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The purpose of this study was to investigate the effect of motor imagery on the premotor time (PMT). Twelve healthy adults performed reaction time movements in response to external visual signals at rest, when holding an object (muscle activation), or performing different background imagined movements (motor imagery). When compared to rest, muscle activation reduced the PMT; imagined finger extension of the right hand and imagined finger flexion of the left hand elongated the PMT; imagined finger flexion of the right hand had no effect on the PMT. This movement-specific effect is interpreted as the sum of the excitatory effect caused by enhanced corticospinal excitability specifically for the primary mover of the imagined movement and an overall inhibition associated with increased task complexity during motor imagery. Our results clearly demonstrate that motor imagery has movement-specific effects on the PMT. [ABSTRACT FROM AUTHOR]

Proprioception is the sense of the position of one's own body. Here, we present a case study of an individual with proprioceptive loss in one limb consequent to stroke. The patient indicated that merely touching his impaired arm with his unimpaired arm temporarily restored his proprioception. We examined this claim and the effects of imagined touch by the unimpaired arm. Assessments were made using three-dimensional tracking of reaching trajectories towards targets in conditions of light and darkness. Both actual and imagined touching significantly reduced movement error and jerk, specifically for targets located in regions that both hands would be able to reach. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To estimate the incidence and direct medical costs for fatal and non-fatal fall injuries among US adults aged >or=65 years in 2000, for three treatment settings stratified by age, sex, body region, and type of injury. METHODS: Incidence data came from the 2000 National Vital Statistics System, 2001 National Electronic Injury Surveillance System-All Injury Program, 2000 Health Care Utilization Program National Inpatient Sample, and 1999 Medical Expenditure Panel Survey. Costs for fatal falls came from Incidence and economic burden of injuries in the United States; costs for non-fatal falls were based on claims from the 1998 and 1999 Medicare fee-for-service 5% Standard Analytical Files. A case crossover approach was used to compare the monthly costs before and after the fall. RESULTS: In 2000, there were almost 10 300 fatal and 2.6 million medically treated non-fatal fall related injuries. Direct medical costs totaled 0.2 billion dollars for fatal and 19 billion dollars for non-fatal injuries. Of the non-fatal injury costs, 63% (12 billion dollars ) were for hospitalizations, 21% (4 billion dollars) were for emergency department visits, and 16% (3 billion dollars) were for treatment in outpatient settings. Medical expenditures for women, who comprised 58% of the older adult population, were 2-3 times higher than for men for all medical treatment settings. Fractures accounted for just 35% of non-fatal injuries but 61% of costs. CONCLUSIONS: Fall related injuries among older adults, especially among older women, are associated with substantial economic costs. Implementing effective intervention strategies could appreciably decrease the incidence and healthcare costs of these injuries. [ABSTRACT FROM AUTHOR]

Objectives: Although the case-crossover design has been used widely in epidemiological and cost-offset studies as an alternative to the case-control design, it is rarely applied to cost-of-illness studies. In this study, costs for a series of hospitalized and nonhospitalized fall-related injuries were computed using the 2 approaches to allow for a direct comparison of the results.Research Design: We used claims data from the Medicare fee-for-service 5% Standard Analytical Files. For the case-control design, those who sustained nonfatal fall-related injuries were tracked for 1 year after their first fall, and costs were compared, using regression analysis, to annual costs for a comparison sample of nonfallers. The case-crossover design used a modified regression approach that compared monthly costs of fallers before and after fall.Results: We present unit costs for falls requiring (1) a hospitalization resulting in a live discharge, (2) an emergency department visit not resulting in an admission, and (3) falls requiring office-based or hospital outpatient visits only. Using the case-control design, these costs were $22,260, $3890, and $5040 respectively. Using the case-crossover design, these estimates were reduced to $20,920, $3230, and $4200.Conclusions: On average, estimates of the costs of fall injuries from the case-control design were between 6% and 17% greater than those from the case-crossover approach. These differences likely result from our inability to control for comorbidity differences between fallers and nonfallers in the case-control design. Under several scenarios, including unobserved heterogeneity between cases and controls, the case-crossover design, although computationally more intensive, produces more accurate results. [ABSTRACT FROM AUTHOR]

Scope of the Problem: Fall-related injuries are the leading cause of injury deaths and disabilities among older adults (i.e., persons aged -/=65 years). The most serious fall injury is hip fracture; one half of all older adults hospitalized for hip fracture never regain their former level of function. In 1996, a total of 340,000 hospitalizations for hip fracture occurred among persons aged -/=65 years, and 80% of these admissions occurred among women. From 1988 to 1996, hip fracture hospitalization rates for women aged -/=65 years increased 23%. Etiologic or Risk Factors: Risk factors for falls include increasing age, muscle weakness, functional limitations, environmental hazards, use of psychoactive medications, and a history of falls. Age is also a risk factor for hip fracture. Women aged -/=85 years are nearly eight times more likely than women aged 65-74 years to be hospitalized for hip fracture. White women aged -/=65 years are at higher risk for hip fracture than black women. Other risk factors for hip fracture include lack of physical activity, osteoporosis, low body mass index, and a previous hip fracture. Recommendations for Prevention: Because approximately 95% of hip fractures result from falls, minimizing fall risk is a practical approach to reducing these serious injuries. Research demonstrates that effective fall prevention strategies require a multifaceted approach with both behavioral and environmental components. Important elements include education and skill building to increase knowledge about fall risk factors, exercise to improve strength and balance, home modifications to reduce fall hazards, and medication assessment to minimize side effects (e.g., dizziness and grogginess). Program and Research Needs: Coordination needs to be improved among the diverse Federal, state, and local organizations that conduct fall prevention activities. The effectiveness of existing fall prevention programs among specific groups of women (e.g., those aged -/=85 years or living with functional limitations) needs careful evaluation. New primary fall prevention approaches are needed (e.g., characterizing footwear that promotes stability), as well as secondary prevention strategies (e.g., protective hip pads) that can prevent injuries when falls occur. Finally, efforts are needed to increase collaboration among national experts from various disciplines, to reach consensus regarding priority research areas and program issues, and to work toward long-term strategies for reducing falls and fall-related injuries among older adults. Conclusion: Persons aged -/=65 years constitute the fastest-growing segment of the U.S. population. Without effective intervention strategies, the number of hip fractures will increase as the U.S. population ages. Fall prevention programs have reduced falls and fall-related injuries among high-risk populations using multifaceted approaches that include education, exercise, environmental modifications, and medication review. These programs need to be evaluated among older adults aged -/=65 years who are living independently in the community. In addition, secondary prevention strategies are needed to prevent hip fractures when falls occur. Effective public health strategies need to be implemented to promote behavioral changes, improve current interventions, and develop new fall prevention strategies to reduce future morbidity and mortality associated with hip fractures among older adults. [ABSTRACT FROM AUTHOR]

The article looks at the U.S. Centers for Disease Control and Prevention's statistics on injuries and fatalities from falls among older people. According to the article, falls in older adults can lead to disability, nursing-home admission, increased medical costs, and death. The article discusses the rates of fatal falls, hospitalizations for hip fractures, and nonfatal fall injuries. During the time periods examined it was found that rates of falls resulting in death were highest in men and whites.