摘    要：從姿势控制能力的视角对老年人跌倒风险综合测评指标进行优选与分析，旨在完善老年人跌倒风险评估体系，为老年人跌倒防控及身体功能锻炼提供理论依据。方法：随机招募60岁以上的老年人284人作为测试对象，将受试者按照既往跌倒史分为跌倒组和无跌倒组。采用录像分析、足底压力、人体机能等测评系统对老年人自然行走步态以及姿势控制能力相关指标进行测试，并对实验数据进行独立样本t检验和典型判别分析。结果：统计筛选出优势判别指标分别为标准化步速（dc=-0.662）、95%椭圆摆动面积（dc=0.541）、右脚第2跖骨受力面积（dc=-0.321）、选择反应时（dc=0.310）、横向COP轨迹（dc=0.292）、左脚第1跖骨峰值力（dc=0.291）、左脚着地髋角（dc=0.268）、左右摆动路径长度（dc=0.218）、闭眼单脚站立时间（dc=-0.208）、左脚峰值压力点COM位移（dc=-0.205）。结论：老年人跌倒相关的姿势控制能力变量中运动功能指标所占比例最大，其次是感觉功能指标和认知功能指标。标准化步速、95%椭圆摆动面积和选择反应时可视为姿势控制敏感指标，是老年人跌倒防控的重点观测变量。

关键词：老年人;跌倒;测评指标;风险预测

中图分类号：G 804.5          学科代码：040302           文献标识码：A

Abstract：From the perspective of postural control ability， this paper optimizes and analyzes the comprehensive assessment indexes of fall risk in the elderly， aiming to improve the risk assessment system of fall in the elderly and provide theoretical basis for the prevention and control of fall and functional exercise in the elderly. Method： 284 subjects were randomly recruited from the elderly over 60 years old. The samples were divided into the falling group and the non-falling group according to their previous history of falling. Video analysis， plantar pressure， human body function and other assessment systems were used to test the related indicators of natural walking gait and posture control ability of the elderly， and the experimental data were subject to independent sample t test and typical discriminant analysis. Results： Statistical advantage judging indexes are respectively screened， including standardization pace（dc=0.662）， 95% elliptical swinging area（dc=0.541）， the second metatarsal stress area of right foot （dc=0.321）， choice reaction time （dc=0.310）， horizontal COP trajectory （dc= 0.292）， the first metatarsal peak force of left foot（dc=0.291）， the hip angle of left foot（dc=0.268）， left-right swinging path length（dc=0.218）， time standing on one foot with eyes shut（dc=0.208）， peak pressure displacement dot COM of left foot（dc=0.205）.Conclusions： Among the fall related postural control ability variables， motor function index accounted for the largest proportion， followed by sensory function index and cognitive function index. Standardized walking speed， 95% elliptical swing area and selective reaction time can be regarded as sensitive indicators of posture control， which are key observation variables for fall prevention and control of the elderly.

Keywords：the elderly; fall; evaluation indicators; risk prediction

姿势控制是调控肢体各关节的力学关系以达到控制身体在空间位置的稳定性和方向性的目的 [1]。姿势控制系统包括运动功能、感觉功能和认知功能3个方面[2-3]。平衡能力是姿势控制的关键因素，它主要受神经肌肉控制系统的影响，平衡能力失调和步态异常普遍被认为是跌倒最大的风险因素[4-5]。平衡能力包括静态和动态两大类，其中动态平衡能力又可分为自动态平衡能力和他动态平衡能力[6]。……