Aging and mixed perturbation training to reduce falls in locomotion

 描述(申请人提供)：本研究的长期目标是开发一种有效的训练范式，以增强老年人对跌倒的防御机制，并可能降低医疗成本。疾病控制和预防中心估计，每年与跌倒相关的伤害的直接医疗成本为300亿美元。在社区老年人的户外跌倒中，滑倒和旅行的比例超过50%。这些环境扰动本质上是相反的，滑倒主要导致向后坠落，在向前坠落时绊倒。本项目以运动学习原理为基础，通过滑行和绊倒两种方式探索摄动训练。该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引起的稳定性控制干扰(如果有的话)的能力。它还引入了一种新颖的滑倒和绊倒扰动训练范例，以增强一个人保留和推广所获得的预防跌倒的技能的能力。地面人行道上的滑倒和绊倒将被用来准备电机系统，以改善稳定性控制和垂直肢体支撑，以防止跌倒。还将评估这种组合扰动训练在减少实验室引起的和实际生活中的跌倒方面比单纯滑行或仅旅行扰动训练更长期的好处。这项研究的假设如果得到结果的支持，将提供一个证据支持的培训方案，以减少社区老年人跌倒的风险。

 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.