Background

Assistive devices provide balance and stability to those who require a greater base of support, especially during ambulation or in tasks essential to functional daily living. In ambulatory assistive device use, center of pressure (COP) movement as one of the measurements of postural control is a factor when assessing fall risk, with an overall goal of maintaining postural equilibrium. There is a lack of research on assistive devices, such as walkers, regarding measurable outcome variables related to fall risk. The purpose of this study was to determine how much the postural control in single limb stance during a balance perturbance is affected by utilizing three different walker types designed to promote stability: the standard walker, the front-wheeled walker with straight wheels and the front-wheeled walker with caster wheels.

Research question

Is postural sway control in single limb stance during a balance perturbance affected by walker type?

Methods

Twenty-three healthy adults participated and gave consent. The NeuroCom® SMART EquiTest® system was utilized to simulate forward falls. Subjects stood on the system’s force plate, which was tipped backwards quickly, forcing subjects to attempt to maintain balance. Each participant experienced 18 simulated perturbations, during which they were asked to maintain balance while using one of three walkers in single-limb stance. Each trial was completed using random assignment of three different walker types. Leg dominance of the stance leg was also randomized for each trial.

Results

The type of walker and the leg dominance in the standing limb significantly affected postural control in a balance perturbance in the A-P direction. The walker type significantly affected the COP maximum displacement in anterior-posterior (AP) direction. However, the leg dominance significantly affected COP maximum displacement in AP and medio-lateral (ML) directions and COP velocity in AP direction.

Significance

The findings suggest that when fully grounded, a standard walker is more stable than the front-wheeled walker. However, this does not indicate that the standard walker is more stable than other types of walkers when it is being picked up and moved forward during normal use.

中文翻译：

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前后方向平衡障碍后辅助装置对姿势控制的影响

背景

辅助设备为需要更大支持基础的人提供平衡和稳定性，尤其是在步行或执行对正常日常生活必不可少的任务时。在使用非卧床辅助设备时，压力中心 (COP) 运动作为姿势控制的测量之一是评估跌倒风险的一个因素，其总体目标是保持姿势平衡。关于与跌倒风险相关的可测量结果变量，缺乏对助行器（例如助行器）的研究。本研究的目的是确定在平衡扰动期间单肢站姿的姿势控制受到多大程度的影响，这三种不同的助行器类型旨在提高稳定性：标准助行器、带直轮的前轮助行器和前轮助行器。带脚轮的轮式助行器。

研究问题

在平衡扰动期间，单肢站立时的姿势摇摆控制是否受步行者类型的影响？

方法

23 名健康成年人参与并表示同意。NeuroCom® SMART EquiTest® 系统用于模拟向前跌倒。受试者站在系统的测力台上，测力台迅速向后倾斜，迫使受试者试图保持平衡。每个参与者都经历了 18 次模拟扰动，在此期间，他们被要求保持平衡，同时使用三个步行者中的一个单肢站立。每个试验都是使用随机分配的三种不同步行者类型完成的。对于每个试验，站立腿的腿部优势也被随机化。

结果

步行者的类型和站立肢体的腿部优势显着影响了 AP 方向平衡扰动的姿势控制。步行者类型显着影响前后 (AP) 方向的 COP 最大位移。然而，腿部优势显着影响 AP 和中间横向 (ML) 方向的 COP 最大位移以及 AP 方向的 COP 速度。

意义

研究结果表明，当完全接地时，标准助行器比前轮助行器更稳定。但是，这并不表示标准助行器在正常使用过程中被拾起向前移动时比其他类型的助行器更稳定。