FALLS AND LEG WEAKNESS IN OLDER PEOPLE

我们的目标是通过运动计划预防老年人跌倒 来维持或增加腿部力量。这项建议的具体目的 是：(1)估计跌倒的发生率和跌倒的归因风险 由于老年人腿部无力，他们可能会参与 肌肉强化计划，(2)表征两者之间的关系 腿部肌肉力量(膝屈肌、膝伸肌、踝背屈肌、 以及(3)评估是否有简单的临床应用。 腿部力量测试可以筛查跌倒风险增加的患者 由于腿部无力。该提案试图回答某些问题 与实现长期目标有关：什么是潜在的 预防跌倒的锻炼计划？应该锻炼哪些腿部肌肉？ 这些项目得到了加强，力度有多大？是对立的相对力量 肌肉群重要吗？如何才能确定患者有哪些风险 跌倒可以通过力量训练来减少吗？ 研究设计结合了回溯性病例对照方法和 前瞻性队列研究方法。这项研究将随机抽取130名样本 年龄65-85岁的患者来自已知规模的医疗保健组织人口。患有疾病的患者 已知的肌肉疾病和运动禁忌症将是 不包括在内。样本将根据年龄、性别和 在前一年下降(下降50%，没有下降50%)。力量的力量 控制膝盖和脚踝的肌肉将在四个不同的位置进行测量 使用测功器测量双腿各肌群的肌肉速度。 测功机的测量和跌倒将与简单的临床相关 力量测试包括行走、站立、抬起脚趾和握手。 根据以前的跌倒历史，病例对照方法将估计 严重的腿部无力会增加摔倒的风险。因为这个回顾展 方法无法确定疲软是在跌倒之前还是之后， 队列方法将基于以下因素对相对风险进行第二次估计 对坠落的预期确定。逻辑分析将控制 力量与跌倒关系中的潜在混杂变量， 包括步态异常，视力异常，整体健康状况， 处方药的使用，以及周围感觉神经的功能。这项研究 将检验特定力量缺陷与以下假设 瀑布。正如一些数据显示的那样，假设的赤字在一定程度上 可逆的，这样的研究对预防跌倒有直接的影响。

Our objective is to prevent falls in the elderly through exercise programs that maintain or increase leg strength. The specific aims of this proposal are: (1) to estimate the incidence of falls and attributable risk of falls due to leg weakness in older people who could potentially participate in muscle strengthening programs, (2) to characterize the relationship between leg muscle strength (knee flexors, knee extensors, ankle dorsiflexors, ankle plantarflexors) and falls, and (3) to assess whether simple clinical tests of leg strength can screen for patients at increased risk of falls due to leg weakness. The proposal seeks to answer certain questions relating to accomplishing the long-term goal: What is the potential of exercise programs to prevent falls? Which leg muscles should exercise programs strengthen, and how much? Are relative strengths of opposing muscle groups important? How can patients be identified whose risk of falls might be reduced through strength training? The study design combines a retrospective case control method and a prospective cohort method. The study will recruit a random sample of 130 patients age 65-85 from a HMO population of known size. Patients with known muscular disease and with contraindications to exercise will be excluded. The sample will be stratified on the basis of age, sex, and falls in the previous year (50% fallers, 50% nonfallers). Strength of the muscles controlling the knees and ankles will be measured at four different muscle velocities for each muscle group in both legs using a dynamometer. Dynamometer measurements and falls will be correlated with simple clinical tests of strength involving walking, standing, toe raises, and handgrip. Based on previous history of falls, a case control method will estimate how much leg weakness increases risk of falls. Because this retrospective method cannot determine whether weakness precedes or follows a fall, a cohort method will make a second estimate of the relative risk based upon prospective ascertainment of falls. Logistic analysis will control for potential confounding variables in the relationship of strength to falls, including abnormal gait, abnormal vision, overall health status, prescription drug use, and peripheral sensory nerve function. The study will test hypotheses that specific strength deficits are associated with falls. As some data suggests the hypothesized deficits are partly reversible, such research has direct implications for fall prevention.