PERIPHERAL NEUROPATHY, SENSORIMOTOR FUNCTIONS & BALANCE

描述：(来自应用程序)。此应用程序请求支持 申请人接受教学培训和实践研究的经验 对于他成为一名独立的、以病人为中心的调查员来说是必要的。 在获奖的头两年里，教学课程的工作将占主导地位， 在后三项研究中，将是更大的重点；然而， 将成为教学教育和参与研究的要素 在整个获奖期限内。课程作业的主要焦点将是 在生物统计学、流行病学和实验设计方面。其他教学作品 将通过参加由密歇根大学赞助的研讨会 胡椒中心和老年学研究所，以及相应的基础 其他科室的科学和临床会议。 将进行的研究将在詹姆斯·阿什顿-米勒的指导下进行， 谁将担任申请者的导师。据观察，在 老年患者即使是轻微的周围神经病变(PN)，跌倒的比率是 增加了。特定的下肢远端传入和传出损伤 在这类患者中，他们姿势不稳定的基础也是 已确认身份。本应用程序中拟议的研究将调查 通过两种方式补偿这些损害的干预措施的有效性 随机对照研究。首先，老年人将被随机分组 接受垂直表面、标准手杖或与健康相关的 录像。结果将包括踝关节内翻/外翻本体感觉 挑战性步行任务中的阈值、舒适步速和错误 (曲面不规则，光线较弱)。在第二组中，患有PN的老年人将 参加专门为他们设计的为期12周的强化计划或 控制疗法。结果将包括踝关节的最大自愿力量 内翻/外翻，舒适的步速和相同挑战中的错误 步行任务、侧倾测试恢复能力、脚踝活动率 力量发展，单脚站立时间。社会阶层的分层 第一组受试者根据腕管综合征的存在和 在第3周和第12周对第二组受试者进行测试可能会给他们带来洞察力 纳入所指出的负责改进的机制。

DESCRIPTION: (From application). This application requests support for the applicant to receive the didactic training and practical research experience necessary for him to become an independent, patient-oriented investigator. During the first two years of the award didactic course work will predominate, and during the last three research will be the greater focus; however, there will be elements of didactic education and participation in research throughout the duration of an award. The main focus of the coursework will be in biostatistics, epidemiology, and experimental design. Other didactic work will be through attendance at seminars sponsored by the University of Michigan Pepper Center and Institute of Gerontology, as well as appropriate basic science and clinical conferences in other departments. Research to be performed will be under the direction of James Ashton-Miller, who will function as the applicant's mentor. It has been observed that in older patients with even mild peripheral neuropathy (PN) the rate of falls is increased. Specific distal lower extremity afferent and efferent impairments in such patients which underlie their postural instability have also been identified. The proposed research in this application will investigate the efficacy of interventions to compensate for these impairments by means of two randomized, controlled studies. In the first, older adults will be randomized to receive touch of a vertical surface, a standard cane, or a health-related video. Outcomes will include ankle inversion/eversion proprioceptive thresholds and comfortable gait speed and errors on a challenging walking task (irregular surface, low light). In the second, older adults with PN will undergo a 12-week strengthening program specifically designed for them or a control regimen. Outcomes will include maximum voluntary strength of ankle inversion/eversion, comfortable gait speed and errors on the same challenging walking task, ability to recover from a lateral leans test, rate of ankle strength development, and unipedal stance time. Stratification of the subjects in the first group by the presence of carpal tunnel syndrome and testing the subjects in the second group at 3 and 12 weeks may give insight into the mechanisms responsible for improvement noted.