Description du projet :
Summary
The overall aim of this PhD project is to investigate the role of hip motor functions, in particular frontal plane muscle functions, for fall risk prevention in elderly persons.
The total number of elderly persons ('65 years) in Switzerland is rapidly increasing. This will lead to a higher number of falls with an often associated loss of independency. Therefore, the identification of easily measurable and targetable fall risk predictors is clinically essential.
Lateral and postero-lateral falls have greater hip injury potential than falls in other directions. This leads to an increasing interest in lateral control and its influence on fall risk. This project will provide for the first time solid data on frontal plane hip motor dysfunctions in elderly and their consequences.
The PhD project is subdivided in five work packages. Each package answers a specific research question and will lead to a publication in a peer-reviewed journal.
The first work package consists of a systematic review, which aims to summarize psychometric properties of the following currently used functional fall risk predictors in elderly: timed up and go test (TUG), performance oriented mobility assessment (POMA), short physical performance battery (SPPB) and spatiotemporal gait parameters.
The second work package aims to assess if hip frontal plane muscle strength can reliably be measured in elderly patients at risk of falls. We measure the hip abduction and adduction maximum voluntary isometric strength (MVIS) and the rate of force development (RFD) in elderly fallers and non-fallers on two different time points. The ICCagreement will be calculated.
The third work package aims to evaluate if hip frontal plane muscles better distinguish between fallers and non-fallers than other hip muscle groups (flexors, extensors, internal rotators and external rotators). We additionally assess grip strength, which is supposed to be related to whole body strength, and check if hip muscles can better distinguish between fallers and non-fallers than grip strength.
The forth work package aims to assess the construct validity of the parameter hip abductor MVIS and RFD. We check if these parameters differ between elderly persons known as fallers, elderly persons who were classified as being at risk of falling and elderly non-fallers. We further test the hypothesis that the hip abductor MVIS and RFD correlates with currently used fall risk predictors (TUG, POMA, SPPB and spatiotemporal gait parameters).
The fifth work package investigates the predictive validity of the parameter hip abductor muscle strength (MVIS and RFD) for falls. For that we measure hip MVIS and RFD of elderly. We afterwards follow them during 12 months and record their fall rate and fall related injuries on a monthly basis.
The results of this study will validate hip frontal plane muscle strength measures as clinically important fall risk predictor. As hip strength is directly targetable, this project fosters the development of innovative and more efficient physical therapeutic interventions for fall prevention. This might help to maintain the independency of elderly persons. The benefits will concern a substantial percentage (~40%) of the elderly population, with positive social impact and better use of financial and human resources.
Equipe de recherche au sein de la HES-SO:
Gafner Simone
Partenaires académiques: Santé
Durée du projet:
01.07.2016 - 31.08.2018
Montant global du projet: 25'000 CHF
Statut: Terminé
SWITCH edu-ID
Administration
