Lateral Stability and Falls in Aging

横向稳定性和老化下降

• 批准号: 7915446
• 负责人: MARK W ROGERS
• 金额: $ 55.66万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-15 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7915446
• 关键词: Activities of Daily Living; Age; Aging; Behavior; Caring; Computer Simulation; Control Groups; Economics; Elderly; Equilibrium; Experimental Models; Fall prevention; Functional disorder; Future; Gait; Generations; Goals; Hip region structure; Human; Impairment; Incidence; Individual; Intervention; Joints; Kinetics; Lateral; Lead; Length; Limb structure; Measures; Medical; Movement; Muscle; Musculoskeletal Equilibrium; Neuromechanics; Outcome; Pattern; Performance; Prospective Studies; Public Health; Reaction; Recovery; Research; Source; Step training; Therapeutic; Therapeutic Intervention; Torque; Training; Variant; experience; fall risk; falls; group intervention; high risk; improved; kinematics; motor control; programs; public health relevance; response

DESCRIPTION (provided by applicant): The long term objectives of this research are to identify the mechanisms of neuromechanical (NM) impairments underlying postural balance dysfunction in older people, and to establish a scientifically grounded therapeutic program for enhancing balance function and reducing the risk of falls. When human balance is challenged, the stepping reaction is a powerful means of stabilizing the body and preventing falling. Protective stepping is therefore a vital strategy for maintaining balance during activities of daily life. We propose that aging limitations in regional medio-lateral (M-L) hip abductor/adductor (AB/AD) NM responses compromise lateral balance stability by disrupting protective stepping. Consequently, many older people may be particularly vulnerable to lateral instability and injurious falls. Accordingly, our aims involve experimental, modeling, and interventional approaches to understanding these relationships. Aim one is to a) identify the balance perturbation magnitude level at which older subjects transition to a riskier and more problematic crossover protective stepping pattern due to limitations in hip AB/AD NM control as determined by movement kinetics and kinematics; and to b) assess whether balance perturbation magnitude and associated stepping and hip AB/AD NM response measures discriminate between subjects with low fall risk and those with high fall risk. Aim two is to develop and apply a computational model that predicts the balance limits of M-L stepping patterns in relation to regional hip AB/AD NM limitations. Aim three is to assess feasibility factors (compliance, tolerance, benefits) necessary to advance a full-scale therapeutic intervention for preventing falls. We hypothesize that an intervention approach that combines induced step training and hip AB/AD muscle strengthening will demonstrate greater improvements in performance outcomes and fewer prospectively identified falls than either program performed alone. PUBLIC HEALTH RELEVANCE. The relevance of this research to public health lies in its focus on understanding the causes and interventions for minimizing the devastating economic, societal, and personal consequences of age-associated falls.

描述（由申请人提供）：这项研究的长期目标是确定老年人的神经力学（NM）损害的机制（NM）损害的机制，并建立科学扎根的治疗计划，以增强平衡功能并降低跌倒风险。当人类平衡受到挑战时，垫脚反应是稳定身体并防止下降的有力手段。因此，保护​​性步进是在日常生活活动中保持平衡的至关重要策略。我们提出，通过破坏保护性步进，衰老的衰老限制（M-L）髋部绑架器/内收肌（AB/AD）NM响应损害了横向平衡稳定性。因此，许多老年人可能特别容易受到横向不稳定和有害跌倒的影响。因此，我们的目标涉及实验，建模和介入的方法来理解这些关系。目的是a）确定较老的受试者过渡到更风险和有问题的交叉保护模式的平衡扰动幅度水平，这是由于髋关节/AD NM控制的限制，由运动动力学和运动学确定； b）评估平衡扰动幅度和相关的踩踏和臀部AB/AD NM响应是否会衡量跌倒风险低的受试者和跌落高风险的受试者之间的区分。目标二是开发和应用一个计算模型，该模型可以预测与区域髋关节AB/AD NM限制相关的M-L步进模式的平衡限制。目的三是评估可行性因素（合规性，容忍度，收益），以推进防止跌倒的全面治疗干预措施。我们假设，一种结合了诱导的步骤训练和髋关节肌肉加强的干预方法将表现出比单独执行的任何一个计划的表现更大的改善，而前瞻性降低的跌倒更少。公共卫生相关性。这项研究与公共卫生的相关性在于它的重点是了解最大程度地减少与年龄相关的灾难性的经济，社会和个人后果的原因和干预措施。