Quantitative Assessment of Balance in Elderly Fallers and Nonfallers
張梅蘭(Mei-Lan Chang)；王子娟(Tzyy-Jiuan Wang)；劉作仁(Tcho-Jen Liu)；李淑美(Shui-Mei Lee)；梁家豐(Chia-Fong Liang)；徐道昌(Tao-Chang Hsu)
跌倒 ； 身體搖擺幅度 ； 老人 ； 平衡 ； Falls ； Body sway ； Elderly ； Balance
|Volume or Term/Year and Month of Publication||
23卷4期（1998 / 10 / 01）
255 - 268
老人跌倒是常見的問題，而失去平衡是老人跌倒的主因。老人跌倒後往往在生理和心理各層面皆影響生活甚鉅；因此，預防老人跌倒以改善老人的生活品質並節約醫療費用是當今重要的課題。本研究的目的為定量評估老人身體搖擺的幅度並探討老人跌倒者與非跌倒者之間有無差異，主要利用電腦化平衡測試儀(Chattecx Balance System)定量評估老人站立時之平衡。平衡之測試以記錄身體搖擺的幅度為指標。共有七十八位住在安養院的老人接受測試，其平均年齡為七十六歲，測試內容為將儀器中踏板以動靜態各種不同的移動方式、受測者眼睛張閉不同狀況加以組合成十項動作協調平衡測試。結果顯示：(1)站立時，體重分佈之分析得知百分之八十五的老人其腳跟承載較多的體重。(2)在十項測試中，除了踏板平移之方式外，其餘方式的測試比較中，閉眼之搖擺指數、前後搖擺幅度、左右搖擺幅度皆大於張開眼睛的狀況。(3)在十項測試中，踏板前後和左右傾斜時，閉眼之搖擺指數，前後搖擺幅度，左右搖擺幅皆大於張開眼睛的狀況。(4)老人跌倒組和老人非跌倒組於十項測試中，搖擺指數，前後搖擺幅度，以及左右搖擺幅度皆無一致性，且無顯著差異；(5)在十項測試中，當踏板左右傾斜且受測者閉上眼睛時，選取前庭系統和視力立體感良好之老人，分組分析得知，老人跌倒組之搖擺指數、左右搖擺幅度皆高於老人非跌倒組。因此，利用踏板左右以及前後傾斜再讓受測者閉上眼睛可能是測驗老人的平衡能力最為敏感的方式。而利用踏板左右傾斜並閉上眼睛可能有助於偵測前庭系統、本體感覺和立體感較佳老人有無跌倒的經歷。
Falls are the most common problem in the elderly population because, at such ages, falls create major risks of morbidity and mortality. Balance disorders in the elderly are common causes of falls. To improve the quality of life of the elderly and reduce medical care expenditure, investigating the issues surrounding falls and their causes is very important. The purposes of this study were to quantitatively evaluate the postural sway of the elderly and to compare differences in postural sway between the fallers and the nonfallers. There were 78 elderly subjects (mean age=76.0±4.5 years; 44 females, 34 males), all selected from a senior center. Each subject underwent quantitative balance evaluation with 10 Motor Coordination Tests (MCTs) consisting of a combination of different platform manipulations and visual conditions. The results were as follows: (1) the right heel and left heel were the areas which most frequently supported body weight; (2) sway index, left/right (L/R) sway distance and anterior/posterior (A/F) sway distance with the eyes closed were higher than with the eyes opened on all MCTs except during the forward/backward (F/B) linear movement of the platform; (3) sway index, left/right (L/R) sway distance and anterior/posterior sway distance with the eyes closed were significantly higher than with the eyes opened on F/B and L/R tilting movement; (4) For the sway index, L/R sway distance, A/P sway distance, there were no significant differences between falter and nonfaller groups during 10 MCTs; (5) In older adults who had fair stereopsis and fair vestibular function, the sway index, L/R sway distance of the non falter group were lower than those of the faller group when the platform was manipulated by left/right tilting movement and the subjects' eyes were closed. Thus, among the various MCTs, postural sway during platform F/B and L/R tilting movement with the subjects' eyes closed was the most sensitive measure in reflecting the perturbation reaction of the elderly, while L/R tilting movement with eyes closed was helpful in detecting the falling history of the elderly with fair vestibular, proprioceptive and stereopsis functions.