CHILD MOBILITY: ROLE OF STRENGTH, BODY FAT & ENERGY COST

儿童活动能力：力量、身体脂肪的作用

• 批准号: 2674134
• 负责人: Craig M. McDonald
• 金额: $ 13.24万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-08-01 至 2001-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2674134
• 关键词: adipose tissue; adolescence (12-20); assistive device /technology; basal metabolism; bioenergetics; body physical activity; clinical research; human subject; middle childhood (6-11); muscle strength; person with disability; young adult human (21-34)

Strength is the most important determinant of mobility status among children with motor impairments. Obesity, a common problem among disabled children, is a second important factor negatively influencing mobility status in disabled children. this study focuses on strength and body fat as determinants of energy cost of ambulation and wheelchair locomotion in children with variable degrees of mobility impairment due to myelomeningocele (MM), spinal cord injury (SCI), cerebral palsy (CP), and Duchenne Muscular dystrophy (DMD). Specifically, the primary aims of the proposal will address two hypotheses: 1) excess body fat increases the energy cost of ambulation and wheelchair locomotion over and beyond the increased costs associated with lean tissue deficits and weakness, and 2) higher energy cost of locomotion is associated with reductions in daily total energy expenditure (TEE) and physical activity; reduced physical activity will be associated with increased adiposity. The study population consists of 375 male and female children ages 6 to 20: 90 MM, 45 SCI, 120 CP, 30 DMD, and 90 controls. Measurements include: 1) anthropometrics, 2) whole body and regional body composition by dual-energy x-ray absorptiometry (DXA), 3) quantitative isometric and isokinetic strength at the elbow and knee, 4) resting metabolic rate (RMR) by indirect calorimetry, 5) energy cost of ambulation and/or wheelchair locomotion (ml O2/Kg meter and Kcal/Kg meter) via a portable telemetric metabolic, measurement system, and 6) TEE and physical activity index (TEE/RMR ratio) by continuous three day heart rate (HR) monitoring. The energy cost of locomotion will be accessed at baseline and with added weight via a pelvic belt equivalent to a 10% increase in % body fat and a 20% increase in % body fat. We will determine the relative importance of weakness and decreased ratio of lean tissue to total body mass in producing increased energy cost of locomotion, reduced physical activity (as evidenced by the TEE:RMR ratio) and a risk of increased adiposity for disabled children. Objective measures of both energy economy of locomotion and physical activity are functionally relevant outcomes. Establishment of a relationship of both impaired strength and increased adiposity to increased energy cost, and hence, reduced physical activity, will provide a basis for varied interventions to improve functional mobility. Outcome studies assessing interventions directed at improving the energy efficiency of locomotion will need to also consider body composition changes over time if there are indeed significant incremental energy costs during locomotion associated with increased adiposity.

力量是机动性状况最重要的决定因素 在有运动障碍的儿童中。 肥胖，一个常见的问题 在残疾儿童中，是第二个重要因素负面因素 影响残疾儿童的流动状况。 这项研究 专注于力量和体内脂肪作为能源成本的决定因素 有变化的儿童的行动和轮椅运动 由于脊髓脑膜膨出（MM）引起的活动障碍程度， 脊髓损伤（SCI），脑瘫（CP）和Duchenne 肌肉营养不良（DMD）。 具体而言， 提案将解决两个假设：1）多余的身体脂肪 增加行动和轮椅运动的能源成本 超越与瘦组织相关的成本增加 缺陷和弱点，以及2）移动的能源成本更高 与减少每日总能量消耗有关 （TEE）和体育锻炼；体育锻炼的减少将是 与肥胖的增加有关。 研究人群 由375名6至20：90毫米，45岁的男女儿童组成 SCI，120 CP，30 DMD和90个对照。 测量包括：1） 人类测量法，2）全身和区域身体组成 双能X射线吸收法（DXA），3）定量等距 肘部和膝盖处的同动力力量，4）休息 间接量热法的代谢率（RMR），5）能源成本的 行动和/或轮椅运动（ML O2/kg仪表和/或 kcal/kg仪表）通过便携式远程代谢，测量 系统，以及6）TEE和体育锻炼指数（TEE/RMR比） 通过连续三天的心率（HR）监测。 能量 运动的成本将在基线时访问并增加 通过骨盆带的重量等效于百分比增加10％ 脂肪脂肪％脂肪％增加20％。 我们将确定 弱点的相对重要性和瘦之比的降低 组织到总体重，从而产生增加的能源成本 运动，减少体育锻炼（如 TEE：RMR比），残疾人的肥胖增加风险 孩子们。 两种能源经济的客观衡量 运动和体育锻炼在功能上相关 结果。建立两者的关系 力量和增加能源成本增加的肥胖，以及 因此，减少体育锻炼将为多样化提供基础 提高功能流动性的干预措施。 结果研究 评估旨在改善能源的干预措施 运动效率也需要考虑身体 如果确实有重大 与机动相关的运动期间的增量能源成本 肥胖增加。