pearson product moment correlation were obtained by SPSS 10.0 for window to test the selected variables at .05 significant level.
We concluded that the linear momentum of the center of mass were
significantly different between the elderly and the young people for forward leaning in two different base of support. For forward leaning in two different support base, the angular momentum of the center of mass were significantly different between the elderly and the young people. And there were significant relationship between the linear momentum and the angular momentum of the center of mass, and the parameters for the limit of stability. The linear momentum and angular momentum of the center of mass would be provided as
good parameters to analyze the limit of stability for the elderly forward leaning.
參考文獻
一、中文部分
林佩欣、曾旭民、鄭寶釵、黃美涓、鄧復旦。(1999)。太極拳對老年人感覺運動功能的影響。物理治療, 24(4) , 231-241。
林桑伊、林瑞模。(1999)。中國人不同年齡與性別在站立姿勢控制之差
異。物理治療,24(3) ,174-182。
林桑伊、蔡子同、林倩如、李毅信。(2001) 。老年頭暈病人的站立平衡。物理治療,26(2) ,68-76。
徐慧娟,吳淑瓊,江東亮。(1996)。跌倒對社區老人健康生活品質的
影響。中華衛誌,15(6), 525-532。
莊麗玲、胡名霞、黃靄雯、陳治中、林祁岷、簡登偉。(1998)。站立穩定限度之年齡效應。物理治療, 23(2) ,73-82。
黃子庭,廖秀珠。(1993)。台北市北投區社區居家老人跌倒的情形及
其相關因素之探討。公共衛生,20(3) ,234-245。
陳俊煌、柴惠敏、施偉立。(2001)。不同伸取方向對動態穩定限度的影
響。中華民國物理治療學會第四十三次學術研討會。9 月22 日,
台北。(中華物療誌26: s29)
張梅蘭、王子娟、劉作仁、李淑美、梁家豐、徐道昌。(1998)。老人跌倒者與非跌倒者平衡能力之定量評估。物理治療,23(4) ,255-268。
傅麗蘭。平衡運動訓練前後老年人之平衡表現及步寬的改變。(1998) 。物理治療, 23(2) , 98-105。
二、英文部分
Balon, R.W., Aorona, S., Jacobson, K.M., et al. (1998). A prospective study of posturography in normal older people, Journal of the American Geriatrics Socitey, 46, 438-443.
Bonar, S.K., Tinetti, M.E., Speechley, M., Cooney, L.M. (1990). Factors
associated with short- versus long-term skilled nursing facility
placement among community-living hip fracture patients. Journal of the
American Geriatrics Socitey, 38, 1139-1144.
Cech, D.J., Martin, S.T. (2002). Functional movement development across the
life span (2nd ed.). Philadelphia: W.B. Saunders Company.
Cheng, P.T., Wu, S.H., Liaw, M.Y., Wong, A.M., Tang, F.T. (2001). Symmetrical
body-weight distribution training in stroke patients and its effect on fall
prevention. Archives of Physical Medicine & Rehabilitation, 82(12),
1650-1654.
Cherng, R.J., Su, F.C., Chen, J.J., Kuan, T.S. (1999). Performance of static
standing balance in children with spastic diplegic cerebral palsy under
altered sensory environments. American Journal of Physical Medicine
& Rehabilitation, 78(4), 336-343.
70
Collins, J.J., De Luca, C.J. (1993). Open-loop and close-loop control of
pressure: a random-walk analysis of center-of-pressure trajectories.
Experimental Brain Research, 95, 308-318.
Commissaris, D.A.C.M, & Toussaint, H.M. (1997). Load knowledge affects
lower-back loading and control of balance in lifting tasks. Ergonomics,
40(5), 559-575.
Commissaris, D.A.C.M., Toussaint, H.M., Hirschfeld, H. (2001). Anticipatory
postural adjustments in a bimanual, whole-body lifting task seem not
only aimed at minimizing anterior-posterior center of mass
displacements. Gait and Posture, 14, 44-55.
Day, B.L., Steiger, M.J., Thompson, P.D., Marsden, C.D. (1993). Effect of
vision and stance width on human body motion when standing:
implications for afferent control of lateral sway. Journal of Physiology,
469, 479-499.
Dietz, V., Gollhofer, A., Kleiber, M., Trippel, M. (1992). Regulation of
bipedal stance: dependency on load receptors. Experimental Brain
Research, 89, 229-231.
Downton, J. H. (1993). Falls in the elderly. Great Britain: British Library
Cataloguing in Publication Data.
Ferdjallah, M., Harris, G.F., Smith, P., Wertsch, J.J. (2002). Analysis of postural
control synergies during quiet standing in healthy children and children
with cerebral palsy. Clinical Biomechanics, 17(3), 203-210.
