MOTOR TRAINING FOR FALL PREVENTION: ADAPTATION AND RETENTION IN OLDER ADULTS

描述(由申请人提供)：与滑倒有关的跌倒往往会造成伤害；即使是最健康的老年人，也往往会造成灾难性的后果。我们已经证明，通过在行走过程中反复接触滑倒进行运动训练，年轻人能够在不失去平衡的情况下穿越潜在的滑倒危险，无论是否真的发生滑倒。这些影响不太可能仅仅归因于教育或提高对不断下滑的威胁的认识。此外，我们已经证明，从一次训练中获得的这些提高的运动技能在重新测试后可以保留至少4-6个月，这使得这种干预非常有吸引力。然而，更令人感兴趣的是，老年人在这种培训后能够在多大程度上获得和保留类似的保护技能。到目前为止，这还没有进行过测试。同样未知的是，潜在的混杂因素，如老年人的功能状况，可能会如何与训练相互作用。这些问题很重要，因为建立一种针对与跌倒有关的跌倒的可保留的预防性训练方案无疑将对公共卫生产生重大影响。在这项研究中，我们将证明，老年人通过重复暴露在模拟滑倒和防滑试验中，可以显著降低他们通过运动训练而失去后向平衡和摔倒的近期风险。我们将通过意识控制小组证实，仅靠意识或观察性学习不能取代运动训练。然后，我们将确定在一年中保持适应性改进的程度。最后，我们将验证，尽管单次滑倒暴露可能会产生一定的保留效果，但这种强度控制组在控制重心稳定性、体重支撑、平衡丧失和滑倒时摔倒方面的长期效果明显不如反复滑倒的运动训练组。此外，我们预计，在12个月期间，强度控制组的自我报告跌倒发生率也将高于多次滑倒暴露的运动训练组。公共卫生：与跌倒有关的跌倒往往会造成伤害；这些往往会带来灾难性的后果，即使是最健康的老年人也是如此。建立一种预防跌倒的可保留的训练方法，无疑会对公众健康产生重大影响。在这项研究中，我们将证明，老年人通过多次保护性滑倒暴露的运动训练可以显著降低他们近期后向平衡丧失和摔倒的风险，并且这种预防性训练方案的适应性改善可以在一年的过程中保持下去。

DESCRIPTION (provided by applicant): Slip-related falls often cause injury; these often have catastrophic consequences, even among the healthiest older persons. We have shown that, with motor training by repeated exposure to slips during walking, young adults are able to traverse a potential slipping hazard without losing their balance, regardless of whether a slip actually occurs or not. It is highly unlikely that these effects could be attributed to education or heightened awareness of the slipping threat alone. Furthermore, we have demonstrated that these improved motor skills acquired from a single session can be retained for at least 4-6 months upon re-testing, making such intervention highly attractive. Of greater interest, however, is the extent to which older adults can acquire and retain similar protective skills upon such training. This has not been tested to date. Also unknown is how potential confounding factors such as an older adult's functional status might interact with the training. These issues are of importance in that establishing a retainable prophylactic training regimen against slip-related falls would, without doubt, have major public health implications. In this study, we will demonstrate that older adults can significantly reduce their near-term risk of backward balance loss and falls through motor training by repeated exposure to simulated slips interspersed with no-slip trials. We will verify that awareness or observational learning alone cannot substitute for motor training through an awareness-control group. We will then determine the extent to which adaptive improvements are retained over the course of a year. Finally, we will verify that although a single slip exposure may yield some retainable effect, this intensity control group will exhibit significantly less favorable long-term effect on the control of center of mass stability, body weight support, balance loss and fall upon slipping than the motor training group with repeated slips. In addition, we expect that the intensity-control group will also have a higher self-reported incidence of falls during the 12-month period than the motor training group with multiple slip exposure. PUBLIC HEALTH REVELANCE: Slip-related falls often cause injury; these often have catastrophic consequences, even among the healthiest older persons. Establishing a retainable preventive training regimen against slip-related falls would, without doubt, have major public health implications. In this study, we will demonstrate that older adults can significantly reduce their near-term risk of backward balance loss and falls through motor training with multiple protected slip exposure, and such adaptive improvements from such prophylactic training regimen can be retained over the course of a year.