Vestibular and neck muscle contributions to head control in response to induced head perturbations and falls in balance-impaired older adults

前庭和颈部肌肉对头部控制的贡献，以应对平衡受损老年人的头部扰动和跌倒

• 批准号: 10789703
• 负责人: Jacob J. Sosnoff
• 金额: $ 43.56万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-09-29
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10789703
• 关键词: Adverse event; Age Years; Articular Range of Motion; Cervical; Cervical spine; Code; Craniocerebral Trauma; Data; Development; Elderly; Enrollment; Equilibrium; Extensor; Face; Flexor; Gait; Gender; Goals; Head; Head Movements; Head and neck structure; Impairment; Injury; Intervention; Isometric Exercise; Knowledge; Laboratories; Link; Measures; Mechanics; Modeling; Morbidity - disease rate; Motion; Motor; Muscle; Musculoskeletal Equilibrium; Neck; Neck Injuries; Organ; Participant; Pathway interactions; Play; Postural response; Public Health; Reflex action; Research; Risk; Role; Saccule and Utricle; Saccule structure; Safety; Semicircular canal structure; Series; Skeletal muscle structure of neck; Spinal Injuries; Standardization; System; Techniques; Testing; Time; Torque; Upper Extremity; Vestibular Function Tests; Vision; age related; arm; equilibration disorder; experience; fall injury; fall risk; falls; gaze; head impact; head/neck injury; high reward; high risk; human old age (65+); indexing; innovation; interest; muscle strength; novel strategies; otoconia; protective behavior; response; vestibulo-ocular reflex; young adult

PROJECT SUMMARY/ABSTRACT Falls are common in older adults, and head (including face) and neck injuries are common and result in significant morbidity. Yet, little is known about the mechanisms of control of the head and neck during a fall and few interventions are directed toward limiting these injuries. This high risk/high reward approach is fundamentally different from traditional approaches and measures head motion during lab-based falls in older adults at risk for fall-related injury. We will leverage our experience of collecting fall impact data in older adult participants to maximize safety in the current proposal. The ultimate goal of this innovative proposal is to set the stage for the development of a novel approach(es) to reduce fall related head/neck injuries in older adults. The current proposal seeks to determine whether motor or vestibular function and/or their combination contribute to head control during falls. Our expert research team utilizing state-of the art assessments will explore whether the vestibular system, specifically the sacculo-collic reflex (due to role in modulating reflexive adjustments of the musculature in the neck) and/or neck mechanics (muscle strength, range of motion and muscle activation) are related to head control during a fall. A secondary aim will explore relation between head motion following laboratory-based head pull perturbation and head motion during a fall and if it is modified by neck mechanics. Lastly, other potential factors such as arm use, gender, and abnormal balance/gait will also be explored. A total of 30 older adults (> 65 years of age) with balance impairment, and with varying vestibular function will be enrolled. Participants will undergo a series of standardized tests including comprehensive vestibular assessments, neck mechanics assessment and backward and sideway falls. During all of the tests, head motion and neck muscle activity will be quantified utilizing validated techniques. Studying the links between vestibular function, neck mechanics, and head control in an actual fall provides a better understanding of the mechanisms contributing to head and neck injury and eventually points to better-directed therapies to decrease this injury risk. Preliminary data from this high risk/high reward project will direct larger, more appropriately powered and more definitive testing of the mechanisms underlaying head control during falls.

项目摘要/摘要 跌倒在老年人中很常见，头部（包括面部）和颈部受伤很常见，导致 明显的发病率。然而，关于跌倒期间头部和颈部控制机制知之甚少 很少有干预措施用于限制这些伤害。这种高风险/高奖励方法是 与传统的方法和措施在实验室基于实验室的跌倒期间的措施根本不同 成年人有秋季相关伤害的风险。我们将利用我们收集老年人跌落影响数据的经验 参与者在当前建议中最大化安全性。这项创新提议的最终目标是设定 开发一种新方法（ES）的阶段，以减少老年人秋季相关的头部/颈部损伤。 当前的提案旨在确定电动机或前庭功能和/或其组合 在跌倒期间有助于头部控制。我们利用最先进评估的专家研究团队将 探索前庭系统，特别是Sacculo-Collic反射（由于反射性的作用， 调整颈部肌肉组织）和/或颈部力学（肌肉力量，运动范围和 肌肉激活）与秋天的头部控制有关。次要目标将探索头部之间的关系 基于实验室的头部拉动扰动和头部运动后的运动在秋天，如果被修改 颈部力学。最后，其他潜在因素，例如手臂使用，性别和异常平衡/步态也将 被探索。总共有30名老年人（> 65岁），有余额障碍，前庭有不同 功能将被注册。参与者将接受一系列标准化测试，包括全面 前庭评估，颈部力学评估以及向后和侧向跌落。在所有测试中， 通过经过验证的技术，将对头部运动和颈部肌肉活动进行量化。研究链接 在实际跌倒中的前庭功能，颈部力学和头部控制之间可提供更好的 了解导致头部和颈部损伤的机制，并最终指向更好的指导 降低这种伤害风险的疗法。来自这个高风险/高奖励项目的初步数据将指导更大， 对底层控制机制的机制更加适当的动力和更确定的测试 瀑布。