FUNCTIONAL INDEPENDENCE IN OLDER DISABLED CLAUDICANTS

老年残疾人的功能独立性

• 批准号: 6217043
• 负责人: ANDREW P GOLDBERG
• 金额: $ 13.78万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2001-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6217043
• 关键词: aerobic exercise; arteriosclerosis; behavioral /social science research tag; bioenergetics; body composition; body physical activity; cardiovascular function; claudication; clinical trials; disabling disease; disease /disorder proneness /risk; functional ability; hemodynamics; human old age (65+); human subject; human therapy evaluation; longitudinal human study; medical rehabilitation related tag; muscle function; nutrition education; nutrition of aging; nutrition related tag; oxygen consumption; pain; peripheral blood vessel disorder; physical therapy; quality of life; rehabilitation

Peripheral arterial disease (PAD) is a leading cause of morbidity in older Americans due to disabling claudication leg pain during exercise. Claudication reduces functional independence by placing limitations on performing activities of daily living as well as employment possibilities. Claudication accounts for approximately 17% (4 million) of all Americans who have physical activity limitations (23 million). It is estimated that the 1994 national health care cost will exceed $3.3 billion from surgical procedures alone. We propose that an aggressive risk factor modification (ARFM) program, which includes exercise rehabilitation and dietary modification, will be an effective clinical strategy for the treatment of claudication pain with relatively low expense. The central hypothesis is that an ARFM program will enhance functional independence and quality of life in older claudicants by promoting muscular adaptations which improve peripheral blood flow, exercise capacity, and metabolic function. These beneficial changes will reduce claudication and symptomatology and risk factors for cardiovascular complications. Seventy PAD patients with claudication will be randomly assigned into either a 9-month ARFM program (N=35) or a usual care control group (N=35). The exercise rehabilitation portion of the ARFM program will consist of supervised intermittent walking, performed 3 times per week over 9 months at an initial intensity of 40% of maximum which will increase to 70% by the end of the program. Total time of walking per session will increase from 10 to 50 minutes during the program. The dietary modification portion of the ARFM program will consist of a one-hour weekly class which will educate patients about healthy eating habits based on the National Cholesterol Education Program guidelines. Free-living daily physical activity, claudication pain during treadmill tests, peripheral and central hemodynamic variables, muscle structure and function, and body composition will be assessed before and after the 9-month study. The significance of this clinical trial is that it will demonstrate that older claudicants can improve functional independence and reduce future morbidity by favorably altering cardiovascular disease and metabolic risk factors through an ARFM program.

外围动脉疾病（PAD）是发病率的主要原因 由于锻炼过程中的lau不平腿疼痛而导致的年长美国人。 通过将限制放在 进行日常生活和就业活动 可能性。 claurauration占约17％（400万） 在所有有体育锻炼限制的美国人中（2300万）。 据估计，1994年国家医疗保健成本将超过$ 3.3 仅通过手术程序就获得了十亿。 我们提出了一个积极的 风险因素修改（ARFM）计划，其中包括练习 康复和饮食修改将是有效的临床 治疗clautaination疼痛的策略相对较低 费用。 中心假设是ARFM计划将增强 老年克劳迪克的功能独立性和生活质量 促进肌肉适应，改善外周血流动， 运动能力和代谢功能。 这些有益的改变将 减少claurautic和症状和危险因素 心血管并发症。 七十个pad患者接受laud毛的患者 将随机分配到9个月的ARFM程序（n = 35）或 通常的护理对照组（n = 35）。 锻炼康复部分 ARFM计划的中断将包括有监督的间歇性步行， 在9个月内每周进行3次，最初强度为40％ 到程序结束时最大值将增加到70％。 全部的 每次步行时间将从10分钟增加到50分钟 该程序。 ARFM计划的饮食修改部分将 由每周一小时的课程组成，该课程将教育患者 基于国家胆固醇教育计划的健康饮食习惯 指南。 自由生活的每日体育锻炼，lau痛疼痛 在跑步机测试，外围和中央血液动力学变量中， 肌肉结构和功能以及身体成分将被评估 9个月研究之前和之后。 该临床的意义 试验是，它将证明较老的克劳德人可以改善 功能独立性并通过有利改变来降低未来的发病率 通过ARFM的心血管疾病和代谢危险因素 程序。