FALLS AND LEG WEAKNESS IN OLDER PEOPLE

我们的目标是通过运动计划来预防老年人的福尔斯跌倒 保持或增加腿部力量。 本提案的具体目标 主要是：（1）估计福尔斯的发生率和福尔斯的归因风险 由于老年人腿部无力， 肌肉强化计划，（2）表征之间的关系 腿部肌肉力量（膝屈肌，膝伸肌，踝背屈肌， 踝跖屈肌）和福尔斯，以及（3）评估是否简单的临床 腿部力量测试可以筛选出福尔斯风险增加的病人 由于腿部无力。 该建议旨在回答某些问题 与实现长期目标有关： 预防福尔斯的锻炼计划 应该锻炼哪些腿部肌肉 方案加强，多少？ 是对立双方的相对优势 肌肉群重要吗？ 如何确定患者的风险 力量训练可以减少福尔斯的摔倒？ 研究设计结合了回顾性病例对照方法和 前瞻性队列方法 这项研究将随机招募130名 来自已知规模的HMO人群的65-85岁患者。 患者 已知的肌肉疾病和禁忌运动将 排除 样本将根据年龄、性别和 前一年的福尔斯（50%跌倒者，50%非跌倒者）。 强度 控制膝盖和脚踝的肌肉将在四个不同的时间进行测量。 使用测力计测量两条腿中每个肌肉群的肌肉速度。 测力计测量和福尔斯将与简单的临床 力量测试，包括行走、站立、提趾和握力。 根据之前的福尔斯病史，病例对照方法将估计 腿部无力增加了福尔斯跌倒的风险。 因为这个回顾展 方法无法确定虚弱是在跌倒之前还是之后， 队列方法将根据以下因素对相对风险进行第二次估计： 福尔斯的前瞻性确定。 逻辑分析将控制 强度与福尔斯关系中的潜在混杂变量， 包括异常步态、异常视力、总体健康状况， 处方药使用和外周感觉神经功能。 研究 将检验特定力量缺陷与以下因素相关的假设： 福尔斯。 正如一些数据显示，假设的赤字部分是 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.