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treadmill slip-perturbation training 在社区居住的老年人中防止跌倒行为的保留。

The retention of fall-resisting behavior derived from treadmill slip-perturbation training in community-dwelling older adults.

机构信息

Center for Mobility and Rehabilitation Engineering Research, Kessler Foundation, West Orange, NJ, 07052, USA.

Department of Physical Therapy, University of Illinois at Chicago, 1919 W. Taylor Street, Fourth Floor, Chicago, IL, 60612, USA.

出版信息

Geroscience. 2021 Apr;43(2):913-926. doi: 10.1007/s11357-020-00270-5. Epub 2020 Sep 25.

Abstract

The purpose of this study was to determine whether and to what extent the immediate generalization of treadmill slip-perturbation training could be retained over 6 months to resist overground slip-induced falls. Four protocols (Tc: treadmill control; Tt: treadmill slip-perturbation training; Oc: overground control; Ot: overground slip-perturbation training) from two randomized controlled trials were compared in which two training protocols were executed with single-session repeated slip-perturbation training on the treadmill or overground context, while two control protocols were executed without repeated training. A total of 152 community-dwelling older adults (≥ 65 years) who were trained by one of the four protocols and tested by an overground slip in the initial session attended a retest session 6 months later. Falls were detected by a load cell. Data collected from motion analysis system and force plates were used to calculate stability. Tt group had no significant change in fall incidence from initial post-training test to retest. Tt group had significantly lower fall incidence (p < 0.05) and higher reactive stability (p < 0.05) than Tc group in retest. Tt group had significantly higher fall incidence (p < 0.05) and lower reactive stability (p < 0.01) than Ot group. The generalization of a single session of treadmill slip-perturbation training to overground slip resulted in inferior outcomes compared with overground slip-perturbation training (absolute retention), although the training generalization could be retained over 6 months (relative retention). Thus, treadmill slip-perturbation training could be more convenient to use if future dose-response studies indicate better or equal efficacy to overground slip-perturbation training.

摘要

本研究旨在确定 treadmill slip-perturbation 训练的即时泛化是否以及在何种程度上可以在 6 个月内保持,以抵抗地面滑倒引起的跌倒。比较了两个随机对照试验中的四个方案(Tc:跑步机对照;Tt:跑步机滑倒扰动训练;Oc:地面对照;Ot:地面滑倒扰动训练),其中两个训练方案在跑步机或地面环境下进行单次重复滑倒扰动训练,而两个对照方案则不进行重复训练。共有 152 名居住在社区的老年人(≥65 岁)参加了其中一个方案的训练,并在初始测试中进行了地面滑倒测试,然后在 6 个月后参加了重测测试。跌倒由称重传感器检测。从运动分析系统和力板收集的数据用于计算稳定性。Tt 组在初始训练后测试到重测的跌倒发生率没有显著变化。与 Tc 组相比,Tt 组在重测时的跌倒发生率显著降低(p<0.05),反应稳定性显著提高(p<0.05)。与 Ot 组相比,Tt 组的跌倒发生率显著升高(p<0.05),反应稳定性显著降低(p<0.01)。单次跑步机滑倒扰动训练的泛化导致地面滑倒的结果不如地面滑倒扰动训练(绝对保留),尽管训练的泛化可以在 6 个月内保持(相对保留)。因此,如果未来的剂量反应研究表明 treadmill slip-perturbation 训练与地面滑倒扰动训练具有更好或同等的效果,那么 treadmill slip-perturbation 训练可能更方便使用。

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