Dynamic postural stability and falls prediction in older people during walking in real-world environments.

随着年龄的增长，跌倒的发生率增加(65岁以上的人中有33%-50%)是死亡率(1998年有1014人死亡)、发病率和残疾的一个重要原因，这不仅影响到相关个人，而且影响到医疗保健系统(1998年澳大利亚有45,069人因跌倒住院)和更广泛的社区(国家预防跌倒倡议，2004年)。虽然有许多摔倒风险测试，但大多数依赖于在身体静止而不是运动时站立时身体摇摆的确定。鉴于高达70%的跌倒发生在行走和转移过程中，显然有必要开发跌倒风险预测测试，将在更动态的活动中测量的姿势稳定性指标纳入其中。测试的发展需要有明确的证据来支持，证明与年龄相关的感觉和运动缺陷如何影响行走时的姿势稳定性。本申请中概述的研究将开发和利用基于加速度计的新技术，以确定老年人行走过程中平衡控制的基本机制。具体地说，这个项目的目的是明确了解视力、神经肌肉功能(力量、僵硬)和本体感觉等因素的变化如何导致老年人行走过程中稳定性和平衡性的整体下降。结合研究团队开发的生理评估方法，这项研究将允许开发更明确的稳定性和跌倒风险预测测试。这项测试将能够被卫生专业人员用于评估老年人，以确定针对这些高危个人的最有效的治疗和/或运动干预措施。这项技术还将适用于生物反馈设备，允许个人监控自己的稳定性。

The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body is static rather than in motion. Given that up to 70% of falls occur during walking and performing transfers, there is a clear need to develop tests of falls risk prediction that incorporate indices of postural stability measured during more dynamic activities. Test development needs to be underpinned by clear evidence of how age-related sensory and motor deficits affect postural stability during walking. The studies outlined in this application will develop and utilise new accelerometer-based technologies to determine the fundamental mechanisms underlying balance control during walking in older people. Specifically, this project will aim to develop a clear understanding of how changes in factors as vision, neuromuscular function (strength, stiffness) and proprioception contribute to the overall decline in stability and balance during walking in older people. Combined with physiological assessment measures developed by the research team, the research will allow the development of a more definitive predictive test of stability and falls risk. This test will be able to be used by health professionals for assessment of older people to determine the most effective therapeutic and-or exercise interventions to target those individuals at risk. This technology will also be adaptable to a biofeedback device to allow individuals to monitor their own stability.