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 跌倒是老年人意外受伤和死亡的主要原因。在以下情况下会发生与跌倒相关的伤害 跌倒的冲击力大于组织强度。当前做法的另一种方法是 教老年人保护性动作，当他们跌倒时减少冲击力。这种高风险/高风险 奖励方法在预防伤害方面与传统方法有根本的不同。 有证据表明，教授安全着陆策略(即运动模式)可以显著减少髋关节 年轻人的撞击力和头部加速度。最近的试点数据表明，老年人可以学习 下降，使其冲击力和头部加速度降至最低。然而，样本仅限于较老的。 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能否安全地学会跌倒。 安全无恙。 这一创新提案的最终目标是为开发一种新的方法奠定基础 减少老年人与跌倒相关的伤害。建议的R21的直接目标是确定 跌倒危险老年人群中坠落安全训练计划的可行性，关键可测量阶段 与奥塔戈锻炼计划相比，快速掌握，最重要的是，效果大小(证据- 基于跌倒风险降低计划)控制，以通知更大的未来试验。目前的调查，是一个 必要的步骤，以确定在标准化的进步计划中教导有跌倒风险的老年人是否 安全(目标1)，以及处于危险中的老年人是否可以学习跌倒，头部加速和臀部撞击减少 力量(目标2)。28名参与者将被随机分成两组(秋季训练或平衡训练)。全 参赛者将进行标准化的侧滑，并量化他们的臀部撞击和头部加速 利用经过验证的技术。参与者将接受8个标准化的进阶培训课程， 基线和培训后评估以及为期3个月的后续会议。符合以下原则： 运动学习，学习将通过髋部冲击力和头部加速度的变化来量化 培训，并保留3个月。该项目的总体目标是系统地确定培训是否 老年人安全跌倒具有潜在的效用，可以作为减少跌倒相关伤害的一种策略，这两种策略可以结合起来 以目前的预防跌倒努力。