Neuromechanical mechanisms of human dynamic stability

人体动态稳定性的神经力学机制

• 批准号: RGPIN-2016-06005
• 负责人: Singer, Jonathan
• 金额: $ 1.82万
• 依托单位: University of Manitoba
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2016
• 资助国家: 加拿大
• 起止时间: 2016-01-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=616043
• 关键词: Neuromechanical; mechanisms; human; dynamic; stability

The high incidence of falls and fall-related injuries among Canadians over the age of 65 is a key public health issue. The most current data indicates that this cohort represents approximately 15% of the Canadian population, yet it accounts for 51% of all unintentional fall cases requiring hospitalisation and totals 46% of health care costs for falls. As a result, the direct and indirect healthcare costs have been estimated at over 2 billion and 6 billion Canadian dollars, respectively. Despite population-based work that has revealed numerous factors that are predictive of falls, there has been little change in the population standardised rate of fall-related hospitalisation and injury among older adults. Effective balance control is the result of a complex relationship between proactive (to avoid instability) and reactive (to respond to instability) control processes that are bound by the neural (sensory) and mechanical (musculoskeletal) systems. Notwithstanding considerable clinical research focusing on balance control and falls among older adults, there is a scarcity of basic science research investigating the mechanisms of whole-body stability control. The proposed work will generate novel insights into human stability control and dyscontrol through three research themes that iteratively narrow in focus, moving from (a) a characterisation of whole body dynamic stability control, to (b) experimental manipulation of neuromechanical system properties, to (c) modelling individual-limb and joint-level contributions to dynamic stability. This work will utilise a combination of complementary biomechanical approaches to examine human dynamic stability across a range of activities of daily living. While many previous studies have examined proactive and reactive stability control in isolation, the present work will seek to examine the interaction between proactive and reactive control to determine if challenges in reactive control can be offset by improved proactive control. Such an outcome would support the use of perturbation-based training programs, which seek to improve proactive control through exposure to novel bouts of instability. This work will also seek to quantify the extent to which instability results from alterations to the neural and mechanical systems, given that these systems are directly influenced by growth, ageing and injury processes. Outcomes from this line of work will importantly inform the development of technological interventions seeking to offset neuromechanical deficits. Lastly, understanding individual limb and joint level contributions to dynamic stability provides a specific target to facilitate the development of more effective medical and technological fall prevention interventions. This line of study provides a framework for the training of nine undergraduate and graduate students within this funding period.

65岁以上的加拿大人跌倒和与跌倒有关的伤害发生率很高，这是一个关键的公共卫生问题。最新数据表明，这一群体约占加拿大人口的15%，但他们占所有需要住院的意外跌倒病例的51%，占跌倒医疗费用的46%。因此，直接和间接的医疗成本估计分别超过20亿加元和60亿加元。尽管基于人群的研究揭示了许多预测跌倒的因素，但老年人因跌倒而住院和受伤的人口标准化比率几乎没有变化。 有效的平衡控制是受神经(感觉)和机械(肌肉骨骼)系统约束的主动(避免不稳定)和反应性(对不稳定)控制过程之间复杂关系的结果。尽管相当多的临床研究集中在老年人的平衡控制和跌倒上，但研究全身稳定性控制机制的基础科学研究很少。这项拟议的工作将通过三个反复缩小重点的研究主题，对人类稳定性控制和失控产生新的见解，从(A)全身动态稳定性控制的特征，到(B)神经机械系统特性的实验操作，再到(C)模拟个体肢体和关节水平对动态稳定性的贡献。 这项工作将利用互补的生物力学方法的组合来检查人类在一系列日常生活活动中的动态稳定性。虽然以前的许多研究都是孤立地检查主动稳定性和反应性稳定性控制，但本工作将试图检查主动控制和反应性控制之间的相互作用，以确定改进的主动控制是否可以抵消反应控制中的挑战。这样的结果将支持基于扰动的培训计划的使用，该计划寻求通过暴露在新的不稳定事件中来改善主动控制。这项工作还将寻求量化神经和机械系统的改变在多大程度上造成不稳定，因为这些系统直接受到生长、衰老和损伤过程的影响。这项工作的成果将为寻求弥补神经机械缺陷的技术干预的发展提供重要信息。最后，了解个体肢体和关节水平对动态稳定性的贡献提供了一个具体的目标，以促进开发更有效的医疗和技术预防跌倒干预措施。这一研究方向为在这一资助期内培训9名本科生和研究生提供了一个框架。