Mobility in Daily Life and Falls in Parkinson's Disease: Potential for Rehabilitation

日常生活中的活动能力和帕金森病的跌倒：康复的潜力

• 批准号: 10630819
• 负责人: FAY BAHLING HORAK
• 金额: $ 52.44万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10630819
• 关键词: Affect; Age; Boxing; Characteristics; Chronic Disease; Clinical; Clinical Trials; Cross-Sectional Studies; Data; Disease; Effectiveness; Elderly; Ensure; Equilibrium; Fall prevention; Fracture; Future; Gait; Gait abnormality; Goals; Healthcare; Hip Fractures; Home; Hour; Impairment; Intervention; Intervention Studies; Life; Measurement; Measures; Monitor; Outcome; Outcome Measure; Parkinson Disease; Parkinsonian Disorders; Persons; Pharmaceutical Preparations; Physical Rehabilitation; Pilot Projects; Prospective Studies; Protocols documentation; Randomized; Recording of previous events; Rehabilitation therapy; Reporting; Severity of illness; Tai Ji; Testing; Time; Walking; Weight; active control; clinical practice; community living; design; disability; effectiveness testing; equilibration disorder; exercise intervention; exercise program; experience; fall risk; falls; flexibility; foot; functional outcomes; improved; improved mobility; innovation; mobility rehabilitation; nervous system disorder; new technology; novel; programs; prospective; recruit; sensor; strength training; wearable sensor technology

Project Summary/Abstract Our long-term goal is to develop effective physical rehabilitation approaches to improve mobility and prevent falls in people with Parkinson’s disease (PD). To reach this goal, the purpose of our proposal is to identify objective measures of turning, gait and mobility activity during daily life that best reflect fall risk and to explore the use of daily life monitoring of mobility as outcome measures for rehabilitation to improve turning quality. Quantification of turning ability with new technology involving body-worn, inertial sensors could provide powerful, new outcomes for clinical trials and clinical practice focused on mobility disability. We hypothesize that objective measures of turning will best discriminate fallers versus nonfallers, predict falls in people with PD without a fall history, and turning can be improved with rehabilitation in PD. Two cross-sectional studies will determine the usefulness of innovative, objective measures of turning, gait, and activity over 7 days of daily living with body-worn inertial sensors for use in rehabilitation. Aim I is a retrospective, observational, study comparing turning, gait, and activity with body-worn sensors in people with PD with and without a history of falls in the previous 12 months. Aim II is a prospective study, only in the nonfallers, investigating the best set of measures of mobility during daily life to predict the first falls in the 12 months after 7 days of daily life monitoring. Aim III is an exploratory, randomized, exercise intervention study to plan a future clinical trial for improving turning in daily life. Specifically, the fallers collected in Aim I will be randomized into a novel, 6-week, Turning Boot Camp group or an Active Control Strengthening) group. This study is designed to advance healthcare of people with PD by improving their mobility function and the quality of their lives by developing more effective rehabilitation for mobility disability. Balance and gait disorders affect most people with chronic disease or neurological disease, resulting in inability to control a critical balance task – quickly change walking direction (turning). This proposal will improve our understanding of the contribution of turning impairments during community living to falls and parkinsonian impairments and explore whether rehabilitation can improve quality of turning for functional mobility in daily life. Based on these studies, clinicians will be able to use body-worn sensors to quickly and accurately assess quality of turning and implement a novel Turning Boot Camp program focused on improving mobility disability.

项目概要/摘要 我们的长期目标是开发有效的假肢康复方法，以改善活动能力并预防 为了实现这一目标，我们提案的目的是确定帕金森病 (PD) 患者的患病率。 日常生活中最能反映跌倒风险的转身、步态和移动活动的客观测量，并探索 使用日常生活监测活动能力作为康复的结果措施，以提高转弯质量。 利用涉及身体佩戴的惯性传感器的新技术量化转向能力可以提供 针对行动障碍的临床试验和临床实践提供了强有力的新成果。 客观的翻身测量可以最好地区分跌倒者与非跌倒者，预测帕金森病患者的跌倒情况 没有跌倒史，并且可以通过 PD 康复来改善转身。 两项横断面研究将确定创新、客观的转身、步态测量方法的实用性。 Aim I 是使用身体佩戴的惯性传感器进行超过 7 天的日常生活活动。 回顾性、观察性研究，比较患有以下疾病的人的转身、步态和活动与身体佩戴的传感器 Aim II 是一项前瞻性研究，仅在过去 12 个月内有或没有跌倒史。 不会跌倒的人，调查日常生活中最好的活动测量方法，以预测 12 天内的第一次跌倒 Aim III 是一项探索性、随机的运动干预研究，旨在进行 7 天的日常生活监测。 具体来说，计划一项未来的临床试验，以改善日常生活中的翻身情况，目标 I 中收集的跌倒者将被用于治疗。 随机分为新的为期 6 周的转向训练营组或主动控制强化组。 本研究旨在通过改善帕金森病患者的行动功能和行动能力来促进他们的医疗保健 通过开发更有效的平衡和步态障碍康复治疗来提高他们的生活质量。 影响大多数患有慢性病或神经系统疾病的人，导致无法控制严重的疾病 平衡任务——快速改变行走方向（转弯）。这个建议将提高我们对行走的理解。 社区生活期间的转身障碍对跌倒和帕金森障碍及探索的影响 根据这些研究，康复是否可以提高日常生活中功能活动的转身质量。 战士们将能够使用身体佩戴的传感器来快速准确地评估转弯和移动的质量 实施一项新颖的转向训练营计划，重点关注改善行动障碍。

项目成果

Gait and turning characteristics from daily life increase ability to predict future falls in people with Parkinson's disease.

• DOI: 10.3389/fneur.2023.1096401
• 发表时间: 2023
• 期刊: Frontiers in neurology
• 影响因子: 3.4

Evaluation of movement and brain activity.

• DOI: 10.1016/j.clinph.2021.04.023
• 发表时间: 2021-10
• 期刊: Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
• 作者: Hallett M;DelRosso LM;Elble R;Ferri R;Horak FB;Lehericy S;Mancini M;Matsuhashi M;Matsumoto R;Muthuraman M;Raethjen J;Shibasaki H
• 通讯作者: Shibasaki H