Intervention to Enhance Lateral Balance Function and Prevent Falls in Aging

增强横向平衡功能并预防衰老的干预措施

• 批准号: 8133396
• 负责人: MARK W ROGERS
• 金额: $ 37.95万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8133396
• 关键词: Activities of Daily Living; Affect; Age; Aging; Anterior; Balance training; Biomechanics; Caring; Communities; Control Groups; Development; Double-Blind Method; Economics; Effectiveness; Elderly; Enrollment; Equilibrium; Exercise; Fall prevention; Flexor; Frequencies; Goals; Hip Fractures; Hip region structure; Human; Impairment; Incidence; Individual; Injury; Intervention; Joints; Lateral; Leg; Length; Limb structure; Link; Measures; Medical; Modeling; Muscle; Muscle function; Neuromechanics; Outcome; Pattern; Performance; Physiological; Prevention strategy; Public Health; Randomized Controlled Trials; Recording of previous events; Recovery; Relative (related person); Relaxation; Research; Secure; Specificity; Speed; Step training; Therapeutic Intervention; Time; Time Study; Torque; Training; Training Programs; Translating; Walking; Weight-Bearing state; age related; arm; base; community living; effective intervention; fall risk; falls; flexibility; follow-up; group intervention; improved; muscle strength; prevent; programs; prospective; public health relevance; response; strength training

DESCRIPTION (provided by applicant): Falls and their consequences are among the major problems in the medical care of older individuals. The long-term goal of this research is to establish the efficacy of a scientifically grounded and mechanism-based therapeutic intervention for improving balance function and preventing falls in older people. When human balance is challenged, protective stepping is a vital strategy for preventing a fall during activities of daily life. Many older people at risk for falls have particular difficulties with successfully stepping sideways as a protective response to loss of balance in the lateral direction. We propose that age-related declines in lateral balance function through impaired protective stepping that precipitates falls, result from neuromechanical (NM) limitations in hip abductor-adductor (AB-AD) muscle strength (torque and power). Moreover, we hypothesize that these functional and NM impairments are reversible with combined, high intensity induced, step training and muscle strengthening. The specific aims are to conduct a double blind, randomized, and controlled trial with four training arms that will compare the effects of 12 weeks of training and assess its durability after 3 months of no training in community living older adults at risk for falls by determining: 1) the effect of (a) waist-pull induced step training, (b) hip AB-AD muscle strengthening, and (c) a combined step training and muscle strengthening program compared to (d) a standard flexibility and relaxation program involving minimal-intensity exercises (control) on the protective stepping response to an external balance perturbation, as measured by i) the number of multiple balance recovery steps, and ii) first step length; and 2) the effect of high intensity step training, with and without the strengthening intervention, compared to the control group on a) maximum hip AB- AD joint torque and power. A secondary aim will assess whether protective stepping performance and hip AB- AD muscle strength discriminate between a) fallers and non-fallers identified by retrospective fall history at the time of study enrollment, and b) the prospective fall frequency of the different intervention groups during 1-year follow-up post-training. PUBLIC HEALTH RELEVANCE: The relevance of this research to public health lies in its focus on understanding the causes of age-associated falls and on the development of effective interventions for minimizing the devastating economic, societal, and personal consequences of falls among older people.

描述（由申请人提供）：跌倒及其后果是老年人医疗保健的主要问题。这项研究的长期目标是确定基于科学的基于机制的治疗干预措施的功效，以改善平衡功能并防止老年人跌倒。当挑战人的平衡时，保护性步进是防止日常生活活动中跌倒的至关重要策略。许多处于跌倒风险的老年人在侧面成功踏上了跌倒的特殊困难，这是对横向方向失去平衡的保护性反应。我们提出，与年龄相关的横向平衡功能下降，这是由于髋关节外展子 - adductor（AB-AD）肌肉强度（扭矩和功率）的神经力学（NM）局限性导致的保护性阶梯降低了降低的降低。此外，我们假设这些功能性和NM损伤可通过结合，高强度诱导的，步进训练和肌肉增强可逆。 The specific aims are to conduct a double blind, randomized, and controlled trial with four training arms that will compare the effects of 12 weeks of training and assess its durability after 3 months of no training in community living older adults at risk for falls by determining: 1) the effect of (a) waist-pull induced step training, (b) hip AB-AD muscle strengthening, and (c) a combined step training and muscle strengthening program compared to (d) a standard flexibility and relaxation program涉及对外部平衡扰动的保护性踩踏响应的最小强度练习（控制），如i）多个平衡恢复步骤的数量，ii）第一步长度； 2）与对照组相比，高强度步骤训练的影响有或没有加强干预，a）最大髋关节关节扭矩和功率。次要目标将评估保护性的踏步性能和臀部的肌肉力量是否在研究入学时通过回顾性秋季历史而识别出的堕落者和非男人，b）在培训后的1年随访期间，不同干预组的前瞻性下降频率。 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理解与年龄相关的跌倒的原因，以及开发有效的干预措施，以最大程度地减少老年人中毁灭性的经济，社会和个人后果。