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 福尔斯在老年人中很常见，头部（包括面部）和颈部受伤也很常见， 发病率很高。然而，人们对跌倒时头部和颈部的控制机制知之甚少， 很少有干预措施是针对限制这些伤害的。这种高风险/高回报的方法是 从根本上不同于传统的方法和措施头部运动在实验室为基础的福尔斯在老年人 成年人有跌倒相关伤害的风险。我们将利用我们收集老年人跌倒影响数据的经验 参与者在当前提案中最大限度地提高安全性。这一创新提案的最终目标是， 该阶段的发展，一种新的方法（ES），以减少跌倒相关的头部/颈部损伤的老年人。 目前的建议旨在确定是否运动或前庭功能和/或其组合 有助于在福尔斯跌倒时控制头部。我们的专家研究团队利用最先进的评估技术， 探索前庭系统，特别是球囊-结肠反射（由于在调节反射性 颈部肌肉组织的调整）和/或颈部力学（肌肉力量、运动范围和 肌肉激活）与跌倒期间的头部控制有关。第二个目标是探索头部与 在跌倒过程中，根据实验室头部拉力扰动和头部运动的运动，如果通过以下方式进行修改， 颈部力学最后，其他潜在因素，如手臂使用，性别和异常平衡/步态也将 被探索。共有30名老年人（> 65岁）患有平衡障碍，并患有不同的前庭功能障碍。 功能将被注册。参加者将接受一系列标准化测试，包括综合 前庭评估、颈部力学评估以及向后和侧向福尔斯跌倒。在所有的测试中， 头部运动和颈部肌肉活动将利用经验证的技术进行量化。研究链接 前庭功能、颈部力学和头部控制之间的关系， 了解有助于头部和颈部损伤的机制，并最终指向更好的指导 治疗，以降低这种伤害的风险。这个高风险/高回报项目的初步数据将指导更大的， 更适当的动力和更明确的测试机制的基础头部控制， 福尔斯。