中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (17): 3566-3571.doi: 10.12307/2025.662

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

久坐与社区老年人下肢肌力：跌倒恐惧与年龄的中介和调节作用

洪金涛1，王晶晶1，李岩松2，王  晨1，弭守玲3，4，5，6，7   

  1. 1上海体育科学研究所(上海市反兴奋剂中心)，上海市  200030；2青岛大学体育学院，山东省青岛市  266071；3复旦大学附属中山医院心内科，上海市心血管病研究所，上海市  200032；4国家放射与治疗临床医学研究中心，上海市  200032；5心脏病全国重点实验室，上海市  200032；6国家卫生健康委缺血性心脏病重点实验室，上海市  200032；7中国医学科学院病毒性心脏病重点实验室，上海市  200032
  • 收稿日期:2024-07-01 接受日期:2024-08-24 出版日期:2025-06-18 发布日期:2024-10-31
  • 通讯作者: 弭守玲，博士，副主任医师，复旦大学附属中山医院心内科，上海市心血管病研究所，国家放射与治疗临床医学研究中心，心脏病全国重点实验室，国家卫生健康委缺血性心脏病重点实验室，中国医学科学院病毒性心脏病重点实验室，上海市200032
  • 作者简介:洪金涛，女，1994年生，浙江省宁波市人，汉族，2020年上海体育大学毕业，硕士，助理研究员，主要从事体质健康、身体活动方面的研究。
  • 基金资助:
    上海市2023年度“科技创新行动计划”社会发展科技攻关项目(23DZ1204201)，项目负责人：王晨

Sedentary behavior and lower-limb muscle strength in community-dwelling older adults: the mediating and moderating effects of fear of falling and age

Hong Jintao1, Wang Jingjing1, Li Yansong2, Wang Chen1, Mi Shouling3, 4, 5, 6, 7   

  1. 1Shanghai Research Institute of Sports Science (Shanghai Anti-doping Agency), Shanghai 200030, China; 2School of Physical Education, Qingdao University, Qingdao 266071, Shandong Province, China; 3Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China; 4National Clinical Research Center for Interventional Medicine, Shanghai 200032, China; 5State Key Laboratory of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 6NHC Key Laboratory of Ischemic Heart Diseases, Shanghai 200032, China; 7Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai 200032, China
  • Received:2024-07-01 Accepted:2024-08-24 Online:2025-06-18 Published:2024-10-31
  • Contact: Mi Shouling, MD, Associate chief physician, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China; National Clinical Research Center for Interventional Medicine, Shanghai 200032, China; State Key Laboratory of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China; NHC Key Laboratory of Ischemic Heart Diseases, Shanghai 200032, China; Key Laboratory of Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai 200032, China
  • About author:Hong Jintao, MS, Assistant researcher, Shanghai Research Institute of Sports Science (Shanghai Anti-doping Agency), Shanghai 200030, China
  • Supported by:
    Shanghai Municipal Science and Technology Commission Program 2023 – “Science and Technology Innovation Action Plan,” No. 23DZ1204201 (to WC)

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摘要：


文题释义：
久坐：是指个体在清醒状态下，处于坐姿、斜倚或躺姿时，能量消耗≤1.5代谢当量的行为，如坐着看电视、使用电脑、阅读等。
跌倒恐惧：指个体在进行某些活动时，为了避免跌倒而出现的自我效能或信心降低，是与跌倒相关的常见心理问题。

背景：人体老龄化进程中，下肢肌肉力量会随着年龄的增长呈现显著的生理性下降，久坐、跌倒恐惧、年龄与下肢肌力之间可能存在一定关联，但它们之间的影响路径与效应关系尚不明确。
目的：探究社区老年人久坐和下肢肌肉力量之间的关系，并探讨跌倒恐惧和年龄在上述两者关系中的作用。
方法：共招募331名60岁及以上的上海市社区老年人。采用问卷调查法收集基本信息、人口学资料等；采用国际身体活动问卷-短卷评估久坐时间，采用30 s坐站测试测量下肢肌力，采用中文版国际跌倒效能量表测评跌倒恐惧。对数据进行描述统计、相关分析、基于回归的路径分析和中介效应检验。
结果与结论：最终以318名老年人[78.9%为女性，平均年龄(67.8±5.5)岁]的有效数据纳入分析，其中久坐时间≥3 h的185名，< 3 h的133名。①久坐和跌倒恐惧呈正相关关系(P < 0.01)，下肢肌力和久坐(P < 0.01)、跌倒恐惧(P < 0.001)均呈负相关关系。②久坐显著负向预测下肢肌力(β=-0.125，P < 0.05)，久坐显著正向预测跌倒恐惧(β=0.182，P < 0.01)；跌倒恐惧显著负向预测下肢肌力(β=-0.293，P < 0.001)。③跌倒恐惧在久坐和下肢肌力之间起中介作用(β=-0.053，95%CI：-0.100至-0.018)。④久坐对跌倒恐惧的预测效应具有统计学意义(β=0.164，P < 0.01)，这说明年龄调节了久坐对跌倒恐惧的影响。 

https://orcid.org/0000-0003-2087-4007(洪金涛)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 老年群体, 老龄化, 肌肉萎缩, 肌肉力量, 久坐, 跌倒恐惧, 中介效应, 调节作用

Abstract: BACKGROUND: The lower-limb muscle strength shows a significant physiological decline with aging. There may be a certain correlation between sedentary behavior, fear of falling, age and lower-limb muscle strength, but the influence path and effect relationship among them are not yet clear.
OBJECTIVE: To examine the relationship between sedentary behavior and lower-limb muscle strength, and to explore the influences of fear of falling and age in such an association among community-dwelling older adults. 
METHODS: This cross-sectional study recruited 331 community-dwelling older adults (aged ≥ 60 years) in Shanghai. A questionnaire survey was conducted to collect basic information, demographic data, etc. The Short Form of the International Physical Activity Questionnaire was applied to measure sedentary time. Lower-limb muscle strength was assessed by the 30-second chair-stand test. Fear of falling was measured by the Chinese version of Fall Efficacy Scale-International. Descriptive statistics analysis, correlation analysis, regression-based path analysis and mediation analyses were performed on the data. 
RESULTS AND CONCLUSION: Valid data from 318 community-dwelling older adults [78.9% females, mean age (67.8±5.5) years old] were finally included in the analysis. There were 185 with sedentary time ≥ 3 hours and 133 with sedentary time < 3 hours. (1) There was a positive correlation between sedentary behavior and fear of falling (P < 0.01), and there were negative correlations between lower-limb muscle strength and sedentary behavior (P < 0.01) and between lower-limb muscle strength and fear of falling (P < 0.001). (2) Sedentary behavior negatively predicted lower-limb muscle strength (β=−0.125, P < 0.05), and positively predicted fear of falling (β=0.182, P < 0.01). Fear of falling negatively predicted lower-limb muscle strength (β=−0.293, P < 0.001). (3) Fear of falling mediated the relationship between sedentary behavior and lower-limb muscle strength (β =−0.053, 95% confidence interval: −0.100 to −0.018). (4) Sedentary behavior had a statistically significant predictive effect on fear of falling (β=0.164, P < 0.01), indicating that age moderates the effect of sedentary behavior on fear of falling.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: older adults, aging, muscle atrophy, muscle strength, sedentary behavior, fear of falling, mediating effect, moderating effect

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