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经验 他必须成为一个独立的，以病人为导向的调查员。 在前两年的奖项教学课程工作将占主导地位， 在最后三个研究将是更大的重点;然而， 将是教学教育和参与研究的要素 在整个颁奖期间。课程的主要重点将是 生物统计学流行病学和实验设计 其他教学工作 将通过参加密歇根大学主办的研讨会 胡椒中心和老年学研究所，以及适当的基本 其他部门的科学和临床会议。 将在James Ashton-Miller的指导下进行研究， 作为申请人的导师 据观察，在 即使是轻度周围神经病变（PN）的老年患者，福尔斯的发生率也是 增加 特异性下肢远端传入和传出损伤 在这些患者中，其姿势不稳定的基础也被 鉴定 本申请中的拟议研究将调查 通过两种方式补偿这些损害的干预措施的功效 随机对照研究。 首先，老年人将被随机分配 接受垂直表面的触摸，标准手杖，或与健康有关的 视频. 结局将包括踝关节内翻/外翻本体感受 阈值和舒适的步态速度和具有挑战性的行走任务的错误 （不规则表面，低光）。 在第二种情况下，患有PN的老年人将 接受专门为他们设计的为期12周的强化计划， 对照方案。 结果将包括踝关节的最大随意力量 内翻/外翻，舒适的步态速度和错误的相同的挑战 步行任务，侧倾恢复能力，踝关节活动率 力量发展和单足站立时间。 分层 第一组受试者存在腕管综合征， 在第3周和第12周对第二组受试者进行测试可能会让我们了解 注意到负责改进的机制。

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.