Aging and mixed perturbation training to reduce falls in locomotion

 描述（由申请人提供）：本研究的长期目标是开发一种有效的训练模式，以增强老年人对福尔斯的防御机制，并可能降低医疗费用。疾病控制和预防中心估计，每年与跌倒有关的伤害的直接医疗费用为300亿美元。在社区居住的老年人中，滑倒和绊倒占户外福尔斯跌倒的50%以上。这些环境扰动在性质上是相反的，滑动主要导致向后的福尔斯和向前的福尔斯。这个项目探讨了扰动训练，通过两个滑倒和绊倒暴露的基础上，运动学习的原则。项目设计包括一项随机对照试验，以检查中枢神经系统减轻由相反类型的扰动诱导的稳定性控制干扰（如有）的能力。它阿索介绍了一种新的组合滑倒和绊倒扰动训练范式，以提高一个人的能力，以保持和推广获得的跌倒预防技能，以两种类型的福尔斯。地面走道上的滑倒和绊倒将用于准备电机系统，以改善稳定性控制和垂直肢体支撑，以抵抗福尔斯。还将评估这种组合扰动训练在减少实验室诱导和真实的生活福尔斯跌倒方面优于单独的仅滑倒或仅绊倒扰动训练的长期益处。本研究的假设，如果支持的结果，将提供一个证据支持的训练协议，以减少跌倒的风险，在社区居住的老年人。

 DESCRIPTION (provided by applicant): The long-term objective of this research is to develop an efficacious training paradigm to enhance older adults' defense mechanisms against falls and possibility reduce healthcare cost. The Centers for Disease Control and Prevention estimates the direct medical cost for fall related injuries to be $30 billion annually. Slips and trips combied account for more than 50% of the outdoor falls in community-dwelling older adults. These environmental perturbations are opposing in nature, with slips mainly resulting in backward falls and trips in forward falls. This project explores perturbation training through both slip and trip exposure based on the principles of motor learning. The project design consists of a randomized controlled trial to examine the ability of the central nervous system to mitigate the interference in stability control (if any) that is induced by opposing types of perturbations. It aso introduces a novel combined slip and trip perturbation training paradigm to enhance one's ability to retain and generalize the acquired fall-prevention skills to both types of falls. Slips and trip induced on an over ground walkway will be used to prepare the motor system to improve stability control and vertical limb support to resist falls. The longer-term benefits of such combined perturbation training over exclusive slip-only or trip-only perturbation training in reducing both laboratory-induced and real life falls will also be assessed. The hypothesis of this study if supported by the results will provide an evidence-supported training protocol to reduce the fall-risk among community-dwelling older adults.