71
Fleiss JL. (1986). Reliability of measurement. In. Fleiss JL. The Design and
Analysis of Clinical Experiments. Canada: John Wiley & Sons Inc; p. 1-
32.
Gantchev, N., Viallet, F., Aurenty, R., Massion, J. (1996). Impairment of
posturo-kinetic co-ordination during initiation of forward oriented
stepping movements in parkinsonian patients. Electroencephalography
& Clinical Neurophysiology, 101(2), 110-120.
Gantchev, N., Viallet, F., Aurenty, R., Massion, J. (2000). Forward versus
backward oriented stepping movements in Parkinsonian patients. Motor
Control, 4(4), 453-468.
Gatev, P., Thomas, S., Kepple, T., Hallett, M. (1999). Feedforward ankle
strategy of balance during quiet stance in adults. Journal of Physiology,
514 ( Pt 3), 915-928.
Gill, J., Allum, J.H.J., Carpenter, M.G., et al. (2001). Trunk sway measures of
postural stability during clinical balance tests: effects of age. Journal of
Gerontology Series A- Biological Sciences & Medical Sciences, 56(7),
M438-M447.
Grimby, G. (1995). Muscle performance and structure in the elderly as
studied cross-sectionally and longitudinally. Journal of
Gerontology Series A- Biological Sciences & Medical Sciences,
50(A), 17-22.
Goldie, P.A., Evans, O.M., Bach, T.M. (1992). Steadiness in one-legged
72
stance: development of a reliable force-platform testing
procedure. Archives of Physical Medicine and Rehabilitation, 73,
348-354.
Goldie, P.A., Bach, T.M., Evans, O.M. (1989). Force platform measures for
evaluation postural control: reliability and validity. Archives of Physical
Medicine and Rehabilitation, 70, 510-517.
Hasan, S.S., Lichtenstein, M.J., Shiavi, R.G. (1990). Effect of loss of balance on
biomechanics platform measure of sway: influence of stance and a
method for adjustment. Journal of Biomechanics, 23(8), 783-789.
Hay, J.G. (1974). Moment of inertia of the human body. In Committee on
Kinsiology of the Physical Education Division. Kinesiology IV.
American Association for Health Physical Education, and Recreation.
Washingtion, D.C. U.S.A. p43-52.
Heiss, D.G., Shields, R.K., Yack, H.J. (2001). Anticipatory control of vertical
lifting force and momentum during the squat lift with expected and
unexpected loads. Journal of Orthopaedic & Sports Physical Therapy,
31(12), 708-723.
Horak, F.B., Shupert, C.L., Mirka, A.(1989). Components of postural
dyscontrol in the elderly: a review. Neurobiology of aging, 10, 727-738.
Jadelis, K., Miller, M.E., Ettinger, W.H Jr., Messier, S.P. (2001). Strength,
balance, and the modifying effects of obesity and knee pain: results
from the Observational Arthritis Study in Seniors (oasis). Journal of
73
the American Geriatrics Society, 49(7), 884-891.
Jensen, J.L., Brown, L.A., Woollacott, M.H. (2001). Compensatory stepping:
the biomechanics of a preferred response among older adults.
Experimental Aging Research, 27, 361-376.
Jian, Y., Winter, D.A., Gilchrist, I.L. (1993). Trajectory of the body COG and
COP during initiation and termination of gait. Gait and Posture, 1, 9-22.
Kalveram, KT. (1991). Pattern generating and reflex-like processes controlling
aiming movements in the presence of inertia, damping and gravity. A
theoretical note. Biological Cybernetics, 64(5), 413-419.
Kaya, B.K., Krebs, D.E., Riley, P.O. (1998). Dynamic stability in elders:
momentum control in locomotor ADL. Journal of Gerontology
Series A- Biological Sciences & Medical Sciences 53(2), M126-M134.
King, M.B., Judge, J.O., Wolfson, L. (1994). Functional base of support
decreases with age. Journal of Gerontology Series A- Biological
Sciences & Medical Sciences 49(6), M258-M263.
Kuo, A.D. (1995). An optimal control model for analyzing human postural
balance. IEEE Transaction on Bio-medical Engineering, 42, 87-101.
Lauk, M., Chow, C.C., Lipsitz. L.A., Mitchell, S.L., Collins, J.J. (1999).
Assessing muscle stiffness from quiet stance in Parkinson's disease.
Muscle & Nerve, 22(5), 635-639.
Lee, T.H., Lee, Y.H. (2003). An investigation of stability limits while holding a
load. Ergonomics. 46(5), 446-454.
