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

项目摘要/摘要 我们的长期目标是开发有效的身体康复方法，以提高机动性和预防 患帕金森氏病(PD)的人会跌倒。为了实现这一目标，我们提议的目的是确定 客观测量日常生活中最能反映跌倒风险的转身、步态和活动能力，并探讨 使用日常生活活动监测作为康复的结果措施，以提高翻身质量。 利用新技术量化转动能力，包括身体穿戴的惯性传感器可以提供 以行动不便为重点的临床试验和临床实践取得了强大的新成果。我们假设 转身的客观测量将最好地区分跌倒的人和不跌倒的人，预测帕金森病患者的跌倒 无跌倒病史，在帕金森病患者中进行康复治疗可改善翻转情况。 两项横断面研究将确定创新的、客观的转身、步态、 以及超过7天的日常生活活动，使用身体佩戴的惯性传感器进行康复。AIM I是一个 回顾性、观察性研究，将转身、步态和活动与身体佩戴的传感器进行比较 过去12个月有跌倒史和无跌倒史的PD。AIM II是一项前瞻性研究，仅限于 没有跌倒的人，研究日常生活中最佳的一套流动性衡量标准，以预测12个月中的第一次跌倒 在7天的日常生活监测后几个月。AIM III是一项探索性、随机、运动干预研究，旨在 计划未来的临床试验，以改善日常生活中的翻转。具体地说，在Aim I中收集的落差将是 随机分为新的、为期6周的轮训训练组或主动控制强化组。 这项研究旨在通过改善帕金森病患者的活动功能和 通过开发更有效的行动不便康复服务，提高他们的生活质量。平衡和步态障碍 影响大多数患有慢性病或神经系统疾病的人，导致无法控制危重 平衡任务--快速改变行走方向(转身)。这项建议将提高我们对 社区生活中转身障碍对跌倒和帕金森障碍的贡献及探讨 康复训练能否提高日常生活中功能活动的转体质量。基于这些研究， 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车削和 实施一项新的转向训练营计划，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.