Activity and Participation in Vestibulopathy

前庭病的活动和参与

• 批准号: 10596194
• 负责人: Brooke Klatt
• 金额: $ 11.65万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10596194
• 关键词: Address; Adult; Age; Behavioral; Blurred vision; Caring; Case Series; Charities; Chronic; Clinical; Clinical Trials; Clinical Trials Design; Cognition; Cognitive; Complex; Coping Skills; Crowding; Data Analyses; Deterioration; Development Plans; Dizziness; Doctor of Philosophy; Effectiveness of Interventions; Elderly; Environment; Environmental Risk Factor; Epidemiologic Methods; Equilibrium; Equipment and supply inventories; Feedback; Foundations; Fright; Functional disorder; Future; Gait; Impaired cognition; Impairment; Incidence; Individual; Intervention; Intervention Trial; Interview; K-Series Research Career Programs; Measures; Mental Health; Methodology; Moods; Motion; Nausea; Outcome; Patients; Perception; Persons; Population; Positioning Attribute; Predisposing Factor; Protocols documentation; Provider; Quality of life; Recovery; Rehabilitation therapy; Reporting; Research; Research Priority; Science; Scientist; Sensorimotor functions; Series; Structure; Testing; Theoretical model; Training; Translating; United States; Visual; Vulnerable Populations; behavioral clinical trial; career development; cohort; comorbidity; coping; design; disability; effective intervention; efficacy evaluation; efficacy testing; experience; fall risk; gaze; improved; insight; instrument; intervention refinement; longitudinal analysis; medical attention; multidisciplinary; multimodality; novel; physical therapist; rehabilitation science; rehabilitative care; remediation; skills; therapy development

Current vestibular rehabilitation intervenes upon vestibular impairments (balance, gaze stability, and dizziness). Activity and participation are reduced in people with vestibulopathy, but are not addressed in vestibular rehabilitation protocols. Approximately 40% of people with vestibulopathy do not fully recover and transition to a state of chronic disability, which often results from reductions in activity and participation, and. Evidence from rehabilitation science within other populations suggest that return to full activity and participation is related to functional mobility status, and also several behavioral, personal, and environmental factors. Similarly, we suspect that cognitive, mood, and personal (confidence, coping, and fear avoidance) factors that are modifiable, may impact activity and participation in people with vestibulopathy. It is also unknown whether improvements in activity and participation are related to remediation of impairments following vestibular rehabilitation. Activity and participation represent important domains to target to optimize outcomes and reduce chronic disability. This career development award will establish Dr. Brooke Klatt as a clinical scientist with expertise in 3 primary domains: (1) cohort design and analysis; (2) qualitative methodology, and (3) complex rehabilitation intervention development and behavioral clinical trial methodology. Dr. Klatt has assembled a multi-disciplinary team of experts in rehabilitation intervention development and implementation (Jennifer Brach, PhD, PT and Elizabeth Skidmore, PhD, OTR/L), activity and participation assessment and epidemiological methods (Andrea Rosso, PhD, MPH), behavioral impacts on vestibular recovery (Jeffrey Staab, MD), and clinical trial methodology (Megan Hamm, PhD and Charity Patterson, PhD, MSPH). Dr. Klatt will conduct a series of studies to develop an enhanced vestibular intervention that will augment current vestibular rehabilitation targeted to improve activity and participation. She will investigate whether impairments (balance, gait, gaze stability, dizziness, cognition, and mood) as well as personal factors (confidence, coping skills, and fear avoidance) are related to activity and participation in people with vestibulopathy (Aim 1), and she will determine if reductions in vestibular impairment is related to improvements in activity and participation (Aim 2). She will use stakeholder input from clinicians and patients to determine the delivery features that show the greatest promise for improving activity and participation in people with vestibulopathy (Aim 3). Dr. Klatt’s is plan to develop effective interventions to enhance current vestibular rehabilitation addresses the NCMRR research priorities to mitigate acquisition of secondary conditions by using a multimodal approach to promote vestibular plasticity and sensorimotor function. The proposed training will be the foundation for a future R01 application examining the efficacy of the enhanced vestibular intervention to improve activity and participation and the quality of life for individuals with vestibulopathy.

目前的前庭康复针对前庭损伤（平衡、凝视稳定性和 患有前庭病的人的活动和参与度会减少，但在 大约 40% 的前庭病患者没有完全康复 过渡到慢性残疾状态，这通常是由于活动和参与减少造成的，以及。 来自其他人群的康复科学证据表明，恢复充分的活动和参与 与功能移动状态以及一些行为、个人和环境因素有关。 同样，我们怀疑认知、情绪和个人（信心、应对和避免恐惧）因素 是可修改的，可能会影响前庭病患者的活动和参与，目前尚不清楚。 活动和参与的改善与前庭训练后损伤的修复有关 活动和参与是优化结果和减少康复的重要领域。 该职业发展奖将使布鲁克·克拉特博士成为一名临床科学家。 3 个主要领域的专业知识：(1) 队列设计和分析；(2) 定性方法；(3) 复杂性 Klatt 博士制定了康复干预开发和行为临床试验方法。 康复干预开发和实施的多学科专家团队（Jennifer Brach，博士，PT 和 Elizabeth Skidmore，博士，OTR/L），活动和参与评估以及 流行病学方法（Andrea Rosso，博士，公共卫生硕士），行为对前庭恢复的影响（Jeffrey Staab，医学博士）和临床试验方法（Megan Hamm 博士和 Charity Patterson 博士、Klatt 博士）。 将进行一系列研究以开发增强的前庭干预措施，以增强当前的 前庭康复的目标是改善活动和参与。她将调查是否存在障碍。 （平衡、步态、目光稳定性、头晕、认知和情绪）以及个人因素（信心、应对方式） 技能和避免恐惧）与前庭病患者的活动和参与有关（目标 1），并且 她将确定前庭损伤的减少是否与活动和参与的改善有关 （目标 2）。她将利用公众和患者的利益相关者的意见来确定所显示的交付功能。 改善前庭病患者活动和参与的最大希望（目标 3）是 Klatt 博士的。 计划制定有效的干预措施以加强当前的前庭康复，解决 NCMRR 问题 研究重点，通过使用多模式方法促进减轻继发性条件的获得 拟议的训练将成为未来 R01 的基础。 应用检查增强前庭干预改善活动和参与的功效 以及前庭病患者的生活质量。