74
Maki, B.E, & McIlroy, W.E. (1997). The role of limb movements in
maintaining upright stance: the “change-in-support” strategy. Physical
Therapy, 77(5), 489-507.
Maki, B.E., Holliday, P.J., Topper, A.K. (1994). A prospective study of
postural balance and risk of falling in an ambulatory and independent
elderly populations. Journal of Gerontology Series A- Biological
Sciences & Medical Sciences, 52(1), M72-M94.
Martin, M., Shinberg, M., Kuchibhatla, M., Ray, L., Carollo, J.J., Schenkman,
M.L. (2002). Gait initiation in community-dwelling adults with
Parkinson disease: comparison with older and younger adults without the
disease. Physical Therapy, 82(6), 566-577.
Melzer, I., Benjuya, N., Kaplanski, J. (2001). Age-related changes of postural
control: effect of cognitive tasks. Gerontology, 47(4), 189-194.
Mihelj, M., Matjacic, Z., Bajd, T. (2000). Postural activity of constrained
subject in response to disturbance in sagittal plane. Gait & Posture.
12(2), 94-104.
Milczarek, J.J., Kirby, R.L., Harrison, E.R., MacLeod, D.A. (1993). Standard
and four-footed canes: their effect on the standing balance of patients
with hemiparesis. Archives of Physical Medicine & Rehabilitation, 74(3),
281-285.
Morgenthal, A.P. (2001). The age-related challenges of posture and balance. In
J.D. Bougie, A.P. Morgenthal, (Eds.). The aging body: conservative
75
management of common neuromusculoskeletal conditions, U.S.: Mc-
Graw Hill Companies Inc.
Moxley, S.D., Krebs, D.E., Harris, B.A. (1999). Quadriceps muscle strength
and dynamic stability in elderly persons. Gait & Posture, 10(1),10-20.
Niam, S., Cheung, W., Sullivan, P.E., Kent, S., Gu, X. (1999). Balance and
physical impairments after stroke. Archives of Physical Medicine &
Rehabilitation, 80(10), 1227-1233.
Nikfekr, E., Kerr, K., Attfield, S., Playford, D.E. (2002). Trunk movement
in Parkinson’s disease during rising from seated position.
Movement Disorders, 17(2), 274-282.
Owings, T.M., Pavol, M.J., Foley, K.T., Grabiner, M.D. (2000). Measures of
postural stability are not predictors of recovery from large postural
disturbances in healthy older adults. Journal of the American Geriatrics
Society, 48, 42-50.
Pai, Y.C., Maki, B.E., Iqbal, K., et al. (2000). Thresholds for step initiation
induced by support-surface translation: a dynamic center-of-mass
model provides much better prediction than a static model. Journal of
Biomechanics, 33, 387-392.
Pai, Y.C.& Patton, J. (1997). Center of mass velocity-position predictions
for balance control. Journal of Biomechanics, 30(4), 347-354.
Pai, Y.C.& Rogers, M.W. (1991). Segmental contributions to total body
momentum in sit-to-stand. Medicine Sciences in Sports and Exercise,
76
23(2), 225-230.
Pai, Y.C.& Rogers, M.W. (1990). Control of body mass transfer as a
function of speed of ascent in sit-to-stand. Medicine Sciences in
Sports and Exercise, 22(30), 378-384.
Panzer, V.P., Bandinelli, S., Hallett, M.(1995). Biomechanical assessment
of quiet standing and changes associated with aging. Archives of
Physical Medicine and Rehabilitation, 76, 151-157.
Patton, J.L., Lee, W.A., Pai, Y.C. (2000). Relative stability improves with
experience in a dynamic standing task. Experimental Brain Research,
135(1), 117-126.
Patton, J.L., Pai, Y., Lee, W.A. (1999). Evaluation of a model that determines
the stability limits of dynamic balance. Gait & Posture, 9(1), 38-49.
Pescatello, L.S., DiPietro, L. (1993). Physical activity in older adults: an
overview of health benefits. Sports Medicine, 15, 353-364.
Poor, G., Atkinson, E.J., O'Fallon, W.M., Melton, L.J 3rd. (1995). Predictors of
hip fractures in elderly men. Journal of Bone & Mineral Research,
10(12), 1900-1997.
Puniello, M.S., McGibbon, C.A., Krebs DE. (2000). Lifting characteristics of
functionally limited elders. Journal of Rehabilitation Research &
Development, 37(3),341-52.
Reisman, D.S., Scholz, J.P., Schoner, G. (2002). Coordination underlying the
control of whole body momentum during sit-to-stand. Gait and Posture,
77
15, 45-55.
Robinovitch, S.N., Heller, B., Lui, A., Cortez, J. (2002). Effect of strength and
speed of torque development on balance recovery with the ankle strategy.
