Description du projet :
This research project aims to validate hip abductor strength as a relevant targetable variable related to fall risk in community dwelling elderly. It further aims to assess the impact of a specific hip abductor strength training on reduction of fall rate.
Falls are mainly caused by disturbances in balance and gait. Fall injuries, in particularly fractures, might cause fear of falling and restrictions of activities with deleterious effects on metabolic parameters, vascular risk factors, independency and quality of life. To avoid this 'vicious cycle', interventions targeting elderly at risk of falling are needed.
Studying the impact of hip motor function on fall risk is highly important as many elderly have sub-optimal peripheral neurologic function. However these patients can increase proximal strength which has been shown to compensate the distal nerve dysfunction and, hence, prevent falls.
Recent literature shows an increasing interest in lateral control, given that impairments in this domain are known to increase fall risk and to have greater injury potential, including hip fractures, than other falls.
Our previous work indicates that frontal plane hip strength can compensate distal neuromuscular deficits in diabetic neuropathy patients with regard to unipedal stance time and walking on an uneven surface. In prospective work, frontal plane hip strength was the single most important predictor of falls/injuries. A recent pilot study (yet unpublished data) confirmed that hip abductor strength (HAS), including Hip Abductor Maximum Voluntary Isometric Strength and Rate of Force Generation, is related to fall risk, and more effectively discriminated between fallers (' 1 fall in previous 12 months) and non-fallers than hip adductors, hip flexors, extensors and hip rotators.
Therefore, this study aims I) to validate through a prospective study that HAS is a relevant targetable variable related to fall rate in community dwelling elderly and II) to assess the impact of HAS training on fall rate as compared to a general exercise program through a randomized controlled trial.
The quantification of the added value of the targetable variable HAS is a novel and clinical relevant step for the fall risk management. The acquired data will allow clinicians to gather insight on the impact of HAS to assure safe ambulation and prevent falls. The results have the potential for immediate application. HAS can be trained in both, a primary and secondary prevention perspective, to reduce individuals' fall rate and fall-related injuries as well as to maintain independence. Therefore the present project provides a new practical asset for authorities in the field of rehabilitation and movement science allowing the evaluation and reduction of fall risk.
The suggested evaluation and treatment include a method that, if it is effective, would be easy to implement among physiotherapists because the established ideas suit well in their paradigm. The intervention can also be easily understood by patients and community dwellers, hence favoring adhesion.
The benefits will concern a substantial percentage as approximately 40% of the elderly population are at risk of falling. Therefore, positive social impacts and a better use of financial and human resources can be expected.
Research team within HES-SO:
de Preux-Allet Lara
Partenaires académiques: Santé
Durée du projet:
01.04.2016 - 31.12.2016
Montant global du projet: 11'000 CHF