GAIT INSTABILITY IN THE ELDERLY WITH INCREASED FALL RISK

描述(改编自申请人的摘要)：本报告的目标 项目是研究步态的可变性，以便产生新的见解 研究跌倒的机制，并提供实用的手段来改善 跌倒风险评估。使用便携式步态监控系统 首席调查员最近开发的，在逐步变化的 在连续的步态周期中花费的时间及其子阶段可以 第一次，很容易在临床环境中测量。初步结果 展示这些措施的潜在临床重要性：在 与标准的步行测量(例如，速度)相比，步幅 老年跌倒患者的变异性显著增加， 某些有神经功能障碍的受试者。虽然有一些因素 都会影响这些受试者的步态，其机制(S) 步态步幅变化增加(步态不稳定)及其 与跌倒风险的关系还没有研究过。因为步态的可变性 可作为一项敏感且临床相关的步行能力指标。 干预试验和跌倒风险评估的评估，这 调查小组认为，了解其来源至关重要。 因此，该项目的长期目标是：1)从数量上 描述正常的、病理的和与年龄相关的生理变化 改变正常的逐级变异性；2)确定 有助于正常和异常步态变异性；3)识别 减少异常步态变异性和跌倒风险的干预措施；以及，4) 开发实用的步态不稳定性测量方法，可用于 加强临床步态评估，帮助识别有风险的人 瀑布。为了开始实现这些长期目标，调查人员 已经确定了以下具体目标：a)检验假设 肌肉功能、运动控制和有氧能力下降是导致 步态不稳定(步态变异性增加)。B)检验以下假设 锻炼提高步态稳定性，以及C)检验这一假说 步态的可变性使老年人容易摔倒。

DESCRIPTION (Adapted from the Applicant's Abstract): The goal of this project is to investigate gait variability in order to generate new insights into the mechanisms of falls and to provide a practical means for improving assessment of fall risk. Using a portable gait monitoring system that the Principal Investigator recently developed, the step-to-step changes in the time spent in consecutive gait cycles, and their sub-phases can, for the first time, be readily measured in clinical settings. Preliminary results demonstrate the potential clinical importance of these measures: in contrast to standard measures of walking (e.g., velocity), step-to-step variability is significantly increased in elderly fallers, as well as in certain subjects with neurological impairment. While a number of factors are known to affect the gait of these subjects, the mechanisms(s) of the increased step-to-step changes in walking (gait instability) and its relationship to fall risk has not been studied. Because gait variability may serve as a sensitive and clinically relevant index of walking ability in the evaluation of intervention trials and fall risk assessment, this investigative team believe it is critical to understand its origins. The long-term goals of this project, therefore, are 1) to quantitatively characterize normal, pathologic and age-related physiologic changes that alter normal step-to-step variability; 2) to identify the mechanism(s) that contribute to normal and abnormal gait variability; 3) to identify interventions for reducing abnormal gait variability and fall risk; and, 4) to develop practical measures of gait instability that can be used to augment clinical gait assessment and to help identify persons at risk of falls. To begin to achieve these long-term objectives, the investigators have identified the following specific aims: A) Test the hypothesis that decreased muscle function, motor control, and aerobic capacity contribute to gait instability (increased gait variability). B) Test the hypothesis that exercise improves gait stability, and C) Test the hypothesis that increased gait variability predisposes the elderly to falls.