| Summary: | 博士 === 國立臺灣大學 === 醫學工程學研究所 === 94 === Falls are a common problem leading to physical injuries among the elderly, resulting in individual costs such as pain and impairment of locomotion, as well as financial costs related to treatment and rehabilitation. From the literature review, it was suggested that investigating kinematics and kinetics of the locomotor system during obstacle crossing may help in devising strategies to predict and prevent trip-related falls in the elderly. In the present study, young, older and knee osteoarthritic subjects were recruited to investigate the influence of aging and aging-related disease on the biomechanics of obstacle crossing using motion analysis techniques. Compared to the baseline data in the young group, a higher leading toe clearance was adopted in the older group achieved by a swing hip flexion strategy. During the crossing of the leading limb, the older group kept the COM more posterior and longer on the trailing stance limb with increased knee extensor and decreased hip flexor crossing moments. For both leading and trailing stance limbs, bigger abductor moments of the hip and knee were needed in controlling the medial-lateral COM motion. Knee OA seemed to increase peak knee abductor moments for both limbs in the early stance. The corresponding moments were reduced around and after crossing the obstacle through pelvis list and toe-out gait. For reducing knee joint loading and associated pain, bigger hip extensor moments were needed to compensate by anterior tilt of the pelvis. It was suggested that the older group used a more conservative strategy for obstacle-crossing due to the safety considerations. Knee OA altered normal gait pattern during obstacle crossing, which may increase the risk of trip-related falls in the elderly.
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