The role of anticipatory postural adjustments in balance control of older adults

描述（由申请人提供）：老年人的主要健康问题是平衡能力下降，这严重限制了他们的日常生活活动和社区参与。虽然在这一人群中已经研究了使用姿势控制的代偿（反馈）机制的能力下降，但在老年人中使用预期（前馈）姿势调整的情况并没有很好的记录。老年人无法在即将到来的平衡威胁之前（预期）进行最佳的姿势调整，这可能使他们失去平衡的风险更大。了解年龄对预期体位调节在随后的姿势控制中的作用需要将这两种机制结合起来研究。最近，pi开发了一种应用外部身体扰动的新方法，使他们能够检查每种姿势控制机制的个体影响及其相互作用。考虑到老年人预期体位控制数据的不足和一种新的实验技术的可用性，本研究的目的是：1)为老年人预期性体位调节的产生提供重要的基线信息；2)研究老年人平衡控制的预期机制和代偿机制的相互作用；3)研究老年人功能平衡能力的差异对平衡控制的预期机制和代偿机制的相互作用的影响。两个特定的目标将在实验中进行测试，涉及老年人（功能稳定和不稳定）和年轻人，他们在站立时受到外部扰动。将收集和分析肌电图记录、地面反作用力和运动学数据。目前老年人的康复策略并不关注前馈姿势控制的恢复，主要是由于对预期姿势调整在平衡控制中的作用认识不足。这项研究将为一个长期的研究项目奠定基础，该项目的重点是再培训老年人在维持和改善平衡控制中使用预期调节的能力。

DESCRIPTION (provided by applicant): A primary health concern for aging adults is balance deterioration, which severely limits their activities of daily living and community participation. While a decline in the ability to use compensatory (feedback) mechanisms of postural control have been studied in this population, the utilization of anticipatory (feed forward) postural adjustments in the elderly is not well documented. Inability of older adults to optimally generate postural adjustments prior to (in anticipation of) an upcoming balance threat may put them at a greater risk for losing balance. Understanding the effect of aging on the utilization of anticipatory postural adjustments in subsequent control of posture requires studying the two mechanisms together. Recently, the PIs developed a new method of applying external body perturbations that allows them to examine the individual effects of each mechanism of postural control and their interaction. Given the insufficiency of data on the anticipatory postural control in the elderly and the availability of a novel experimental technique, the objectives of this study are: 1) to provide important baseline information regarding the generation of anticipatory postural adjustments in older individuals, 2) to investigate the interaction between anticipatory and compensatory mechanisms of balance control in older adults, and 3) to examine the effect of differences in functional balance capacity of older adults on the interaction between anticipatory and compensatory mechanisms of balance control. Two specific aims will be tested in experiments involving older (functionally stable and unstable) and young adults subjected to external perturbations while standing. Electromyographic recordings, ground reaction forces, and kinematic data will be collected and analyzed. Current rehabilitation strategies in the elderly are not focused on restoration of feed forward postural control, mainly due to an inadequate understanding of the role of anticipatory postural adjustments in balance control. This study will form the foundation for a longer-term research program centered on retraining the ability of older adults to use anticipatory adjustments in maintenance and improvement of balance control. PUBLIC HEALTH RELEVANCE: The proposed project will study control of posture in the elderly. The PIs will investigate the differences in utilization of anticipatory postural adjustments between older (functionally stable and unstable) and young adults subjected to external perturbations while standing. The outcome of the study is important for the future development of therapeutic advances focused on treatment of postural disorders.