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.

项目概要 跌倒是老年人意外伤害和死亡的主要原因。跌倒相关伤害发生在以下情况 跌倒的冲击力大于组织强度。当前实践的另一种方法是 教导老年人进行保护性动作，以减少跌倒时的冲击力。这种高风险/高 奖励方法与传统的伤害预防方法有根本的不同。 有证据表明教授安全着陆策略（即运动模式）可以显着减少髋关节 年轻人的冲击力和头部加速度。最近的试点数据表明，老年人可以学会 跌倒，使他们最大限度地减少冲击力和头部加速度。但样本仅限于较旧的 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是否可以安全地学习跌倒 安全。 这一创新提案的最终目标是为开发一种新方法奠定基础 减少老年人跌倒相关的伤害。 R21 提案的近期目标是确定 在有跌倒风险的老年人群体中进行安全跌倒训练计划的可行性，其中关键的可衡量阶段 与奥塔哥锻炼计划（证据- 基于跌倒风险降低计划）控制，为未来更大规模的试验提供信息。目前的调查，是 必要的步骤，以确定是否可以通过标准化渐进计划来教授有跌倒风险的老年人 安全（目标 1），以及处于危险中的老年人是否可以通过减少头部加速度和臀部冲击来学习跌倒 力（目标 2）。 28 名参与者将被随机分为两组（秋季训练或平衡训练）。全部 参与者将进行标准化的侧向跌倒，并量化其臀部冲击力和头部加速度 利用经过验证的技术。参与者将接受 8 次标准化渐进培训课程， 基线和培训后评估以及为期 3 个月的后续课程。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 培训和 3 个月的保留。该项目的总体目标是系统地确定培训是否 老年人安全跌倒作为减少跌倒相关伤害的策略具有潜在的效用，可以将其结合起来 结合目前的跌倒预防工作。