STEPPING OUT - Understanding the ground truth and mechanisms of falls and balance instability in community dwelling older people.

在欧洲，每年的福尔斯成本为250亿欧元（2015年价格），并将随着人口老龄化而上升。预防福尔斯跌倒的干预措施效果很小，而且持续时间很短，对严重伤害几乎没有影响。我们迫切需要更好的解决方案。由于无法研究发生在生态有效情况下的福尔斯，研究一直受到阻碍。进步是现在可能的新的，超越国家的最先进的设施在埃克塞特大学。VSimulator是一个安装在运动平台上的3.7 m x 3.7 m测力板阵列，具有六个运动自由度，可以创建对福尔斯具有高度生态有效性的脚下扰动。再加上集成的运动捕捉（有或没有虚拟现实），该设施可以生成逼真的场景，包括不受约束的步行过程中的危险（包括测力板的总步行距离为15米）。我们将产生关于平衡系统内发生的事情的经验证据，以克服或屈服于扰动，并开发新的感觉依赖性测试。我们将使用先进的数学分析来解开老年人平衡控制的秘密。有5个工作计划（WP）。WP 1将通过使用原始方法（惯性测量装置）分析真实的生活情况中记录的220起福尔斯，最大限度地了解福尔斯常见的情况。这将为项目后期阶段（WP2）扰动情景的设计和实施提供信息。中心部分是一个大型实验，其中228名老年人将接受VSimulator测试（WP 3）。WP4将开发分析方法，WP5将专注于转化机会，包括新的治疗和测试。该项目将为跌倒预防的根本改进奠定基础，并培养下一代跌倒和平衡研究人员。PI在福尔斯和康复研究方面有着良好的记录，并有着杰出的领导记录。

In Europe the costs of falls are 25 billion euros each year (2015 prices) and will rise with population ageing. Interventions to prevent falls have a small and short-lived effect and virtually no impact on serious injuries.We desperately need better solutions. Research has been held back by an inability to study falls whilst they happen in ecologically valid situations. Advances are now made possible by new, beyond state of the art facilities at the University of Exeter. The VSimulator is a 3.7m x 3.7m force plate array mounted on a motion platform with six degrees of freedom of movement allowing the creation of underfoot perturbations which have high ecological validity for falls. Coupled with integrated motion capture with or without Virtual Reality the facility generates life like scenarios including hazards during unconstrained walking (total walk distance including the force plate 15m). We will generate empirical evidence about what is happening within the balance systems to overcome or succumb to perturbations, and develop novel sensory dependency tests. We will use advanced mathematical analysis to unlock the secrets of balance control in older adults.There are 5 work programmes (WPs). WP1 will maximise knowledge about the situations in which falls commonly occur by analysing 220 falls recorded in real life situations using a crude method (inertial measurement units). This will inform the design and implementation of perturbation scenarios in later stages of the project (WP2). The centre piece is a large experiment in which 228 older people will undergo VSimulator tests (WP3). WP4 will develop analytical approaches, and WP5 will focus on the translational opportunities including new treatments and tests. The project will lay the foundation for radical improvements in fall prevention and develop the next generation of fall and balance researchers. The PI has a strong record in falls and rehabilitation research, and a distinguished leadership record.