Gait control – visuo-motor interactions and plasticity in glaucoma

步态不稳是老年人福尔斯发生率增加和活动能力降低的原因，因此是生活质量显著降低的原因。步态控制的一个关键因素是，除了运动技能本身，运动系统与感觉和认知过程的相互作用。这使得有感觉障碍的老年人特别容易福尔斯。重要的例子是患有青光眼的人，这是一种引起严重视力损害的流行病。对视觉、认知和视觉认知功能的作用及其在步态控制过程中的相互作用的理解有望为有效的介入器械铺平道路，以改善青光眼及其他疾病的步态控制。这就提出了一个问题，是否多模式运动相关的干预，即，我们的项目旨在了解步态控制过程中运动、视觉、认知和视觉认知功能的相互作用及其对介入器械发展的影响。它将青光眼作为感觉障碍风险人群的重要和相关模型。该项目采用多学科方法，结合了身体活动和运动科学、眼科学和神经科学方面的专门知识，以解决以下步骤：（i）开发研究工具，以确定实验室环境以及重要的日常条件下视觉功能、认知、视觉认知和步态控制的相互作用。(ii)在≥50名青光眼受试者和匹配对照者中应用这些工具，以揭示和了解视觉功能、认知和视觉认知对步态控制的相对重要性。(iii)在两个青光眼干预组（共包括≥50名受试者）中，在纵向设计中比较两种干预概念（单模态和多模态运动相关干预）。干预效果的行为读数将与静息状态功能磁共振成像的生理相关性相结合，以揭示神经可塑性的机制及其与行为措施的相关性。这将针对代表运动技能，视觉和cognition.We的大脑区域之间的功能连接的变化，我们期望在青光眼步态控制和匹配的控制，以大大增加我们的理解步态控制的认知，视觉和视觉认知的相互作用的调查，并指导识别有效的干预概念，预防和康复一般。

Unsteady gait is a cause of increased incidences of falls and reduced mobility in the elderly, and is thus a source of a significant reduction in quality of life. A critical factor of gait control constitutes, apart from the motor-skills themselves, the interplay of the motoric system with both sensory and cognitive processes. This renders elderly with sensory impairment particularly prone to falls. Important examples are persons with glaucoma, a prevalent disease causing substantial visual impairment. An understanding of the role of visual, cognitive and visuo-cognitive functionality and their interactions during gait control is expected to pave the way for efficient interventional instruments to improve gait control in glaucoma and beyond. This prompts the question, whether multimodal movement-related interventions, i.e., those addressing motor-, sensory, and cognitive functions in a combined manner, are superior to unimodal movement-related interventions in their effect on gait control.Our project aims to understand the interplay of motor-, visual, cognitive and visuo-cognitive function during gait control and its impact on the development of interventional instruments. It addresses glaucoma as an important and relevant model for risk groups with sensory impairment. In a multidisciplinary approach the project combines expertise in physical-activity and movement sciences, ophthalmology and neurosciences to address the following steps: (i) Development of research tools to identify interactions of visual function, cognition, visuo-cognition and gait control for both laboratory settings and, importantly, everyday like conditions. (ii) Application of these tools in ≥50 participants with glaucoma and matched controls to uncover and understand the relative importance of visual function, cognition, and visuo-cognition for gait control. (iii) Comparison of two interventional concepts, a unimodal and a multimodal movement-related intervention, in a longitudinal design in two glaucoma intervention groups, comprising a total of ≥50 participants. Behavioural readouts of the intervention effects will be combined with physiological correlates from resting state fMRI, to uncover mechanisms of neuro-plasticity and their correlation with behavioural measures. This will target changes in functional connectivity between brain regions representing motor skills, vision and cognition.We expect this investigation of the interaction of cognition, vision, and visuo-cognition in gait control in glaucoma and matched controls to considerably increase our understanding of gait control and to guide the identification of efficient interventional concepts for prevention and rehabilitation in general.