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

在美国，每年约有1500万老年人跌倒，预防跌倒的计划只有 在控制下降速度方面取得了一定的成功。这项建议使用的运动学习原则源自 注意力集中文献，以确定是否训练一个人在平衡过程中将注意力集中在哪里 TASK增强平衡控制，降低摔倒风险。老年人(N=90)，被归类为失败者(一人或 在过去12个月中有更多的跌倒)将被招募。一系列平衡控制，跌倒风险的临床指标，以及 患者报告的结果将在12周干预之前、期间和之后进行评估，以检查变化 在性能和跌倒风险方面。为期12周的干预也将强调引导参与者的注意力 在一系列平衡任务期间，在内部或外部。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会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焦点来检查12周平衡干预后平衡控制的变化 范型，我们将把平衡控制变化与指示跌倒风险和患者的临床指标联系起来- 报告结果。此外，我们的建议还包括一种新的姿势摆动的熵模型，这一度量具有 被提出与平衡能力有关，以帮助解释假设的平衡增强。因此，这一点 提案将把运动学习原则与12周的平衡干预结合起来，以确定跌倒的风险是否 在老年人中减少。具体目标1比较在整个过程中每个试验/会话中的平衡性能 12周的平衡训练，以评估注意力集中组(外部和内部)在他们的 关于平衡任务的运动学习轨迹。特定目标2比较运动能力的结果 与小组之间的跌倒风险相关的措施(外部关注、内部关注或控制) 在为期12周的平衡干预之后。具体目标3比较患者报告的结果衡量标准 害怕跌倒、功能健康和福祉，以及害怕群体之间的移动受伤(外部 焦点、内部焦点或对照)在12周平衡干预之前、期间和之后。

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.