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Dynamic Postural Stability And Falls Prediction In Older People During Walking In Real-world Environments.
Funder
National Health and Medical Research Council
Funding Amount
$680,793.00
Summary
The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body i ....The increased occurrence of falls with advancing age (33-50% of people aged >65 years) is a significant cause of mortality (1014 deaths in 1998), morbidity, and disability, affecting not only the individuals concerned, but the health care system (45,069 fall related hospitalizations in 1998 in Australia) and the broader community (National falls Prevention Initiative, 2004). Although there are a number of falls risk tests, most rely on determination of body sway while standing when the body is static rather than in motion. Given that up to 70% of falls occur during walking and performing transfers, there is a clear need to develop tests of falls risk prediction that incorporate indices of postural stability measured during more dynamic activities. Test development needs to be underpinned by clear evidence of how age-related sensory and motor deficits affect postural stability during walking. The studies outlined in this application will develop and utilise new accelerometer-based technologies to determine the fundamental mechanisms underlying balance control during walking in older people. Specifically, this project will aim to develop a clear understanding of how changes in factors as vision, neuromuscular function (strength, stiffness) and proprioception contribute to the overall decline in stability and balance during walking in older people. Combined with physiological assessment measures developed by the research team, the research will allow the development of a more definitive predictive test of stability and falls risk. This test will be able to be used by health professionals for assessment of older people to determine the most effective therapeutic and-or exercise interventions to target those individuals at risk. This technology will also be adaptable to a biofeedback device to allow individuals to monitor their own stability.Read moreRead less
The Effect Of Antiepileptic Medication On Indices Of Bone Health And Risk Factors For Falls And Fractures
Funder
National Health and Medical Research Council
Funding Amount
$469,605.00
Summary
Epilepsy is a common brain disorder and most patients with epilepsy take anti-epileptic drugs (AEDs) for many years. These patients have high rates of bone fractures, but the reasons are uncertain. Earlier studies identifying an association between AED use and bone disease were performed on institutionalised patients, and more recent studies on outpatient populations have been conflicting. A better understanding of this problem is critical for designing potential preventive measures and treatmen ....Epilepsy is a common brain disorder and most patients with epilepsy take anti-epileptic drugs (AEDs) for many years. These patients have high rates of bone fractures, but the reasons are uncertain. Earlier studies identifying an association between AED use and bone disease were performed on institutionalised patients, and more recent studies on outpatient populations have been conflicting. A better understanding of this problem is critical for designing potential preventive measures and treatments. One important additional mechanism by which AEDs may increase fracture risk is impairment of gait and balance, leading to a high risk of falls. We have novel data demonstrating the power of a Twin and Matched Sibling approach to study this important problem. This study showed that chronic AED use was associated with significant deficits in bone mineral density (BMD), a key predictor of the risk of fractures. The proposed project will ask the following questions: 1. Is BMD and estimated bone strength lower in the bones most at risk for fracture in women and men chronically taking AEDs? 2. Is the loss of bone in measurements over time greater in patients continuing to take AEDs? 3. Is the risk of bone loss greater for certain types of AEDs, and is the risk influenced by length of exposure, age and menopausal status? 4. How does AED treatment lead to reductions in BMD and bone strength? 5. Are measures of muscle strength, gait and balance impaired in patients taking AEDs compared with matched people not taking AEDs? The proposed study will utilise twins and pairs of siblings to investigate the effects of the long-term use of AEDs for epilepsy on measures of bone mass and strength, indices of bone turnover, vitamin D status, calcium regulating hormones, mineral levels, sex hormone levels, and measures of muscle strength, gait and balance function. In addition, a group of patients newly commencing AED treatment for epilepsy will be studied over 2 years.Read moreRead less
Task-specific Strength Training For Mobility Following Traumatic Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$184,768.00
Summary
I am a senior physiotherapist working in the traumatic brain injury (TBI) unit at Epworth Rehabilitation. We have identified and described the nature and extent of walking problems following TBI. Previous researchers focused on the impact of balance disorders on walking. Our research found that balance disorders are prevalent; the main cause of walking problems is muscle weakness. We will compare balance and muscle strengthening exercises to determine which has a greater impact on walking.
Otago Exercise Program For Older Adults Recovering From PFF: Feasibility, Gait Analysis And Physical Function.
Funder
National Health and Medical Research Council
Funding Amount
$88,214.00
Summary
Hip fractures are a common, serious and rapidly growing problem for older people. The consequences for an individual can be devastating including reduced mobility, loss of independence and ultimately admission to a nursing home. This study aims to identify strategies to assist clinicians in the individual prescription of the most appropriate therapy, improve rehabilitation programs and ultimately the outcomes for hip fracture sufferers.
Improving Postural Stability In People With Parkinson's Disease Using Textured Insoles.
Funder
National Health and Medical Research Council
Funding Amount
$968,538.00
Summary
Falls are a major health and injury problem for people with Parkinson's disease (PD). In this study we propose to undertake a randomised control trial to determine the efficacy of textured insoles to improve postural stability and reduce falls risk in people with Parkinson’s disease. The success of such an inexpensive device would result in improved health outcomes for individuals and large savings in health care through a reduction in fall-related injuries.
Improving Mobility After Traumatic Brain Injury With Ballistic Strength Training
Funder
National Health and Medical Research Council
Funding Amount
$661,430.00
Summary
Traumatic Brain Injury (TBI) is the leading cause of disability amongst young adults, many of whom have difficulty walking. Muscle weakness is the main cause of these walking problems, but previous trials have failed to improve walking performance. We have developed new strengthening exercises which focus on how quickly the muscles can contract, rather than just how strong they are. These exercises can increase muscle power by 60-74% and are likely to improve people’s ability to walk.