The Sensorimotor Locus of Balance Control in Elderly Gait

老年人步态平衡控制的感觉运动轨迹

基本信息

批准号：
9566373
负责人：
Jason R Franz
金额：
$ 22.77万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-30 至 2019-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9566373
关键词：
Address Adult Age Aging Anterior Back Benchmarking Biomechanics Biomedical Engineering Clinical Cognitive Confidence Intervals Crossover Design Custom Data Dependence Development Diagnostic Elderly Equilibrium Exposure to Gait Goals Immersion Investigative Technique Individual Differences Injury Instinct Intervention Studies Lead Leg Methods Modeling Motor Muscle Neuromechanics Optics Outcome Measure Patient Self-Report Performance Peripheral Physical therapy Posture Predisposition Process Quality of life Randomized Recording of previous events Rehabilitation therapy Research Research Personnel Sensory Series Side Technology Testing Time Torque Training Trunk structure Vision Visual Walking age related aging population balance testing conditioning cost design experience fall risk falls foot high risk improved innovation insight interdisciplinary collaboration kinematics motor control multisensory novel strategies programs resilience response retinal rods sensory feedback somatosensory treadmill treadmill training virtual virtual reality visual motor visual stimulus young adult

项目摘要

Our aging population is at an exceptionally high risk of debilitating falls, contributing significantly to reduced independence and quality of life. Despite conventional diagnostic and rehabilitative efforts, one-third of people over age 65 fall annually and 20-30% of these falls lead to moderate to severe injury. Remarkably, evidence even suggests that the rate of injurious falls among older adults is accelerating. Through an innovative sensorimotor paradigm using optical flow perturbations in a custom virtual environment, this proposal seeks to address the critical and immediate need for transformative new approaches for identifying and mitigating falls risk in our aging population. Our overarching goal is to investigate the efficacy of optical flow perturbations, particularly when applied during walking, to: (i) elucidate aging and falls history effects on standing and walking balance control, and (ii) subsequently condition successful balance control strategies through training. The first aim will tightly integrate virtual reality, visuomotor entrainment (i.e., the instinctive synchronization of motor responses to visual stimuli), and a series of clinical and self-reported benchmarks to investigate aging and falls history effects on the response to optical flow perturbations during standing and walking. We will test the hypothesis that optical flow perturbations during walking will distinguish age and falls history more effectively than those during standing and with effect sizes larger than those from conventional balance testing. The second aim will investigate sensory, motor, and cognitive-motor mechanisms governing susceptibility to optical flow perturbations. Using a strategically-selected combination of outcome measures and multivariate modeling, we will test the hypothesis that entrainment to optical flow perturbations will correlate most strongly with visual dependence and decreased somatosensory function, alluding to an age-associated process of multi-sensory reweighting that will emerge most prominently in walking. Finally, our third aim is designed to gain preliminary insight into the efficacy of prolonged optical flow perturbations to condition strategies used to successfully control walking balance in older adult fallers. In a randomized cross-over design, older adults with a history of falls will complete two treadmill training sessions – one with (i.e., “training” session) and one without (i.e., “control” session) dynamic optical flow perturbations. We will test the hypothesis that older adults with a history of falls will adapt to prolonged exposure to perturbations, conditioning their step to step adjustments in walking balance control and improving their response to unexpected balance challenges following training. This research represents an interdisciplinary collaboration involving experienced investigators in biomedical engineering, physical therapy, and motor control. Successful completion of this R21 will provide the necessary mechanistic and preliminary efficacy information needed to design larger diagnostic and intervention studies to determine the value and applicability of perturbed optical flow to mitigate fall risk. With the advent of wearable and low cost virtual reality technology, this proposal is both timely and clinically feasible.

我们的人口老龄化面临着极高的跌倒风险，这极大地减少了尽管进行了传统的诊断和康复努力，仍有三分之一的人无法获得独立性和生活质量。 65 岁以上的人每年都会跌倒，其中 20-30% 的跌倒会导致中度至重度伤害，甚至有证据表明。表明老年人受伤性跌倒的发生率正在通过创新的感觉运动而加速。在自定义虚拟环境中使用光流扰动的范例，该提案旨在解决我们迫切需要变革性的新方法来识别和减轻跌倒风险我们的首要目标是研究光流扰动的功效，尤其是人口老龄化。在步行过程中应用时，可以：(i) 阐明衰老和跌倒史对站立和步行平衡的影响控制，以及（ii）随后通过训练来调节成功的平衡控制策略。紧密整合虚拟现实、视觉运动夹带（即运动反应的本能同步视觉刺激），以及一系列临床和自我报告的基准来调查衰老和跌倒历史我们将检验该假设。步行过程中的光流扰动将比那些光流扰动更有效地区分年龄和跌倒史第二个目标是站立时的效果大小大于传统平衡测试的效果大小。研究控制光流敏感性的感觉、运动和认知运动机制使用策略性选择的结果测量和多元模型组合，我们将检验光流扰动的夹带与视觉相关性最强的假设依赖性和体感功能下降，暗示与年龄相关的多感觉过程最后，我们的第三个目标是获得初步的成果。深入了解长期光流扰动对成功使用的条件策略的功效在随机交叉设计中，控制有跌倒史的老年人的步行平衡。跌倒将完成两次跑步机训练课程——一项有（即“训练”课程），另一项没有（即“训练”课程） “控制”会话）动态光流扰动我们将测试有病史的老年人的假设。的跌倒者会适应长时间的扰动，从而调节他们步行时的一步步调整平衡控制并提高他们在训练后对意外平衡挑战的反应。代表生物医学工程领域经验丰富的研究人员参与的跨学科合作，物理治疗和运动控制的成功完成此 R21 将提供必要的机械治疗。以及设计更大规模的诊断和干预研究所需的初步疗效信息，以确定随着可穿戴设备和低功耗设备的出现，扰动光流在降低跌倒风险方面的价值和适用性。考虑到虚拟现实技术的成本，这一建议既及时又临床可行。

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Age and falls history effects on antagonist leg muscle coactivation during walking with balance perturbations.

DOI：
10.1016/j.clinbiomech.2018.09.011
发表时间：
2018-11
期刊：
Clinical biomechanics (Bristol, Avon)
影响因子：
0
作者：
Thompson JD;Plummer P;Franz JR
通讯作者：
Franz JR

Does local dynamic stability during unperturbed walking predict the response to balance perturbations? An examination across age and falls history.

不受干扰行走期间的局部动态稳定性是否可以预测对平衡扰动的响应？

DOI：
10.1016/j.gaitpost.2018.03.011
发表时间：
2018
期刊：
Gait & posture
影响因子：
2.4
作者：
Qiao,Mu;Truong,KinhN;Franz,JasonR
通讯作者：
Franz,JasonR

Time-dependent tuning of balance control and aftereffects following optical flow perturbation training in older adults.

老年人光流扰动训练后平衡控制和后遗症的时间依赖性调整。

DOI：
10.1186/s12984-019-0555-3
发表时间：
2019
期刊：
Journal of neuroengineering and rehabilitation
影响因子：
5.1
作者：
Richards,JacksonT;Selgrade,BrianP;Qiao,Mu;Plummer,Prudence;Wikstrom,ErikA;Franz,JasonR
通讯作者：
Franz,JasonR

Effects of aging and target location on reaction time and accuracy of lateral precision stepping during walking.

老化和目标位置对步行过程中横向精确步进的反应时间和准确性的影响。