Effects of task-specific obstacle-induced trip-perturbation training: proactive and reactive adaptation to reduce fall-risk in community-dwelling older adults.
Effects of task-specific obstacle-induced trip-perturbation training: proactive and reactive adaptation to reduce fall-risk in community-dwelling older adults.
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DOI：
10.1007/s40520-019-01268-6
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发表时间：
2020-05
影响因子：
4
通讯作者：
Bhatt T
中科院分区：
文献类型：
--
作者：
Wang Y;Wang S;Bolton R;Kaur T;Bhatt T
在居住在社区的老年人中，旅行占户外跌倒的一半以上。目的：研究障碍物诱导的绊倒干扰训练在多大程度上可以降低老年人跌倒风险，并观察训练效果是否可以在短期内保持。40名居住在社区的老年人暴露于24次以“阻塞和混合”方式在地上行走的重复旅行扰动中。另一次旅行在训练后30分钟进行。对于每次旅行，分析恢复策略和结果（摔倒与不摔倒）。试验期间，分析了主动和被动动力质量中心稳定性、起下钻前脚趾间隙和躯干角度、完井时躯干角度和恢复步长的变化。48%的参与者爱上了他们的新奇之旅。在随后的行程中，坠落率显著下降，最后一次没有坠落。由于改进了控制质量中心稳定性和身体运动学的前馈和反馈调节，摔倒发生率降低。主动适应包括降低前重心速度，这减少了前向不稳定性，更大的脚趾间隙，这增加了避障的可能性。反应性调整包括在恢复步骤完成时减少前向不稳定性和改善躯干控制（减少前向旋转）。训练后，训练效果在跌倒发生率方面保持不变，脚趾间隙和反应稳定性略有下降。老年人表现出适当的基于运动的主动和反应性适应，以重复的障碍引起的旅行，短期保持类似于年轻人，因此可以通过这种训练减少跌倒的风险。
Trips account for over half of outdoor falls among community-dwelling older adults. To investigate to what extent obstacle-induced trip perturbation training could reduce fall-risk among older adults and to see whether training effects could be retained short term. Forty community-dwelling older adults were exposed to twenty-four repeated trip perturbations given in a “blocked-and-mixed” manner during over-ground gait. Another trip was given thirty minutes post-training. For each trip, recovery strategies and outcomes (fall versus no fall) were analyzed. Within-trial changes to proactive and reactive dynamic center of mass stability, pre-trip toe clearance and trunk angle, trunk angle at recovery completion, and recovery step length were analyzed. 48% of participants fell on their novel trip. The fall rate decreased significantly for subsequent trips, with no falls on the last trip. The decreased fall incidence resulted from improved feedforward and feedback adjustments for controlling center of mass stability and body kinematics. Proactive adaptations included reduced forward center of mass velocity, which lessened forward instability, and larger toe clearance, which increased the likelihood of obstacle avoidance. Reactive adjustments included reduced forward instability and improved trunk control (reduced forward rotation) at recovery step completion. Post-training, training effects were retained in terms of fall incidence, with slight decay in toe clearance and reactive stability. Older adults demonstrated appropriate locomotor-based proactive and reactive adaptations to repeated obstacle-induced trips with short-term retention similar to young adults, and thus could reduce their fall-risk through such training.
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影响因子：
2.4
作者：
Liu, Xuan;Bhatt, Tanvi;Pai, Yi-Chung (Clive)
通讯作者：
Pai, Yi-Chung (Clive)
影响因子：
2
作者：
Bhatt, T;Wening, JD;Pai, YC
通讯作者：
Pai, YC
影响因子：
5.1
作者：
KUMAR, S;FERNANDO, DJS;BOULTON, AJM
通讯作者：
BOULTON, AJM
影响因子：
2.4
作者：
Konig, Matthias;Epro, Gaspar;Karamanidis, Kiros
通讯作者：
Karamanidis, Kiros
影响因子：
4
作者：
Luukinen, H;Herala, M;Kivelä, SL
通讯作者：
Kivelä, SL