Motor learning of fall resistant skills from laboratory-induced falling among people with Alzheimer's disease

阿尔茨海默病患者从实验室诱发的跌倒中学习抗跌倒技能

基本信息

批准号：
10652621
负责人：
Feng Yang
金额：
$ 23.4万
依托单位：
GEORGIA STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10652621
关键词：
Adult Alzheimer&apos s Disease Alzheimer&apos s disease related dementia Central Nervous System Clinical Cognitive deficits Data Elderly Environment Exercise Exposure to Fall prevention Fracture Goals Human body Impairment Injury Laboratories Learning Learning Skill Life Living Wills Modality Morbidity - disease rate Motor Skills Multiple Sclerosis Muscle Nature Neural Pathways Neuronal Plasticity Outcome Participant Patient Self-Report Pattern Persons Placebos Process Public Health Quality of life Randomized Reaction Regimen Research Resistance Risk Safety Societies Specificity Stroke Testing Time Training Walking arm cost design experience fall risk falls hazard high risk improved interest longitudinal design mortality motor learning motor skill learning neuromuscular training novel preservation prevent primary outcome programs prospective recruit skill acquisition skills skills training treadmill

项目摘要

ABSTRACT The long-term objective of this research is to develop an effective approach that can reduce falls for people with Alzheimer’s disease (AD) and related disorders. This project’s overall goal is to systematically examine if people with AD can acquire fall prevention skills from a novel paradigm - perturbation training. The specific aims of this proposed project are (1) to test if people with AD can adapt to perturbations on a treadmill and learn fall resistant motor skills; (2) to inspect if people with AD can retain motor skills learned in Aim 1 for at least 6 months; and (3) to determine if people with AD can generalize fall resistant skills gained on the treadmill to overground perturbations and daily living conditions. We will use a two-arm randomized, controlled longitudinal design to achieve these goals. A group of 30 older adults with mild AD will be randomized into two groups: A (training) and B (placebo). Group A will undergo a perturbation training-based motor learning session including 20 slips (S1-S20) and 20 trips (T1-T20) on a special treadmill. These perturbation trials will be mixed with regular walking trials in random order. Group B will walk on the treadmill with no perturbations for the same time as group A. Then, both groups will be exposed to a sudden overground slip (initial overground slip) and trip (initial overground trip). Participants will return for a retention session 6 months later to undergo another treadmill slip and trip (treadmill reslip and retrip) followed by an overground slip and trip (overground reslip and retrip). The perturbation outcome (fall or non-fall) and dynamic stability will be determined for slip and trip trials. Self-reported real-life falls over 6 months after the learning session will be collected for both groups. The primary outcome is the binary perturbation outcome following either the slip or trip. Dynamic stability during slips and trips and the all-cause falls in daily living will be our secondary variables. The primary outcome and dynamic stability will be compared between S1 and S20 and between T1 and T20 within group A to test if people with AD can adapt to large-scale slips and trips (Aim 1). To determine whether people with AD can retain the skills learned in Aim 1 for at least 6 months (Aim 2), the primary outcome and dynamic stability on treadmill reslip and retrip during the retention session will be compared between groups. The primary outcome and dynamic stability will also be compared between groups on the overground slips and trips during the acquisition and retention sessions to test if people with AD can immediately transfer the skills learned in Aim 1 to overground and if this transfer can maintain for 6 months (Aim 3). In addition, the prospective falls will be compared between groups to verify if people with AD can transfer the acquired fall resistant skills on the treadmill to everyday living conditions (Aim 3). Perturbation is a promising modality to prevent falls for people with AD due to its inherent natures: safety, task-specific, and implicit learning process. This project will have a profound impact on people with AD and society.

抽象的这项研究的长期目标是开发一种有效的方法来减少患有跌倒的人的跌倒该项目的总体目标是系统地检查人们是否患有阿尔茨海默病 (AD) 和相关疾病。患有 AD 的人可以从一种新颖的范式中获得跌倒预防技能——扰动训练的具体目标。该拟议项目的目的是 (1) 测试 AD 患者是否能够适应跑步机上的干扰并学会摔倒抵抗运动技能；(2) 检查 AD 患者是否能够保留目标 1 中学到的运动技能至少 6 年 (3) 确定患有 AD 的人是否可以将在跑步机上获得的防跌倒技能推广到我们将使用两臂随机、受控的模型来研究地面扰动和日常生活条件。为实现这些目标而进行的纵向设计将 30 名患有轻度 AD 的老年人随机分为两组。组：A（训练）和 B（安慰剂）A 组将接受基于扰动训练的运动学习。训练包括在特殊跑步机上进行 20 次滑动 (S1-S20) 和 20 次行程 (T1-T20)。以随机顺序与常规步行试验混合在一起，B 组将在跑步机上行走，不受干扰。与 A 组同时进行。然后，两组都将面临突然的地面滑移（最初的地面滑移滑）和旅行（最初的地面旅行），参与者将在 6 个月后返回参加保留课程以接受治疗。另一次跑步机滑倒和绊倒（跑步机重新打滑和重新跳闸），然后是地上滑倒和绊倒（地上重滑和重跳）。扰动结果（跌落或非跌落）和动态稳定性将由滑移确定。以及学习课程后 6 个月内自我报告的现实生活跌倒情况。主要结果是滑动或跳闸之后的二元扰动结果。滑倒和旅行时的稳定性以及日常生活中的各种原因跌倒将是我们的主要变量。将比较 A 组内 S1 和 S20 之间以及 T1 和 T20 之间的结果和动态稳定性，以测试 AD 患者能否适应大规模滑倒和绊倒（目标 1）。能够保留目标 1 中学到的技能至少 6 个月（目标 2），主要成果和动态稳定性将比较各组之间跑步机的重新滑动和重新跳动。还将对地上滑行和行程期间各组之间的结果和动态稳定性进行比较习得和保留课程，以测试 AD 患者是否可以立即转移所学到的技能目标1到地上，如果这种转移能够维持6个月（目标3），另外，预期会下降。将在各组之间进行比较，以验证患有 AD 的人是否可以将获得的防跌倒技能转移到跑步机对日常生活条件的影响（目标 3）是一种很有前景的预防跌倒的方法。 AD 由于其固有的性质：安全性、特定任务和隐性学习过程。对AD患者和社会产生了深远的影响。