Dynamic balance and rapid step training in impaired elders

残疾长者的动态平衡和快速步伐训练

• 批准号: 6221999
• 负责人: Neil Alexander
• 金额: $ 14.27万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-01 至 2004-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6221999
• 关键词: accidental falls; body movement; chordate locomotion; clinical research; disease /disorder prevention /control; exercise; geriatrics; human old age (65+); human subject; human therapy evaluation; injury prevention; interview

Falls are an important and potentially costly cause of injuries in older adults. Despite being heavily promoted, traditional exercise programs have thus far been inconsistently successful in reducing falls in older adults. Many of these exercise programs focus on improving maintenance stance as the body moves but in a relatively slow manner, i.e. slow dynamic balance. Perhaps an exercise program that is also directed toward dynamic balance but involving relatively fast movements might improve the ability to respond quickly to an impending fall (i.e. improving fall protective responses) and therefore show a stronger effect in reducing falls. Among these fall protective responses, the ability to make rapid stepping responses is often required to maintain standing balance. We propose to train older adults in a 3-month balance training program, combining a focus on improving both the ability to maintain stance and the ability to improve rapid stepping response. We will randomize older adults with mild-moderate balance deficits to one of other two groups: 1) the Combined Balance Training program or 2) T'ai Chi. The 3-month Combined Training and T'ai Chi will be followed by a 12 month home- based maintenance program with weekly group "refresher" sessions. Both groups will be under surveillance, via postcard responses and telephone calls, for the primary outcome, occurrence of falls and fall-related injuries. Intermediate outcomes at baseline, 3 months and 15 months will include measures of maintaining stance and rapid stepping. Secondary analyses will explore the relationships between apparent underlying mechanisms such as changes in rapid strength development and self efficacy as explanations for changes in maintenance of stance, rapid stepping, and the occurrence of falls. Thus, in addition to improving the balance and rapid stepping ability of participating subjects, a number of questions may be explored regarding postural control and the ability to avoid falls in an at-risk older adult population.

跌倒是老年人受伤的重要且可能昂贵的原因。尽管得到了大力晋升，但迄今为止，传统的锻炼计划在减少老年人的跌倒方面取得了不一致的成功。这些运动计划中的许多集中在身体移动时改善维护立场，但以相对较慢的方式，即动态缓慢的平衡。也许也针对动态平衡的锻炼计划，但涉及相对快速的运动可能会提高迅速反应即将来临的跌倒的能力（即改善秋天的保护反应），因此在减少跌倒方面表现出更强的影响。在这些跌倒的保护性反应中，通常需要保持快速踏脚反应的能力来维持立足平衡。我们建议在为期3个月的平衡训练计划中培训老年人，并将重点放在提高维持立场的能力和改善快速步进反应的能力上。我们将对其他两个组之​​一的温和平衡不足的老年人随机，1）合并的平衡训练计划或2）T'ai chi。为期3个月的培训和T'ai Chi将进行12个月的家庭维护计划，每周“复习”课程。两组将通过明信片的反应和电话受到监视，以进行主要结果，发生跌倒和与跌倒有关的伤害。基线，3个月零15个月的中级结果将包括维持立场和快速步步的措施。次要分析将探讨明显的潜在机制（例如快速力量发展和自我效能的变化）之间的关系，这是对维持立场，快速步进和跌倒发生变化的解释。因此，除了提高参与受试者的平衡和快速步进能力外，还可以探讨有关姿势控制和避免在高危老年人中跌倒的能力的许多问题。