Merging attentional focus and balance training to reduce fall risk in older adults

结合注意力集中和平衡训练以降低老年人跌倒风险

• 批准号: 9302886
• 负责人: Louisa Dominique Raisbeck
• 金额: $ 34.55万
• 依托单位: UNIVERSITY OF NORTH CAROLINA GREENSBORO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9302886
• 关键词: Activities of Daily Living; Administrator; Adopted; Area; Attention; Balance training; Behavior; Body part; Characteristics; Clinical; Complex; Conscious; Control Groups; Costs and Benefits; Data; Devices; Educational Intervention; Elderly; Entropy; Environment; Equilibrium; Evidence based intervention; Exhibits; Fall prevention; Focus Groups; Fright; Goals; Health; Injury; Instruction; Intervention; Laboratories; Lead; Literature; Mediating; Modeling; Modification; Motion; Motor; Movement; Musculoskeletal Equilibrium; Outcome Measure; Participant; Patient Outcomes Assessments; Perception; Performance; Population; Positioning Attribute; Posture; Prevalence; Prevention program; Preventive Intervention; Recording of previous events; Recruitment Activity; Research; Sensory; Series; Surface; System; Testing; Time; Training; United States; Vision; body position; clinical practice; cognitive function; cohort; cost; design; experience; fall risk; falls; fear of falling; follow-up; foot; improved; motor control; motor learning; novel; somatosensory; tool

Approximately 15 million older adults fall every year in the United States and fall prevention programs have only been moderately successful in arresting fall rates. This proposal uses motor learning principles derived from the attentional focus literature to determine whether training someone where to focus their attention during a balance task enhances balance control and reduces fall risk. Older adults (N=90) who are classified as fallers (one or more falls in the past 12 months) will be recruited. A series of balance control, clinical metrics of fall risk, and patient-reported outcomes will be assessed prior, during, and after a 12-week intervention to examine changes in performance and fall risk. The 12-week intervention will emphasize directing the participants’ attention either internally or externally during a series of balance tasks. Empirical evidence and our preliminary data leads us to hypothesize that an external focus of attention training will positively influence balance control. This will be the first study to will examine balance control changes over 12-week balance intervention using an attentional focus paradigm and we will relate the balance control changes to clinical metrics that indicate fall risk and patient- reported outcomes. Further, our proposal includes a novel model of entropy in postural sway, a metric that has been proposed to relate to balance ability, to help explain the hypothesized enhancement in balance. Thus, this proposal will merge motor learning principles with a 12-week balance intervention to determine if fall risk is reduced in older adults. Specific Aim 1 compares balance performance within each trial/session throughout the 12 weeks of balance training to evaluate whether the attentional focus groups (external vs. internal) differ in their motor learning trajectory with respect to the balance task. Specific Aim 2 compares the motor ability outcome measures that relate to fall-risk between the groups (external focus, internal focus, or control) before, during, and after the 12-week balance intervention. Specific Aim 3 compares the patient-reported outcome measures of fear of falling, functional health and well-being, and fear of injury from movement between the groups (external focus, internal focus, or control) before, during, and after the 12-week balance intervention.

美国每年约有 1500 万老年人跌倒，而跌倒预防计划仅 在控制下降率方面取得了一定的成功。该提案使用源自以下内容的运动学习原理： 注意力集中文献确定是否训练某人在平衡过程中将注意力集中在哪里 任务增强平衡控制并降低跌倒风险。被归类为跌倒者（一名或多名）的老年人 (N=90) 过去 12 个月内有更多跌倒者）将被招募。一系列平衡控制、跌倒风险的临床指标以及 将在 12 周干预之前、期间和之后评估患者报告的结果，以检查变化 在性能和跌倒风险方面。为期 12 周的干预将强调引导参与者的注意力 在一系列平衡任务期间内部或外部。经验证据和我们的初步数据引导我们 假设外部注意力集中训练将对平衡控制产生积极影响。这将是 第一项研究将使用注意力集中检查 12 周平衡干预中的平衡控制变化 范式，我们将把平衡控制的变化与指示跌倒风险和患者的临床指标联系起来。 报告的结果。此外，我们的建议包括一种新的姿势摇摆熵模型，这是一种度量 被提议与平衡能力相关，以帮助解释假设的平衡能力增强。因此，这个 该提案将运动学习原则与为期 12 周的平衡干预相结合，以确定跌倒风险是否是 老年人减少。具体目标 1 比较整个试验/会话中的平衡性能 12 周的平衡训练，以评估注意力焦点组（外部与内部）的注意力是否存在差异 相对于平衡任务的运动学习轨迹。具体目标 2 比较运动能力结果 在之前、期间、期间与各组之间跌倒风险相关的措施（外部焦点、内部焦点或控制） 以及12周平衡干预后。具体目标 3 比较了患者报告的结果测量 对跌倒的恐惧、功能健康和幸福感，以及对团体之间运动受伤的恐惧（外部） 在 12 周平衡干预之前、期间和之后。