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.

我们的老龄化人口的衰落风险异常高，有助于减少独立性和生活质量。尽管常规的诊断和康复努力，但三分之一的人每年65岁以上，这些跌倒中有20％至30％导致中度到重度受伤。值得注意的是，甚至证据表明老年人中有害的跌幅正在加速。通过创新的感觉运动使用光流扰动在自定义虚拟环境中，该提案旨在解决该范式批判性和直接需要进行变革性的新方法来识别和减轻我们的跌倒风险人口老龄化。我们的总体目标是研究光流扰动的效率，尤其是步行期间应用时，到：（i）阐明老化和跌倒历史对站立和步行平衡的影响控制，以及（ii）随后通过培训来调节成功的平衡控制策略。第一个目标紧密整合的虚拟现实，Visuomotor入口（即，电机响应的本能同步进行视觉刺激）以及一系列临床和自我报告的基准，以研究衰老和下降历史对站立和行走过程中对光流扰动的响应的影响。我们将检验假设步行过程中的光流扰动将比年龄的历史更有效地区分年龄和衰落的历史在站立期间，效果尺寸大于常规平衡测试的大小。第二个目标研究有关光流敏感性的感觉，运动和认知运动机制扰动。使用策略性地选择结果度量和多元建模的组合，我们将检验以下假设，即光流扰动的入口将与视觉最密切相关依赖性和改善的体感功能，暗示了与年龄相关的多感应过程在步行中最突出的重新加权将最突出。最后，我们的第三个目标旨在获得初步深入了解长期光流扰动的效率，以解决成功的策略控制老年瀑布的步行平衡。在随机跨界设计中，具有历史的老年人 Falls将完成两个跑步机培训课程 - 一个与（即“培训”会议），一个没有（即 “控制”会话）动态光流扰动。我们将测试有历史的老年人的假设瀑布的瀑布将适应长时间暴露于扰动，从而使他们的步骤进行步骤调整训练后，平衡控制并改善他们对意外平衡挑战的反应。这项研究代表一个跨学科的合作，参与经验丰富的生物医学工程研究人员，物理疗法和运动控制。成功完成此R21将提供必要的机械以及设计更大的诊断和干预研究所需的初步有效性信息以确定扰动光流的价值和适用性以减轻跌落风险。随着可穿戴和低的冒险成本虚拟现实技术，该建议既及时又可行。

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。