Lateral Stability and Falls in Aging

横向稳定性和老化下降

• 批准号: 7915446
• 负责人: MARK W ROGERS
• 金额: $ 55.66万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-15 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7915446
• 关键词: Activities of Daily Living; Age; Aging; Behavior; Caring; Computer Simulation; Control Groups; Economics; Elderly; Equilibrium; Experimental Models; Fall prevention; Functional disorder; Future; Gait; Generations; Goals; Hip region structure; Human; Impairment; Incidence; Individual; Intervention; Joints; Kinetics; Lateral; Lead; Length; Limb structure; Measures; Medical; Movement; Muscle; Musculoskeletal Equilibrium; Neuromechanics; Outcome; Pattern; Performance; Prospective Studies; Public Health; Reaction; Recovery; Research; Source; Step training; Therapeutic; Therapeutic Intervention; Torque; Training; Variant; experience; fall risk; falls; group intervention; high risk; improved; kinematics; motor control; programs; public health relevance; response

DESCRIPTION (provided by applicant): The long term objectives of this research are to identify the mechanisms of neuromechanical (NM) impairments underlying postural balance dysfunction in older people, and to establish a scientifically grounded therapeutic program for enhancing balance function and reducing the risk of falls. When human balance is challenged, the stepping reaction is a powerful means of stabilizing the body and preventing falling. Protective stepping is therefore a vital strategy for maintaining balance during activities of daily life. We propose that aging limitations in regional medio-lateral (M-L) hip abductor/adductor (AB/AD) NM responses compromise lateral balance stability by disrupting protective stepping. Consequently, many older people may be particularly vulnerable to lateral instability and injurious falls. Accordingly, our aims involve experimental, modeling, and interventional approaches to understanding these relationships. Aim one is to a) identify the balance perturbation magnitude level at which older subjects transition to a riskier and more problematic crossover protective stepping pattern due to limitations in hip AB/AD NM control as determined by movement kinetics and kinematics; and to b) assess whether balance perturbation magnitude and associated stepping and hip AB/AD NM response measures discriminate between subjects with low fall risk and those with high fall risk. Aim two is to develop and apply a computational model that predicts the balance limits of M-L stepping patterns in relation to regional hip AB/AD NM limitations. Aim three is to assess feasibility factors (compliance, tolerance, benefits) necessary to advance a full-scale therapeutic intervention for preventing falls. We hypothesize that an intervention approach that combines induced step training and hip AB/AD muscle strengthening will demonstrate greater improvements in performance outcomes and fewer prospectively identified falls than either program performed alone. PUBLIC HEALTH RELEVANCE. The relevance of this research to public health lies in its focus on understanding the causes and interventions for minimizing the devastating economic, societal, and personal consequences of age-associated falls.

描述（由申请人提供）：本研究的长期目标是确定老年人姿势平衡功能障碍的神经机械（NM）损伤机制，并建立一个有科学依据的治疗方案，以增强平衡功能和降低跌倒风险。当人体平衡受到挑战时，迈步反应是稳定身体、防止跌倒的有力手段。因此，保护​​性步伐是日常生活活动中保持平衡的重要策略。我们认为，区域内外侧（M-L）髋关节外展肌/内收肌（AB/AD）NM 反应的老化限制会破坏保护性步进，从而损害横向平衡稳定性。因此，许多老年人可能特别容易遭受侧向不稳定和跌倒伤害。因此，我们的目标包括通过实验、建模和干预方法来理解这些关系。目标一是 a) 确定平衡扰动幅度水平，在该水平上，由于运动动力学和运动学确定的髋部 AB/AD NM 控制的限制，老年受试者过渡到风险更高、问题更严重的交叉保护性步进模式； b) 评估平衡扰动幅度以及相关的迈步和髋部 AB/AD NM 反应测量是否能够区分跌倒风险低的受试者和跌倒风险高的受试者。目标二是开发并应用一个计算模型，预测与区域髋部 AB/AD NM 限制相关的 M-L 步进模式的平衡限制。目标三是评估推进预防跌倒的全面治疗干预所需的可行性因素（依从性、耐受性、益处）。我们假设，与单独执行任何一个计划相比，结合诱导步进训练和髋部 AB/AD 肌肉强化的干预方法将在性能结果方面取得更大的改善，并减少预期跌倒的发生。公共卫生相关性。这项研究与公共卫生的相关性在于其重点是了解原因和干预措施，以尽量减少与年龄相关的跌倒对经济、社会和个人造成的破坏性后果。