上下樓梯是日常生活中很平常卻也很重要的活動。在復建治療計畫中，上下樓梯常被視為功能恢復的指標，也常是功能評估及訓練的重要項目之一。因為樓梯間正常的行進位移 (stair locomotion) 需要有一定的肌力、關節活動度、平衡和肌肉關節間的協調，而老年人在上述各方面都有不定程度的退化或退步，以致在許多正式或非正式的報告中都提及老年人在上下樓梯多少都有些困難，而導致意外傷害的產生。目前關於樓梯間行進的步態、動作研究並不多，且多是針對年輕健康或少數膝關節病變的成年人。這種生物力學資料並不適用於在感覺，前庭，肌肉骨骼系統有不定程度老化老年族群。老年人在樓梯行進的資料非常有限且片面，所以完整量化老年人上下樓梯時的運動學、動力學及平衡是必要的。
本實驗將利用力板及三度空間動作分析全面探討老年人及年輕人上下樓梯時的步態、動力學 (kinetics)、運動學 (kinematics)，及身體重心和足底壓力中心點的關係。 此研究的特定目的如下：(1)探討老年人軀幹及下肢在三度空間的動作並年輕成年人做比較; (2)探討老年人在上下樓梯時，髖、膝和踝關節的受力及力矩，並比較其與年輕族群的差異; (3)探討並比較重心的位移，以及重心垂直投射和足底壓力中心點在行進時的距離；(4) 探討性別對以上所測量的參數的影響，並比較此影響在年輕及年老族群的差別。另外，此研究利用鞋跟高度作為挑戰平衡的外在因素，觀察年老女性穿低跟鞋和高跟鞋在上下樓梯的生物力學及平衡策略。同時，比較年輕及年長女性在穿不同鞋跟高度鞋子時上下進一步探討不同年齡是否有不同的平衡機制。
本實驗受測者包括二十八位健康年輕人(16位女性， 12為男性，年齡介於22和38歲之間)，21位健康老年人(11位女性，10位男性，年齡介於65和80歲之間)。受測者必須能。結果顯示，年老的受測者在上樓梯時完成一個步距的時間較長，站立期及雙腳站立期較長；在下樓梯時，年老的受測者完成一個步距的時間較長，但雙腳站立期較短。年輕及年老組在髖、膝關節的運動學籍動力學的測量值有較大差異。上樓梯時，年老者除了有顯著較大的最大髖關節屈曲角度，及髖關節內轉力矩也顯著的比年輕組大；但膝關節及踝關節的伸張力矩較小。在下樓梯時，老年組有顯著較大的最大髖關節和膝關節屈曲，和較大的髖關節伸直力矩，較低的膝關節伸直和外展力矩。無論是上或下樓梯，老年組在人體重心在左右方向的位移，以及重心的垂直投射和足底壓力中心的距離都比年輕組大。
至於鞋跟高度效應試驗，年老女性和年輕女性組在穿不同的鞋跟高度的時候，踝關節，膝關節和髖關節在矢狀面和橫向面的角度有顯著性差異。從動作曲線圖中觀察，年齡差別所引起的動作學的差異似乎比鞋跟高度所造成的影響明顯，但在動力學數據上有相反的發現。鞋跟的高度，似乎對年輕女性下肢的動力學數據有較大的影響。在下樓梯時穿高跟鞋，年老的女性在步態參數和動力學圍做較多的調整;年輕的女性則在膝關節和髖關節受力和力矩有所改變。
這項研究的結果，提供基本的生物力學的資料，老人在樓梯運動，並有可能幫助臨床醫護人員制定老年人的治療計畫。

Ascending and descending stairs is a common and important activity of daily living. Since stair locomotion challenges muscle strength, range of motion, balance and muscular coordination, it is not surprising that elderly people and individuals with physical disabilities both report formally and informally that they experience difficulty with stair negotiation. Several kinematic and kinetic measures of stair locomotion have been undertaken in the normal and knee pathological conditions in young population. Due to age-related changes in the sensory, vestibular, and musculoskeletal systems, this baseline biomechanical information is not generalized to elderly population, and a thorough quantitative examination of the performance of the older people is needed. Based on these clinical and theoretical needs, this study was proposed to use motion analysis system and force platforms to investigate baseline kinematic and kinetic data during stair ascent (SA) and stair descent (SD). The specific aims of the study were followings: (1) To investigate and compare three-dimensional joint motions of the trunk and lower extremities; (2) To investigate and compare joint force and moment of the ankle, knee and hip joints in the young and elderly adults during stair climbing; (3) To determine sole effect of gender and interacting effect of gender and age on all measured kinematic and kinetic parameters; (4) To investigate and compare center of mass (COM) displacement, center of pressure (COP) excursion and their spatial relationship in the young and elderly adults during SA and SD. In addition, the heel height of shoes were used to challenge the balance of female participants since footwear has been considered one of major factors disturbing balance and contributing to falls either level or stairs walking. Same kinemtaic and kinetic parameters will be measured and compared under the condition wearing low-heels shoes (LHS) and high-heeled shoes (HHS) to determine the effect of shoe heel height on balance strategies in the young and elderly women during SA and SD.
Twenty eight young healthy adults (16 women, 12 men, age 22~38 years) and 21 elder healthy adults (11 women, 10 men, age 65 ~ 80 years) were included in this study. Kinematic and kinetic data were collected when the subjects ascended stairs reciprocally with their preferred speed. The results reveal that the elder group demonstrated longer stride cycle duration, stance phase and double support stance (DS) in SA, and longer cycle duration but shorter DS in SD. More kinematic and kinetic differences between young and elder group were found at the knee and hip joints. In SA, besides significant larger peak hip flexion, the internal extensor moment of the hip joint was greater than young individuals while the knee extensor and ankle plantarflexion moments were lower. In SD, The elder groups had significantly larger peak hip and knee flexion, and larger hip extension moment than the younger groups, less knee extension and abduction moments than the younger groups. The COM displacement in lateral-medial (LM) direction and COM-COP divergence was larger in the elderly either in SA or SD.
For heel height effect test, significant differences in peak angle of the ankle, knee and hip joints were found in sagittal and transverse planes between shoe conditions in young and elder female groups in SA. The differences in motion profiles between groups were more apparent than between shoe conditions, but the findings in kinetic data were opposite. Heel height seemed have a greater effect on the kinetic data in young group, particularly in the frontal plane. And, it might account for the differences at the hip joint moment between two groups while wearing HHS. In SD, more adjustments in the temporal gait parameters and range of the motions were observed in the elderly; the younger adults demonstrated more changes in forces and moments at the knee and hip.
The findings of this study provide basic biomechanical information of the elderly in stair locomotion, and may help clinicians develop treatment protocol for aged individuals.

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