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用于预防跌倒的步态适应性泛化:从可移动平台到滑溜地面。

Generalization of gait adaptation for fall prevention: from moveable platform to slippery floor.

作者信息

Bhatt T, Pai Y C

机构信息

Department of Physical Therapy, University of Illinois at Chicago, Chicago, Illinois 60612, USA.

出版信息

J Neurophysiol. 2009 Feb;101(2):948-57. doi: 10.1152/jn.91004.2008. Epub 2008 Dec 10.

Abstract

A person's ability to transfer the acquired improvements in the control of center of mass (COM) state stability to slips induced in everyday conditions can have profound theoretical and practical implications for fall prevention. This study investigated the extent to which such generalization could take place. A training group (n=8) initially experienced 24 right-side slips in blocked-and-random order (from the 1st unannounced, novel slip, S-1 to the last, S-24) resulting from release of a low-friction moveable platform in walking. They then experienced a single unannounced slip while walking on an oil-lubricated vinyl floor surface (V-T). A control group (n=8) received only one unannounced slip on the same slippery floor (V-C). Results demonstrated that the incidence of balance loss and fall on V-T was comparable to that on S-24. In both trials, fall and balance-loss incidence was significantly reduced in comparison with that on S-1 or on V-C, resulting from significant improvements in the COM state stability. The observed generalization indicates that the control of COM stability can be optimally acquired to accommodate alterations in environmental constraints, and it may be broadly coded and easily modifiable within the CNS. Because of such mechanisms, it is possible that the locomotor-balance skills acquired with the aid of low-friction moveable platforms can translate into resisting falls encountered in daily living.

摘要

一个人将在控制质心(COM)状态稳定性方面所获得的改进转化为日常条件下滑倒情况的能力,对于预防跌倒可能具有深远的理论和实际意义。本研究调查了这种泛化能够发生的程度。一个训练组(n = 8)最初以分组和随机顺序经历了24次右侧滑倒(从第一次未宣布的新滑倒,S - 1到最后一次,S - 24),滑倒是在行走过程中释放低摩擦可移动平台导致的。然后他们在油润滑乙烯基地板表面(V - T)行走时经历了一次未宣布的滑倒。一个对照组(n = 8)只在相同的滑地板上(V - C)经历了一次未宣布的滑倒。结果表明,在V - T上失去平衡和跌倒的发生率与在S - 24上相当。在这两个试验中,与在S - 1或V - C上相比,跌倒和失去平衡的发生率显著降低,这是由于COM状态稳定性有显著改善。观察到的泛化表明,COM稳定性的控制可以得到最佳获取,以适应环境约束的变化,并且它可能在中枢神经系统内被广泛编码且易于修改。由于这种机制,借助低摩擦可移动平台获得的运动平衡技能有可能转化为抵抗日常生活中遇到的跌倒。

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