Reducing Fall Risk with the use of Neuromuscular Electrical Stimulation to Maximize the Hip Abductor Muscles in Older Veterans

通过使用神经肌肉电刺激最大化老年退伍军人的髋关节外展肌来降低跌倒风险

• 批准号: 10516031
• 负责人: Odessa Addison
• 金额: --
• 依托单位: BALTIMORE VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10516031
• 关键词: Address; Adipose tissue; Age; Area; Balance training; Caring; Cessation of life; Clinical Treatment; Data; Educational Intervention; Elderly; Electrodes; Equation; Equilibrium; Exercise; Exhibits; Fall prevention; Fascia lata structure; Fatty acid glycerol esters; Future; Gait; Health; Hip region structure; Hospitalization; Impairment; Incidence; Infiltration; Injury; Intervention; Intramuscular; Isometric Exercise; Lower Extremity; Mechanics; Methods; Mission; Muscle; Muscle Contraction; Muscle function; Muscular Atrophy; Physical Performance; Prevention program; Publishing; Randomized, Controlled Trials; Recommendation; Rehabilitation therapy; Research; Role; Step Tests; Surface; Testing; Time; Training; Translational Research; Trauma; Veterans; Work; X-Ray Computed Tomography; cost; cost effective; exercise training; fall risk; falls; follow-up; functional outcomes; improved; intervention program; multimodality; muscle form; muscle strength; neuromuscular stimulation; novel; patient oriented; patient safety; performance tests; primary outcome; programs; recruit; response; tool

Falls are a leading cause of injurious death and non-fatal injuries in older adults. While fall prevention is a major VA initiative, the current best fall preventions program only reduces falls by ~30% suggesting further research and interventions are needed to reduce fall risk. Decreased lower extremity muscle mass and strength contribute to balance and mobility limitations. Our recent studies show the hip abductors have a unique role in balance and mobility function. Older adults with impaired hip abductor muscles demonstrate decreased hip abductor strength, lower balance scores, and poor stepping mechanics when recovering from a balance perturbation. Our preliminary results also show increased fatty infiltration of the hip abductor muscles may contribute to poor muscle recruitment and make changing the hip abductor muscles with a traditional strength intervention difficult. Neuromuscular electrical stimulation is one method to improve muscles in older adults, though it is not traditionally used on the hip abductors. Our preliminary results demonstrate that older adults who use neuromuscular electrical stimulation on their hip abductors, in conjunction with a balance training intervention; demonstrate larger improvements in hip abductor strength, balance, and mobility function. Our central hypothesis is that the addition of neuromuscular electrical stimulation applied to the hip abductors during a balance intervention will result in: improved balance, larger improvements in muscle and mobility function, and fewer falls than a balance intervention alone. In this randomized control trial, we will determine the effects of a balance and strengthening program with and without neuromuscular electrical stimulation on fall risk and mobility (aim 1), changes in hip abductor composition, function, activation and gait variability (aim 2), and the retention of these changes at a six and twelve-month follow up (aim 3). We anticipate that this patient-oriented translational research will provide the first evidence from a large randomized control trial for the use of neuromuscular electrical stimulation applied to the primary hip abductors as an efficacious adjunct to traditional rehabilitation programs to improve balance, mobility, and muscle in older Veterans at risk for falls.

跌倒是造成老年人伤害性死亡和非致命性伤害的主要原因。预防跌倒是一项重要的