Minimizing Fall-Related Injury in Older Adults: a motor learning approach

最大限度地减少老年人跌倒相关的伤害：一种运动学习方法

• 批准号: 10287052
• 负责人: Jacob J. Sosnoff
• 金额: $ 23.26万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-05 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10287052
• 关键词: Acceleration; Accidental Injury; Balance training; Cessation of life; Communities; Craniocerebral Trauma; Data; Development; Educational process of instructing; Effectiveness; Elderly; Fall prevention; Funding; Future; Goals; Head; Helmet; Hip Injuries; Hip region structure; Hour; Injury; Intervention; Investigation; Learning; Measures; Motion; Movement; Musculoskeletal; Participant; Pattern; Phase; Procedures; Protocols documentation; Public Health; Randomized; Risk; Risk Reduction; Sampling; Series; Standardization; Techniques; Testing; Tissues; Training; Training Programs; Translations; base; bone strength; equilibration disorder; evidence base; exercise program; fall injury; fall risk; falls; follow-up; high reward; high risk; injury prevention; injury-related death; innovation; minimal risk; motor learning; novel; novel strategies; participant safety; power analysis; pragmatic trial; prevent; programs; project-based learning; risk minimization; safety and feasibility; standard care; young adult

PROJECT SUMMARY Falls are the leading cause of accidental injury and death among older adults. Fall related injuries occur when the impact force of the fall is greater than tissue strength. An alternative approach to current practice is teaching older adults protective movements that reduce the impact force when they to fall. This high risk/high reward approach is fundamentally different from traditional approaches in injury prevention. There is evidence that teaching safe landing strategies (i.e. movement patterns) can significantly reduce hip impact forces and head acceleration in young adults. Recent pilot data suggests that older adults can learn to fall so that they minimize their impact forces and head acceleration. However, the sample was limited to older adults with minimal risk of falls. Consequently it is not clear if older adults at risk of falls can safely learn to fall safely. The ultimate goal of this innovative proposal is to set the stage for the development of a novel approach to reduce fall related injuries in older adults. The immediate goal of this proposed R21 is to determine the feasibility of Falling Safely Training program in an at-fall risk older adult group, the key measureable stages of FAST mastery, and, most importantly, the effect size, compared to Otago Exercise Program (an evidence- based fall risk reduction program) controls, to inform a larger future trial. The current investigation, is a necessary step, to determine if teaching older adults at risk of falls in a standardized progressive program is safe (Aim 1), and whether at risk older adults can learn to fall with reduced head acceleration and hip impact forces (Aim 2). 28 participants will be randomized into one of two groups (fall training or balance training). All participants will perform standardized sideway falls and have their hip impact and head acceleration quantified utilizing validated techniques. Participants will undergo 8 standardized progressive training sessions, undergo baseline and post training assessments and a 3-month follow-up session. Consistent with the principles of motor learning, learning will be quantified with changes in hip impact force and head acceleration following training, and 3-month retention. The overall goal of this project is to systematically determine whether training older adults to fall safely has potential utility as a strategy to reduce fall-related injuries which can be combined with current fall prevention efforts.

项目摘要 跌倒是老年人意外伤害和死亡的主要原因。跌倒有关的伤害发生 跌落的影响力大于组织强度。当前实践的另一种方法是 教老年人保护性运动，以减少跌倒时的影响力。这个高风险/高 奖励方法与预防伤害的传统方法根本不同。 有证据表明，教学安全着陆策略（即运动模式）可以大大减少臀部 年轻人的影响力和头部加速度。最近的飞行员数据表明​​，老年人可以学会 跌倒，使它们最大程度地减少了其影响力和头部加速度。但是，样本仅限于较老 跌倒风险最小的成年人。因此，尚不清楚有跌倒风险的老年人是否可以安全地学会跌倒 安全。 这项创新提议的最终目标是为开发一种新颖的方法奠定了基础 减少老年人的秋季相关伤害。该提议的R21的直接目标是确定 在fall风险老年人群体中安全训练计划的可行性，可衡量的关键阶段 与奥塔哥运动计划相比，快速精通，最重要的是效应大小 基于降低风险的计划）控制，以告知更大的未来试验。当前的调查是 必要的步骤，确定在标准化渐进式计划中教老年人是否有跌倒的风险是 安全（AIM 1），以及面临危险的老年人是否可以学会以减少的头部加速和髋关节撞击跌落 力量（目标2）。 28名参与者将被随机分为两组之一（秋季训练或平衡训练）。全部 参与者将侧向跌倒，并量化其髋关节撞击和头部加速度 利用经过验证的技术。参与者将参加8个标准化的渐进培训课程，参加 基线和培训后评估以及3个月的随访。与原则一致 运动学习，学习将随着臀部撞击力和头部加速的变化而量化 培训和3个月保留。该项目的总体目标是系统地确定是否培训 安全跌倒的老年人具有潜在的效用，作为减少跌倒相关伤害的策略 随着当前的秋季预防努力。