ABNORMALITIES OF BALANCE GAIT AND SENSORIMOTOR FUNCTION

我们已经确定，很大一部分养老院 有多次跌倒病史的居民有严重的、可量化的 步态和平衡都有异常。使用简单的定量测试 平衡(体位压力测试)，以及更多 在平衡台上进行全面测试，以及量化步态 分析作为预测因素，我们建议进行为期4年的纵向研究 在1300名健康相关设施的居民中确定我们是否有能力 预测未来跌倒的发生，并描述 老年跌倒者的自然历史。在那些有 我们已经演示过：力量受损，特别是在 踝关节背屈肌、小腿触觉振动和 躯体感觉功能与CT异常(低密度) 半球白质。使用120名跌倒者和对照的队列 纵向研究，以病例对照的形式，我们将确定 跌倒的生理基础。这将通过以下方式实现 上述步态和平衡对感觉和平衡的测量异常 运动功能障碍，并最终导致神经损伤和/或疾病 系统。坠落的预测试验及对坠落的描述 潜在跌倒的感觉运动障碍将很容易适用于 改进我们治疗跌倒的方法。

We have determined that a significant portion of elderly nursing home residents with a history of multiple falls have severe, quantifiable abnormalities of both gait and balance. Using a simple quantitative test of balance (the Postural Stress Test), in conjunction with more comprehensive testing on a balance platform, as well as a quantitative gait analysis as predictors, we propose to perform a 4 year longitudinal study in 1,300 residents of health related facilities to determine our ability to predict the occurrence of falls in the future as well as describing the natural history of elderly fallers. In those individuals with a history of falls, we have already demonstrated: impaired power especially in the ankle dorsiflexors, diminished lower extremity tactile-vibratory and proprioception function and CT abnormalities (hypodensity) in the hemispheric white matter. Using a cohort of 120 fallers and controls from the longitudinal study, in a case control format, we will determine the physiologic substrates of falling. This will be accomplished by relating the above abnormalities of gait and balance to measures of sensory and motor dysfunction, and ultimately, to lesions and/or disease of the nervous system. The predictive tests of falling and description of the sensorimotor dysfunction underlying falls will be readily applicable to improving our therapeutic approach to falling.