Reducing Fall Risk with the use of Neuromuscular Electrical Stimulation to Maximize the Hip Abductor Muscles in Older Veterans

通过使用神经肌肉电刺激最大化老年退伍军人的髋关节外展肌来降低跌倒风险

• 批准号: 10516031
• 负责人: Odessa Addison
• 金额: --
• 依托单位: BALTIMORE VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10516031
• 关键词: Address; Adipose tissue; Age; Area; Balance training; Caring; Cessation of life; Clinical Treatment; Data; Educational Intervention; Elderly; Electrodes; Equation; Equilibrium; Exercise; Exhibits; Fall prevention; Fascia lata structure; Fatty acid glycerol esters; Future; Gait; Health; Hip region structure; Hospitalization; Impairment; Incidence; Infiltration; Injury; Intervention; Intramuscular; Isometric Exercise; Lower Extremity; Mechanics; Methods; Mission; Muscle; Muscle Contraction; Muscle function; Muscular Atrophy; Physical Performance; Prevention program; Publishing; Randomized, Controlled Trials; Recommendation; Rehabilitation therapy; Research; Role; Step Tests; Surface; Testing; Time; Training; Translational Research; Trauma; Veterans; Work; X-Ray Computed Tomography; cost; cost effective; exercise training; fall risk; falls; follow-up; functional outcomes; improved; intervention program; multimodality; muscle form; muscle strength; neuromuscular stimulation; novel; patient oriented; patient safety; performance tests; primary outcome; programs; recruit; response; tool

Falls are a leading cause of injurious death and non-fatal injuries in older adults. While fall prevention is a major VA initiative, the current best fall preventions program only reduces falls by ~30% suggesting further research and interventions are needed to reduce fall risk. Decreased lower extremity muscle mass and strength contribute to balance and mobility limitations. Our recent studies show the hip abductors have a unique role in balance and mobility function. Older adults with impaired hip abductor muscles demonstrate decreased hip abductor strength, lower balance scores, and poor stepping mechanics when recovering from a balance perturbation. Our preliminary results also show increased fatty infiltration of the hip abductor muscles may contribute to poor muscle recruitment and make changing the hip abductor muscles with a traditional strength intervention difficult. Neuromuscular electrical stimulation is one method to improve muscles in older adults, though it is not traditionally used on the hip abductors. Our preliminary results demonstrate that older adults who use neuromuscular electrical stimulation on their hip abductors, in conjunction with a balance training intervention; demonstrate larger improvements in hip abductor strength, balance, and mobility function. Our central hypothesis is that the addition of neuromuscular electrical stimulation applied to the hip abductors during a balance intervention will result in: improved balance, larger improvements in muscle and mobility function, and fewer falls than a balance intervention alone. In this randomized control trial, we will determine the effects of a balance and strengthening program with and without neuromuscular electrical stimulation on fall risk and mobility (aim 1), changes in hip abductor composition, function, activation and gait variability (aim 2), and the retention of these changes at a six and twelve-month follow up (aim 3). We anticipate that this patient-oriented translational research will provide the first evidence from a large randomized control trial for the use of neuromuscular electrical stimulation applied to the primary hip abductors as an efficacious adjunct to traditional rehabilitation programs to improve balance, mobility, and muscle in older Veterans at risk for falls.

跌倒是老年人有害死亡和非致命伤害的主要原因。而预防秋天是主要的 VA倡议，目前的最佳跌倒预防计划只会减少约30％，建议进一步研究 需要干预以降低跌倒风险。下肢肌肉质量和力量降低 有助于平衡和流动性限制。我们最近的研究表明，髋关节绑架者在 平衡和移动功能。髋关节肌肉受损的老年人表现出髋关节的降低 从余额中恢复时，绑架者的强度，较低的平衡得分和较差的垫脚力学 扰动。我们的初步结果还表明，髋关节肌肉的脂肪浸润增加可能 助长肌肉不良，并以传统的力量改变髋部绑架肌肉 干预困难。神经肌肉电刺激是一种改善老年人肌肉的方法， 尽管传统上不在髋关节绑架者上使用它。 我们的初步结果表明，在臀部上使用神经肌肉电刺激的老年人 绑架者，结合平衡训练干预；展示髋关节绑架者的更大改进 强度，平衡和机动性功能。我们的中心假设是添加神经肌肉电气 在余额干预期间应用于髋关节绑架者的刺激将导致：改善平衡，较大 肌肉和流动性功能的改善，而跌倒的次数少于仅平衡干预措施。在这个 随机对照试验，我们将在有和没有的情况下确定平衡和加强程序的影响 神经肌肉对跌落风险和迁移率的电刺激（AIM 1），髋关节外展子组成的变化， 功能，激活和步态变异性（AIM 2），并在六个月和十二个月中保留这些变化 跟进（目标3）。我们预计这项面向患者的翻译研究将提供第一个证据 从一项大型随机对照试验中，用于使用应用于原发性髋关节的神经肌肉电刺激 绑架者是传统康复计划的有效辅助手段，以提高平衡，流动性和 老年退伍军人的肌肉有跌倒的风险。