外加屈髖彈力帶對高齡者步態之影響

Effects of an additional elastic hip flexor band on gait performance in older adults

緒論：跌倒是對高齡者的生命最有影響的因子之一，近乎30~50%的高齡者都曾有跌倒的經驗。因此，如何維持正確地行走對於高齡者至關重要。試圖瞭解本研究設計之創新外加屈髖彈力帶，對於高齡者於行走時下肢關節角度、步態參數（步長、步頻、腳趾最大離地高度）以及地面反作用力之影響。方法：本研究召募二十名65至74歲之健康高齡者，隨機使用無拉伸、拉伸率50%、拉伸率100%之外加屈髖彈力帶，並分別依序進行自選速度行走與快速度行走各三次；本研究以三維動作偵測系統和三軸測力板，擷取與分析受試者開始行走三步後，右腳腳跟接觸測力板至右腳腳跟再次著地的步態週期；統計方法以二因子重複量數變異數分析比較使用外加屈髖彈力帶於不同速度行走下，對於下肢關節角度、步態參數以及地面反作用力等參數的差異。結果：使用外加屈髖彈力帶在步行過程中，拉伸率50%與拉伸率100%最大屈髖之角度顯著大於無拉伸（p < .05）；步行過程中腳趾離地最大高度在拉伸率100%時顯著大於無拉伸（p < .05）；步行動作在三種拉伸率間皆未達顯著差異（p > .05）。結論：高齡者使用有拉伸率之外加屈髖彈力帶，雖些許限制步行中最大伸髖角度，但能夠增加高齡者行走時的屈髖角度以及腳趾離地最大高度，此應能幫助高齡者進行跨越門檻、上樓梯、上公車等日常生活之動作，減少抬腳高度不足進而被拌倒的機率。

Introduction: Falls are among the most significant factors affecting older adults’lives. Almost 30%~50% of older adults have experienced a fall. Therefore, walking appropriately is crucial for older adults. Consequently, it is necessary to design walking support equipment. This study investigated the effects of a novel additional elastic hip flexor band on angle (abduction, adduction, dorsiflexion, and plantar flexion), gait (step length, step cadence, and height between ground and toe), and vertical ground reaction force at comfortable and maximum walking speeds in older adults. Methods: Twenty healthy adults aged 65-74 years voluntarily participated in this study. Each subject randomly wore the novel additional elastic hip flexor band at 0%, 50%, and 100% extension while walking three times at comfortable and maximum speeds. A three-dimensional motion capture system and AMTI force plate were used to measure their kinematic and kinetic parameters during walking. The analyzed gait cycle was defined as the right heel touching the force plate to touching the ground again after three steps. All kinematic and kinetic parameters at different walking speeds were compared using repeated measure two-way analysis of variance. Results: Older adults who wore the additional elastic hip flexor band at 50% and 100% extension had greater maximum hip flexion angles than those who wore it at 0% extension (p < 0.05). Older adults who wore the additional elastic hip flexor band at 100% extension had higher toe elevations than those who wore it at 0% extension (p < 0.05). Conclusion: Older adults who wore the additional elastic hip flexor band showed increased hip flexion and extension angles. These findings suggest that the novel additional elastic hip flexor band might help older adults cross the threshold, go upstairs, get on the buses, and perform other daily activities. It might also further reduce their fall risk.