Motor learning of fall resistant skills from laboratory-induced falling among people with Alzheimer's disease

阿尔茨海默病患者从实验室诱发的跌倒中学习抗跌倒技能

• 批准号: 10427842
• 负责人: Feng Yang
• 金额: $ 19.5万
• 依托单位: GEORGIA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10427842
• 关键词: Address; Adult; Alzheimer' s Disease; Clinical; Cognitive deficits; Data; Disease; Elderly; Environment; Exercise; Exposure to; Fall prevention; Fracture; Goals; Human body; Impairment; Injury; Laboratories; Learning; Life; Living Wills; Modality; Morbidity - disease rate; Motor Skills; Multiple Sclerosis; Muscle; Nature; Neural Pathways; Neuraxis; Neuronal Plasticity; Outcome; Participant; Patient Self-Report; Pattern; Persons; Placebos; Process; Public Health; Quality of life; Randomized; Regimen; Research; Resistance; Risk; Safety; Societies; Specificity; Stroke; Testing; Time; Training; Transferable Skills; Walking; arm; base; cost; design; experience; fall risk; falls; hazard; high risk; improved; interest; longitudinal design; mortality; motor learning; neuromuscular training; novel; preservation; prevent; primary outcome; programs; prospective; recruit; skills; skills training; treadmill

ABSTRACT The long-term objective of this research is to develop an effective approach that can reduce falls for people with Alzheimer’s disease (AD) and related disorders. This project’s overall goal is to systematically examine if people with AD can acquire fall prevention skills from a novel paradigm - perturbation training. The specific aims of this proposed project are (1) to test if people with AD can adapt to perturbations on a treadmill and learn fall resistant motor skills; (2) to inspect if people with AD can retain motor skills learned in Aim 1 for at least 6 months; and (3) to determine if people with AD can generalize fall resistant skills gained on the treadmill to overground perturbations and daily living conditions. We will use a two-arm randomized, controlled longitudinal design to achieve these goals. A group of 30 older adults with mild AD will be randomized into two groups: A (training) and B (placebo). Group A will undergo a perturbation training-based motor learning session including 20 slips (S1-S20) and 20 trips (T1-T20) on a special treadmill. These perturbation trials will be mixed with regular walking trials in random order. Group B will walk on the treadmill with no perturbations for the same time as group A. Then, both groups will be exposed to a sudden overground slip (initial overground slip) and trip (initial overground trip). Participants will return for a retention session 6 months later to undergo another treadmill slip and trip (treadmill reslip and retrip) followed by an overground slip and trip (overground reslip and retrip). The perturbation outcome (fall or non-fall) and dynamic stability will be determined for slip and trip trials. Self-reported real-life falls over 6 months after the learning session will be collected for both groups. The primary outcome is the binary perturbation outcome following either the slip or trip. Dynamic stability during slips and trips and the all-cause falls in daily living will be our secondary variables. The primary outcome and dynamic stability will be compared between S1 and S20 and between T1 and T20 within group A to test if people with AD can adapt to large-scale slips and trips (Aim 1). To determine whether people with AD can retain the skills learned in Aim 1 for at least 6 months (Aim 2), the primary outcome and dynamic stability on treadmill reslip and retrip during the retention session will be compared between groups. The primary outcome and dynamic stability will also be compared between groups on the overground slips and trips during the acquisition and retention sessions to test if people with AD can immediately transfer the skills learned in Aim 1 to overground and if this transfer can maintain for 6 months (Aim 3). In addition, the prospective falls will be compared between groups to verify if people with AD can transfer the acquired fall resistant skills on the treadmill to everyday living conditions (Aim 3). Perturbation is a promising modality to prevent falls for people with AD due to its inherent natures: safety, task-specific, and implicit learning process. This project will have a profound impact on people with AD and society.

抽象的 这项研究的长期目标是开发一种有效的方法，可以减少患有 阿尔茨海默氏病（AD）和相关疾病。该项目的总体目标是系统地检查人们是否 通过广告可以通过新颖的范式摄动训练获得秋季预防技能。具体目的 该提议的项目是（1）测试AD的人是否可以适应跑步机上的扰动并学习秋季 抵抗运动技能； （2）检查有AD的人是否可以保留在AIM 1中学习的运动技能至少6 月份； （3）确定有广告的人是否可以推广跑步机上获得的抗跌倒技能 地面扰动和日常生活条件。我们将使用两臂随机控制的 纵向设计以实现这些目标。一组30个患有轻度AD的老年人将被随机分为两个 组：A（训练）和B（安慰剂）。 A组将接受基于扰动培训的运动学习 会议包括20张幻灯片（S1-S20）和20次特殊跑步机上的20次旅行（T1-T20）。这些扰动试验将 将随机顺序与常规步行试验混合。 B组将在跑步机上行走，没有扰动 与组相同的时间。 滑倒）和旅行（初始地面旅行）。参与者将在6个月后返回保留会议 另一条跑步机滑行和旅行（跑步机重新启动和翻新），然后是地面滑动和旅行（地上 重新恢复并翻新）。扰动结果（秋天或非下降）和动态稳定性将确定滑倒 和旅行试验。自我报告的现实生活将在学习课程后6个月内为两者收集 组。主要结果是滑动或行程后的二元扰动结果。动态的 滑移和旅行期间的稳定性以及全因在日常生活中的稳定性将是我们的次要变量。主要 结果和动态稳定性将在S1和S20之间以及A组内的T1和T20之间进行比较 测试AD的人是否可以适应大型幻灯片和旅行（AIM 1）。确定是否有广告的人 可以将在AIM 1中学到的技能保留至少6个月（AIM 2），主要结果和动态稳定性 在跑步机上，将在组之间比较保留会议期间的恢复和返回。主要 还将比较地面滑移和旅行的组之间的结果和动态稳定性 收购和保留会议测试广告患者是否可以立即转移所学的技能 瞄准1到达地面，如果此转移可以维持6个月（AIM 3）。此外，潜在的跌倒 将在小组之间进行比较，以验证有广告的人是否可以转移获得的秋季抗抗抗抗药性技巧 跑步机到每天的生活条件（AIM 3）。扰动是防止人们跌倒的承诺方式 由于其继承本质，AD：安全性，特定于任务和隐性学习过程。这个项目将有一个 对广告和社会人士的深远影响。