Frailty, Strength, and Mobility in Older Hernia Patients: A Novel Abdominal Wall Physical Therapy Program
老年疝气患者的虚弱、力量和活动能力:一种新颖的腹壁物理治疗方案
基本信息
- 批准号:10302868
- 负责人:
- 金额:$ 15.75万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-08-15 至 2023-04-30
- 项目状态:已结题
- 来源:
- 关键词:AbdomenAccountingAffectAgeAgingAmerican College of SurgeonsClimactericClinical TrialsDataDecision MakingDoseElderlyEnrollmentExerciseFaceFoundationsFutureGoalsHealthHealthcareHerniaHernia of abdominal cavityHomeImpairmentIndividualInterventionInterviewJoint repairLeadLifeLiteratureMeasuresMedicalMethodologyMethodsMorbidity - disease rateMorphologyOperative Surgical ProceduresOrthopedicsOutcomePatient Outcomes AssessmentsPatient-Centered CarePatientsPerioperativePerioperative complicationPersonsPhysical therapyPlayPopulationPostoperative PainPostoperative PeriodProceduresProcessQuality of lifeRegistriesReportingRiskRoleScientistStructureSurgeonSurgical complicationTestingTimeTissuesUnited Statesabdominal walladverse outcomeagedcareercohortcomorbiditycostdesignexercise programexperiencefrailtyfunctional statushospital readmissionhuman old age (65+)improvedindexingloss of functionmortalitynovelolder patientpatient populationprogramsprospectiverandomized trialrepairedsatisfactionskillssurgery outcometertiary caretool
项目摘要
PROJECT SUMMARY ABSTRACT
The Frailty, Strength, and Mobility in Older Hernia Patients: A Novel Abdominal Wall Physical Therapy
Program study aims to understand the role of frailty to surgical outcomes and postoperative quality of
life (QOL) for older adults undergoing elective abdominal hernia repair (AHR). Additionally, we seek to evaluate
the feasibility and utility of a novel perioperative abdominal wall physical therapy (AWPT) for AHR patients
over 65. Current literature is scarce on the relationship of frailty to long-term postoperative outcomes in older
AHR patients and, crucially, no studies describe peri-operative QOL changes in older hernia patients
despite the fact that it is a key consideration for AHR patients and their surgeons. Because of the
profound influence QOL gains have on the surgical decision making process, and with the rapid aging of the
hernia patient population, we believe that understanding the relationship of frailty to QOL outcomes after
AHR is essential. We will undertake a retrospective review of prospectively collected data from a national
registry of AHR patients to assess the effect of frailty on patient-reported QOL, as well as standard
postoperative outcomes (such as morbidity, mortality, complications, readmissions) for AHR patients over the
age of 65 (Aim 1). We hypothesize that increasing frailty will confer a dose-dependent risk of adverse
outcomes following AHR, as well as an inverse relationship with quality of life gains. We believe these results
may be used in the future to develop surgical decision making tools for older patients considering elective
AHR. Pre-surgical optimization is especially important in older, frail patients who decide to undergo operative
interventions such as AHR. To that end, we propose to pilot test a novel abdominal wall physical therapy
(AWPT) program in a cohort of older patients undergoing elective AHR at a major tertiary
care center (Aim 2). Hernia patients over the age of 65 will be offered enrollment in an AWPT program
consisting of both home exercises and in-person physical therapy. We will utilize validated measures to assess
the effect of AWPT on both strength (Timed Up and Go Test, Sit to Stand Test) and mobility (Life Space
Assessment) in AHR patients before and after surgery. We will also use semi-structured interviews to
explore older AHR patients’ perspectives on the feasibility and utility of AWPT. We believe that at the
completion of this study we will have a better understanding of how frailty affects QOL gains after AHR and,
additionally, will be able to utilize our AWPT pilot data to undertake a larger trial examining the effects of peri-
operative AWPT on outcomes after AHR in an older cohort.
项目概要摘要
老年疝气患者的虚弱、力量和活动能力:一种新型腹壁物理疗法
项目研究旨在了解虚弱对手术结果和术后质量的影响
此外,我们还试图评估接受选择性腹部疝气修复术(AHR)的老年人的生活质量(QOL)。
针对 AHR 患者的新型围手术期腹壁物理治疗 (AWPT) 的可行性和实用性
65 岁以上。目前关于老年人衰弱与长期术后结果关系的文献很少
AHR 患者,最重要的是,没有研究描述老年疝气患者围手术期生活质量的变化
尽管事实上这是 AHR 患者及其外科医生的一个关键考虑因素。
生活质量的提高对手术决策过程产生广泛的影响,并且随着年龄的快速老龄化
对于疝气患者群体,我们认为了解虚弱与生活质量结果的关系
AHR 至关重要。我们将对从国家收集的前瞻性数据进行回顾性审查。
AHR 患者登记,以评估虚弱对患者报告的 QOL 的影响以及标准
AHR 患者术后结果(如发病率、死亡率、并发症、再入院)
65 岁(目标 1)。我们认为,日益虚弱会带来剂量依赖性的不良风险。
我们相信这些结果与 AHR 后的结果以及与生活质量的提高呈反比关系。
未来可能会用于为考虑择期手术的老年患者开发手术决策工具
AHR 术前优化对于决定接受手术的年长体弱患者尤其重要。
为此,我们建议试点测试一种新型腹壁物理疗法。
(AWPT) 计划,针对在主要三级医院接受选择性 AHR 的老年患者队列
护理中心(目标 2)将向 65 岁以上的疝气患者提供参加 AWPT 计划的机会。
包括家庭锻炼和亲自物理治疗,我们将利用经过验证的措施来评估。
AWPT 对力量(计时起立测试、坐立测试)和活动能力(Life Space
我们还将使用半结构化访谈来对 AHR 患者进行手术前后的评估。
探讨老年 AHR 患者对 AWPT 的可行性和实用性的看法。
完成这项研究后,我们将更好地了解虚弱如何影响 AHR 后的 QOL 收益,并且,
此外,将能够利用我们的 AWPT 试点数据进行更大规模的试验,检查周围环境的影响
手术 AWPT 对老年队列 AHR 后结果的影响。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Courtney Collins其他文献
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{{ truncateString('Courtney Collins', 18)}}的其他基金
Frailty, Strength, and Mobility in Older Hernia Patients: A Novel Abdominal Wall Physical Therapy Program
老年疝气患者的虚弱、力量和活动能力:一种新颖的腹壁物理治疗方案
- 批准号:
10466916 - 财政年份:2021
- 资助金额:
$ 15.75万 - 项目类别:
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