Exercise-Based Fall Prevention in the Elderly: What About Agility?
Exercise-Based Fall Prevention in the Elderly: What About Agility?
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DOI：
10.1007/s40279-015-0389-5
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发表时间：
2016-02-01
期刊：
影响因子：
9.8
通讯作者：
Faude, Oliver
中科院分区：
文献类型：
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作者：
Donath, Lars;van Dieen, Jaap;Faude, Oliver
每年，65岁以上的老年人中有三分之一会摔倒。平衡和力量训练可以减少神经肌肉跌倒的风险因素和跌倒率。除了传统的平衡和力量训练外，爆发力或高速力量训练、离心练习、基于扰动的平衡训练、躯干力量和躯干控制也得到了强调。相比之下，有氧运动迄今尚未被纳入预防跌倒的研究。然而，发达的耐力可能会减弱疲劳引起的运动相关或一般日常生活活动中姿势控制的下降。身体机能指标，如平衡、力量和耐力，通常在运动指南中单独列出。这种方法似乎很耗时，可能会妨碍处理老年人平衡威胁情况所需的感觉运动，神经肌肉和心血管功能的综合训练。一个基于敏捷性的概念训练框架，包括感知和决策（例如，视觉扫描、模式识别、预测）和方向的改变（例如，突然启动、停止和转动;反应性控制;同心和离心收缩）可以实现综合神经肌肉、心血管和认知训练。本论文旨在提供一个科学的草图，如何建立这样一个集成的模块化训练方法，允许适应的强度，复杂性和认知挑战的敏捷性任务的参与者的能力。随后的研究应解决（1）敏捷性和跌倒风险因素以及跌倒率之间的联系，（2）拟议方法的获益风险比，（3）敏捷性训练的心理社会方面（例如，动机），和（4）后勤要求（例如，所需设备）。
Annually, one in three seniors aged over 65 years fall. Balance and strength training can reduce neuromuscular fall risk factors and fall rates. Besides conventional balance and strength training, explosive or high-velocity strength training, eccentric exercises, perturbation-based balance training, trunk strength, and trunk control have also been emphasized. In contrast, aerobic exercise has to date not been included in fall-prevention studies. However, well-developed endurance capacity might attenuate fatigue-induced declines in postural control in sports-related or general activities of daily living. Physical performance indices, such as balance, strength, and endurance, are generally addressed independently in exercise guidelines. This approach seems time consuming and may impede integrative training of sensorimotor, neuromuscular, and cardiocirculatory functions required to deal with balance-threatening situations in the elderly. An agility-based conceptual training framework comprising perception and decision making (e.g., visual scanning, pattern recognition, anticipation) and changes of direction (e.g., sudden starts, stops and turns; reactive control; concentric and eccentric contractions) might enable an integrative neuromuscular, cardiocirculatory, and cognitive training. The present paper aims to provide a scientific sketch of how to build such an integrated modular training approach, allowing adaptation of intensity, complexity, and cognitive challenge of the agility tasks to the participant's capacity. Subsequent research should address the (1) link between agility and fall risk factors as well as fall rates, (2) benefit-risk ratios of the proposed approach, (3) psychosocial aspects of agility training (e.g., motivation), and (4) logistical requirements (e.g., equipment needed).