Motor learning of protective responses to balance perturbations in persons with Parkinson's Disease

帕金森病患者平衡扰动保护性反应的运动学习

• 批准号: 10574010
• 负责人: Ruth Yetunde Akinlosotu
• 金额: $ 4.32万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10574010
• 关键词: Age; Agonist; Anterior; Balance training; Characteristics; Clinical Trials; Development; Doctor of Philosophy; Elderly; Equilibrium; Fatal injury; Future; Individual; Intervention; Learning; Measures; Methods; Motor; Motor Skills; Muscle; Musculoskeletal Equilibrium; Parkinson Disease; Parkinsonian Disorders; Patients; Performance; Persons; Population; Postural response; Posture; Process; Protocols documentation; Public Health; Recurrence; Rehabilitation therapy; Research; Schedule; Symptoms; Testing; Touch sensation; Training; Walking; antagonist; fall injury; fall risk; falls; flexibility; follow-up; habituation; improved; learning strategy; motor learning; pharmacologic; response; skill acquisition; treadmill

Project Summary Two-thirds of persons with Parkinson’s disease (PwPD) fall yearly, resulting in non-fatal and fatal injuries. Many of these patients are recurrent fallers, due primarily to parkinsonian symptoms that interfere with postural control and limit postural responses to both self-initiated and external perturbations. These symptoms cause excessive co-contraction of agonists and antagonist muscle groups, hypometria, delayed stepping, and postural set inflexibility (i.e., an inability to quickly change responses to different types, conditions, and intensities of postural disturbances). Even with pharmacological and rehabilitation interventions, postural and balance deficits persist, and the risk of falls remains intractable. Among older adults, balance perturbation training is emerging as an effective method to reduce fall related injuries. In PwPD, however, one of the challenges to balance training is that postural inflexibility may negatively impact motor skill acquisition, retention, and generalization. As a result, motor learning strategies that are effective in individuals without PD may not be effective in PwPD. The overall objective of this PhD dissertation proposal is to determine the effect of practice schedule on the acquisition, retention, and generalization of protective balance responses in PwPD. The central hypothesis is that PwPD will acquire and retain protective balance responses to treadmill perturbations through blocked, but not random, initial practice schedules, and will require a follow-up set of random practice to generalize improvements to overground perturbations. In specific aim 1, I will compare improvements in protective stepping stability after a single session of blocked versus random practice of 10 slips and 10 trips in PwPD and age-matched healthy controls. In specific aim 2, I will compare generalization of protective stepping stability to unpracticed overground slip perturbations after blocked, followed by random practice sessions (blocked-random) to random, followed by blocked (random-blocked) practice sessions of treadmill-induced perturbations (10 slips and 10 trips) in PwPD and controls. Together, these findings will provide a basis for developing balance rehabilitation protocols based on motor learning principles to mitigate falls in PwPD compared to age-matched controls.

项目摘要 帕金森氏病（PWPD）的三分之二的人每年都会下降，导致非致命和致命伤害。许多 这些患者是反复出现的，这是由于干涉姿势控制的帕金森氏症符号 并限制对自发和外部扰动的姿势反应。这些符号会导致过多 激动剂和拮抗剂群体，体内降低，垫脚延迟和姿势集的共同收缩 僵化（即，无法快速改变对姿势的不同类型，条件和强度的反应 干扰）。即使有药物和康复干预措施，姿势和平衡不足仍然存在， 而且跌倒的风险仍然棘手。在老年人中，平衡扰动培训正在作为一种 减少秋天相关伤害的有效方法。但是，在PWPD中，平衡培训的挑战之一是 姿势僵化性可能会对运动技能的获取，保留和概括产生负面影响。因此， 在没有PD的个体中有效的运动策略在PWPD中可能无效。总体 该博士学位论文建议的目的是确定实践时间表对收购的影响， 保留和概括PWPD中受保护的平衡响应。中心假设是PWPD将 通过阻塞但不是随机的，获取并保留对跑步机扰动的保护平衡响应 最初的练习时间表，并需要一组随机练习，以将改进推广到 地面扰动。在特定目标1中，我将比较保护阶梯稳定性的改进 在PWPD和年龄匹配的健康中，单次障碍与随机练习的单个障碍与随机实践 控件。在特定的目标2中，我将比较保护步进稳定性的概括与地基的不可行 阻塞后的滑动扰动，然后进行随机练习（阻塞随机）到随机，然后是 PWPD中跑步机诱导的扰动（10幻灯片和10次旅行）的阻塞（随机阻塞）练习会话 和控件。这些发现将共同为制定基于平衡康复方案的基础 与年龄匹配的对照相比，关于运动原理可以减轻PWPD的趋势。