Quantifying the Recovery Response and Role of Hand Strength During Ladder Falls

量化梯子跌倒期间手部力量的恢复反应和作用

• 批准号: 8302564
• 负责人: Kurt E Beschorner
• 金额: $ 19.29万
• 依托单位: UNIVERSITY OF WISCONSIN MILWAUKEE
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8302564
• 关键词: Quantifying; Recovery; Response; Role; Hand

DESCRIPTION (provided by applicant): Falls from ladders represent one of the leading causes of occupational injuries and fatalities. The primary factors contributing to falls from ladders are missteps and foot slips, which cause foot de-coupling from the rung leading to a fall. After a slip/misstep occurs, a person must rely on their hands as well as the foot opposite to the misstep to stop their fall and regain balance on the ladder. This response must be executed rapidly and requires coordination between the upper and lower body. Currently, there is a key gap in knowledge related to the ability of a person to recover from slips and missteps during climbing and the biomechanical response necessary to achieve this recovery using the upper or lower limbs. The overall objective of this R21 proposal is to gain quantitative knowledge on biomechanical causes and recovery response from a ladder fall as well as the role of hand strength in recovering from a ladder slip and misstep. The rationale is that successful completion of this objective will lead to improved ladder rung design and climbing practices that maximize the likelihood of a recovery and ultimately reduce ladder fall injuries and fatalities. Specific aim #1 is to characterize the sensorimotor process to a ladder misstep and slip. The first objective is to identify the sensory system that is most critical for detecting that a misstep/slip has occurred. The second objective is to identify the muscle groups that are most responsible for recovery from the perturbation. The coordinated upper- and lower- body response to slips and missteps will be characterized. To accomplish this specific aim, subjects will be exposed to both a simulated misstep and slip during ascent of a ladder by having a rung of the ladder automatically release and a rung freely spin, respectively, while available sensory input and motor response are recorded. Sensory system input will be characterized by foot forces and center of pressure for foot somatosensation, hand forces for hand somatosensation, joint angles for proprioception, and head acceleration for vestibular sensation. The biomechanical response to the misstep/slip will be characterized by recording the joint moments, muscle activity and work performed in the upper and lower body during the response. Onset and magnitude of deviations of the sensorimotor response during perturbation compared to unperturbed ladder climbing as well as the sequencing of muscle activity will be determined to identify the critical sensory system for detecting a perturbation and critical motor response fo recovery. Specific aim #2 is to determine the role of hand strength on a person's ability to recover from ladder fall. The hypothesis is that subjects' hand strength is significantly associate with the perturbation outcome (fall vs. recovery). The perturbation outcome rate will be compared across three subject groups with different levels of hand strength. The hypothesis will be supported if the low hand strength group falls more frequently than other groups. This research represents a step closer to the long-term goal to prevent fatal and disabling injuries from falls on ladders by implementing ergonomic design changes based upon biomechanical factors involved in falls. PUBLIC HEALTH RELEVANCE: Fall accidents from ladders caused by a misstep account for a large number of serious occupational injuries and fatalities. Understanding the response of the body to slips and missteps on a ladder and the role of hand strength is critical to designing ladders and climbing practices that reduce the likelihood of a fall after a misstep. This project will measure and characterize the response process to ladder missteps and determine the contribution of hand strength to the recovery process.

描述（由申请人提供）：梯子跌倒是职业伤害和死亡的主要原因之一。导致梯子掉落的主要因素是失误和脚滑，这导致脚部从梯级造成的脚耦合导致跌落。滑倒/失误发生后，一个人必须依靠自己的手以及与失误相反的脚，以阻止跌倒并重新获得梯子的平衡。该反应必须迅速执行，需要上半身和下半身之间的协调。当前，知识的关键差距与一个人在攀爬过程中从滑移和失误中恢复的能力以及使用上肢或下肢实现此恢复所需的生物力学响应有关。该R21提案的总体目标是从梯子下降的生物力学原因和恢复响应中获得定量知识，以及手部强度从梯子滑动和失误中恢复的作用。理由是，成功完成这一目标将导致梯子的设计和攀登实践的改善，从而最大程度地恢复，并最终减少梯子跌倒的伤害和死亡。特定的目标＃1是将感觉运动过程表征为梯子失误和滑动。第一个目标是确定最重要的感觉系统，这对于检测出现了失误/滑移。第二个目标是确定最负责从扰动中恢复的肌肉群。将表征对滑动和失误的协调上身体和下身体的反应。为了实现这一特定目的，通过让梯子的梯级自动释放和自由旋转时，受试者将在梯子上升期间暴露于模拟的失误和滑动，同时记录了可用的感觉输入和运动响应。感觉系统输入的特征是脚部力和脚压力的压力中心，用于手动敏感的手部力，用于本体感受的关节角度以及前庭感觉的头部加速度。对失误/滑移的生物力学反应将以记录关节矩，肌肉活性和在响应期间在上半身进行的关节力矩，肌肉活动和工作的特征。与不受干扰的梯子攀爬以及肌肉活性的测序相比，在扰动过程中感觉运动反应的偏差的发作和大小将确定，以识别检测扰动和关键运动反应的关键感觉系统FO恢复。特定的目标是确定手力量对一个人从梯子跌倒的能力的作用。假设是受试者的手强度与扰动结果显着相关（秋季与恢复）。将在三个具有不同水平的手动强度的受试者组中比较扰动结果率。如果低手强度组比其他群体更频繁地下降，将支持该假设。这项研究代表了一个长期目标，即通过基于跌倒涉及的生物力学因素实施人体工程学设计变化，以防止梯子跌倒和致残的伤害。 公共卫生相关性：失误造成的阶梯事故是由于大量严重的职业伤害和死亡而导致的。了解身体对在梯子上滑倒和失误的反应以及手力的作用对于设计梯子和攀爬实践至关重要，从而减少失误后跌倒的可能性。该项目将衡量和表征梯子失误的响应过程，并确定手强度对恢复过程的贡献。