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.

项目总结