FEAR OF FALLING & GAIT DYNAMICS IN ELDERLY

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。患有“高度步态障碍”的老年人步态异常，过度害怕摔倒；然而，临床神经运动检查通常不会显示任何明显的潜在损害。与年龄匹配的对照组相比，我们正在研究这一人群中步态动力学的变化，并研究不同干预措施的效果。这些患者走得更慢，步幅之间的可变性增加，步态动力学受损。这些变化中的许多都与对跌倒的恐惧有关。值得注意的是，在高度步态障碍的患者中，约50%报告摔倒。在报告摔倒的受试者和没有摔倒的受试者中，对摔倒的恐惧、步态速度、步态可变性和许多其他指标都是相似的。值得注意的是，步态的分形比例指数成功地区分了跌倒和不跌倒的人。正在进行的工作旨在进一步评估这些患有高水平步态障碍的老年跌倒者的跌倒风险，开发新的技术来定量描述这些患者的步态，确定导致步态变化和跌倒恐惧的机制，并评估不同干预措施的效果。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Older adults with "high level gait disorders" have abnormal gait and an excessive fear of falling; however, clinical neuro-motor examination typically does not reveal any obvious underlying impairment. We are characterizing the changes in gait dynamics in this population compared to aged-matched controls and studying the effects of different interventions. These patients walk more slowly, with increased stride-to-stride variability and impaired gait dynamics. Many of these changes are associated with fear of falling. Of note, among the patients with high level gait disorders, about 50% reported falling. Fear of falling, gait speed, gait variability and many other measures were similar in those subjects who reported falling and those who did not. Of note, a fractal scaling index of gait was successful in discriminating between fallers from non-fallers. Ongoing work is directed at further assessing risk of falling in these elderly fallers with high level gait disorders, developing new techniques for quantitatively characterizing gait in these patients, determining the mechanisms responsible for the gait changes and fear of falling, and evaluating the effects of different interventions.