Mobility in Daily Life and Falls in Parkinson's Disease: Potential for Rehabilitation

项目总结/摘要 我们的长期目标是开发有效的身体康复方法，以改善活动能力， 帕金森病（PD）患者的福尔斯。为了实现这一目标，我们建议的目的是确定 在日常生活中最能反映跌倒风险的转向、步态和移动性活动的客观指标，并探索 使用日常生活活动监测作为康复的结果措施，以提高转弯质量。 使用新技术量化转向能力，包括身体磨损，惯性传感器可以提供 为专注于行动不便的临床试验和临床实践提供强大的新成果。我们假设 旋转的客观测量将最好地区分跌倒者和非跌倒者，预测PD患者的福尔斯跌倒， 没有跌倒史，PD患者的旋转可以通过康复得到改善。 两项横断面研究将确定创新的、客观的转弯、步态、 和活动超过7天的日常生活与身体佩戴的惯性传感器用于康复。Aim I是一个 一项回顾性、观察性研究，比较了患有以下疾病的人的转身、步态和活动情况： 过去12个月内有和无福尔斯跌倒史的PD。Aim II是一项前瞻性研究，仅在 nonfallers，调查日常生活中的最佳流动性措施，以预测12岁以下儿童的第一次福尔斯。 7天后进行日常生活监测。目的III是一项探索性、随机、运动干预研究， 计划未来的临床试验，以改善日常生活中的转向。具体来说，目标I中收集的坠落物将是 随机分为新的6周翻转靴子训练组或主动控制强化组。 本研究旨在通过改善PD患者的移动功能和运动能力， 通过制定更有效的行动残疾康复方案，提高残疾人的生活质量。平衡和步态障碍 影响大多数患有慢性疾病或神经系统疾病的人，导致无法控制关键的 平衡任务-快速改变行走方向（转弯）。这一建议将增进我们对 社区生活中转向障碍对福尔斯和帕金森病损伤的贡献及探讨 康复治疗是否能提高患者日常生活中的功能性活动的转向质量。根据这些研究， 临床医生将能够使用身体佩戴的传感器来快速准确地评估转弯的质量， 实施一个新的转向靴子营计划，重点是改善行动不便。

Project Summary/Abstract Our long-term goal is to develop effective physical rehabilitation approaches to improve mobility and prevent falls in people with Parkinson’s disease (PD). To reach this goal, the purpose of our proposal is to identify objective measures of turning, gait and mobility activity during daily life that best reflect fall risk and to explore the use of daily life monitoring of mobility as outcome measures for rehabilitation to improve turning quality. Quantification of turning ability with new technology involving body-worn, inertial sensors could provide powerful, new outcomes for clinical trials and clinical practice focused on mobility disability. We hypothesize that objective measures of turning will best discriminate fallers versus nonfallers, predict falls in people with PD without a fall history, and turning can be improved with rehabilitation in PD. Two cross-sectional studies will determine the usefulness of innovative, objective measures of turning, gait, and activity over 7 days of daily living with body-worn inertial sensors for use in rehabilitation. Aim I is a retrospective, observational, study comparing turning, gait, and activity with body-worn sensors in people with PD with and without a history of falls in the previous 12 months. Aim II is a prospective study, only in the nonfallers, investigating the best set of measures of mobility during daily life to predict the first falls in the 12 months after 7 days of daily life monitoring. Aim III is an exploratory, randomized, exercise intervention study to plan a future clinical trial for improving turning in daily life. Specifically, the fallers collected in Aim I will be randomized into a novel, 6-week, Turning Boot Camp group or an Active Control Strengthening) group. This study is designed to advance healthcare of people with PD by improving their mobility function and the quality of their lives by developing more effective rehabilitation for mobility disability. Balance and gait disorders affect most people with chronic disease or neurological disease, resulting in inability to control a critical balance task – quickly change walking direction (turning). This proposal will improve our understanding of the contribution of turning impairments during community living to falls and parkinsonian impairments and explore whether rehabilitation can improve quality of turning for functional mobility in daily life. Based on these studies, clinicians will be able to use body-worn sensors to quickly and accurately assess quality of turning and implement a novel Turning Boot Camp program focused on improving mobility disability.