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

描述（由申请人提供）：与滑倒有关的福尔斯通常会造成伤害;这些通常会造成灾难性的后果，即使是在最健康的老年人中。我们已经证明，通过在行走过程中反复暴露于滑倒的运动训练，年轻人能够在不失去平衡的情况下穿越潜在的滑倒危险，无论滑倒是否真的发生。这些影响不太可能仅仅归因于教育或对下滑威胁的认识提高。此外，我们已经证明，从一个单一的会话中获得的这些改善的运动技能可以在重新测试时保留至少4-6个月，使得这种干预非常有吸引力。然而，更令人感兴趣的是，老年人在接受这种培训后能够在多大程度上获得并保持类似的保护技能。迄今尚未对此进行测试。同样未知的是潜在的混杂因素，如老年人的功能状态可能与训练相互作用。这些问题的重要性在于，建立一个预防滑倒相关福尔斯的康复训练方案无疑会对公共卫生产生重大影响。在这项研究中，我们将证明，老年人可以显着降低他们的短期风险向后平衡损失和福尔斯通过运动训练，反复暴露于模拟滑穿插无滑试验。我们将通过一个意识控制组来验证意识或观察学习本身不能代替运动训练。然后，我们将确定在一年的时间内，适应性改进的保留程度。最后，我们将验证，虽然单次滑倒暴露可能会产生一些恢复效果，但与重复滑倒的运动训练组相比，该强度控制组在控制质心稳定性、体重支撑、平衡丧失和滑倒时跌倒方面的长期效果明显较差。此外，我们预计强度控制组在12个月期间的福尔斯自我报告发生率也将高于多次滑倒暴露的运动训练组。公共卫生宣传：与滑倒有关的福尔斯经常会造成伤害;这些伤害往往会造成灾难性的后果，即使是最健康的老年人也是如此。毫无疑问，建立一个预防滑倒相关福尔斯的康复训练方案将对公共卫生产生重大影响。在这项研究中，我们将证明，老年人可以显着降低他们的短期风险向后平衡损失和福尔斯通过运动训练与多个保护滑暴露，这种适应性的改善，从这种预防性训练方案可以保留在一年的过程中。

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.