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.

项目摘要/摘要 我们的长期目标是开发有效的身体康复方法，以提高流动性并防止 属于帕金森氏病（PD）的人。为了实现这一目标，我们的建议的目的是确定 日常生活中转弯，步态和流动性活动的客观衡量，最能反映跌倒风险并探索 将流动性的日常生活监测用作康复的结果指标，以提高转弯质量。 用涉及身体破坏的新技术量化转弯能力，惯性传感器可以提供 针对临床试验和临床实践的强大，新的结果集中在移动性残疾上。我们假设 转弯的客观衡量标准将最好地区分堕落者与非堕落者，预测PD患者的跌倒 没有秋天的历史，可以通过PD的康复来改善转折。 两项横断面研究将确定创新的转弯，步态客观度量的有用性 在日常工作7天的活动中，有磨损的惯性传感器用于康复。目标我是一个 回顾性，观察性，研究，比较转弯，步态和活动与患有人体磨损的传感器的研究 在过去的12个月中，有和没有跌倒病史的PD。 AIM II是一项前瞻性研究，仅在 非堕落者，调查日常生活中最佳的流动措施，以预测12次的第一次跌倒 日常生活监测7天后的几个月。 AIM III是一项探索性，随机的运动干预研究 计划未来的临床试验，以改善日常生活的转变。具体来说，我将收集的堕落者我将是 随机分为一个小说，为期6周，转弯训练营组或一个主动控制加强组）。 这项研究旨在通过改善其移动功能和PD患者的医疗保健 通过开发更有效的流动性残疾康复，他们的生活质量。平衡和步态障碍 影响大多数慢性疾病或神经疾病的人，导致无法控制关键 平衡任务 - 快速改变步行方向（转弯）。该建议将提高我们对 在社区生活期间，转弯障碍的贡献和帕金森氏症障碍和探索 康复是否可以提高日常生活中功能流动性的转向质量。基于这些研究， 临床医生将能够使用磨损的传感器快速，准确地评估转弯的质量 实施一个新颖的转弯训练营计划，旨在改善移动性残疾。

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