Journal of Neurophysiology, 88(2),613-620.
Runge, C.F., Shupert, C.L., Horak, F.B., Zajac, F.E. (1999). Ankle and hip
postural strategies defined by joint torques. Gait & Posture, 10(2), 161-
170.
Scarborough, D.M., Krebs, D.E., Harris, B.A. (1999). Quadriceps muscle
strength and dynamic stability in elderly persons. Gait and Posture, 10,
10-20.
Schultz, A.B. (1992). Mobility impairment in the elderly: challenges for
biomechanics research. Journal of Biomechanics, 25(5), 519-528.
Shumway-Cook, A., Anson, D., Haller, S. (1988). Postural sway biofeedback:
its effect on reestablishing stance stability in hemiplegic patients.
Archives of Physical Medicine & Rehabilitation, 69(6), 395-400.
Stapley, P., Pozzo, T., Grishin, A. (1998). The role of anticipatory postural
adjustments during whole body forward reaching movements.
Neuroreport, 9(3), 395-401.
Testa, M., Martin, L., Debu, B. (1999). Effects of the type of holds and
movement amplitude on postural control associated with a climbing task.
Gait and Posture, 9, 57-64.
Testa, M., Martin, L., Debu, B. (2003). 3D analysis of posturo-kinetic
78
coordination associated with a climbing task in children and teenagers.
Neuroscience Letters, 336, 45-49.
Thelen, D.G., Wojcik, L.A., Schultz, A.B., et al. (1997). Age differences
in using a rapid step to regain balance during a forward fall.
Journal of Gerontology Series A- Biological Sciences & Medical
Sciences, 52(1), M8-M13.
Thyssen, H.H., Brynskov, J., Jansen, E.C., Munster-Swendsen, J. (1982).
Normal ranges and reproducibility for the quantitative Romberg’s test.
Acta neurologica Scandinavica, 66, 100-104.
Tinetti, M.E., Baker, D.I., Garrett, P.A., Gottschalk, M., Koch, M.L., Horwitz,
R.I. (1993). Yale ficsit: risk factor abatement strategy for fall
prevention. Journal of the American Geriatrics Socitey, 41, 315-320.
Tinetti, M.E., Baker, D.I., McAvay, G., Claus, E.B., Garrett, P., Gottschalk, M.,
et al. (1994). A multifactorial intervention to reduce the risk of falling
among elderly people living in the community. The New England
Journal of Medicine, 331(13), 821-827.
Tinetti, M.E., McAvay, G., Claus, E. (1996). Dose multiple risk factor
reduction explain the reduction in fall rate in the Yale FICSIT trial?
American Journal of Epidemiology, 144(4), 389-399.
Tinetti, M.E., Doucette, J., Claus, E., Marottoli, R. (2000). Risk factors for
serious injury during falls by older persons in the community. Journal of
the American Geriatrics Society, 43(11), 1412-1421.
79
van Wegen, E.E., van Emmerik, R.E., Wagenaar, R.C., Ellis, T. (2001).
Stability boundaries and lateral postural control in parkinson's disease.
Motor Control, 5(3), 254-269.
Walker, C., Brouwer, B.J., Culham, E.G. (2000). Use of visual feedback in
retraining balance following acute stroke. Physical Therapy, 80(9), 886-
895.
Winter, D.A. (1995). Anatomy, biomechanics and control of balance
during standing and walking. Canada: Canadian Cataloguing in
Publication Data.
Winter, D.A. (1990). Biomechanics and motor control of human movement (2nd
ed). Canada: John Wiley & Sons, Inc.
Wojcik, L.A., Thelen, D.G., Schultz, A.B., Ashton-Miller, J.A,, Alexander, N.B.
(1999). Age and gender differences in single-step recovery from a
forward fall. Journal of Gerontology Series A- Biological Sciences &
Medical Sciences ,54(1), M44-M50.
Wolff, D.R., Rose, J., Jones. V.K., Bloch, D.A., Oehlert, J.W., Gamble, J.G.
(1998). Postural balance measurements for children and adolescents.
Journal of Orthopaedic Research, 16(2), 271-275.
Wolfson, L., Judge, J., Whipple, R., King, M. (1995). Strength is a major
factor in balance, gait and the occurrence of falls. Journal of
Gerontology Series A- Biological Sciences & Medical Sciences,
50A(special issue), 64-67.
80
Wolfson, L., Whipple, M., Derby, C.A., et al. (1992). A dynamic
posturography study of balance in healthy elderly, Neurology, 42,
2069-2075.
Woollacott, M.H,, & Tang, P.F. (1997). Balance control during walking in the
older adult: research and its implications. Physical Therapy, 77(6), 646-
660.
81