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.

外周动脉疾病（PAD）是导致以下人群发病的主要原因 美国老年人因运动时腿部疼痛而致残跛行。 跛行通过限制功能来降低功能独立性 进行日常生活和就业活动 可能性。 跛行约占 17%（400 万） 身体活动受限的所有美国人（2300 万）。 估计1994年全国医疗费用将超过3.3美元 仅外科手术就产生了数十亿美元。 我们建议积极进取 风险因素修正（ARFM）计划，其中包括锻炼 康复和饮食调整将是有效的临床 治疗跛行疼痛的策略相对较低 费用。 中心假设是 ARFM 计划将增强 老年跛行者的功能独立性和生活质量 促进肌肉适应，改善外周血流量， 运动能力、代谢功能。 这些有益的改变将 减少跛行、症状和危险因素 心血管并发症。 70 名跛行 PAD 患者 将被随机分配到为期 9 个月的 ARFM 计划 (N=35) 或 常规护理对照组（N=35）。 运动康复部分 ARFM 计划的一部分将包括监督间歇性步行， 9 个月内每周进行 3 次，初始强度为 40% 到项目结束时最高将增加到 70%。 全部的 每次训练期间步行时间将从 10 分钟增加到 50 分钟 程序。 ARFM 计划的饮食调整部分将 包括每周一小时的课程，向患者介绍 基于国家胆固醇教育计划的健康饮食习惯 指导方针。 自由生活的日常体力活动，跛行疼痛 在跑步机测试期间，外周和中心血流动力学变量， 将评估肌肉结构和功能以及身体成分 9个月的研究之前和之后。 本研究的临床意义 试验表明，老年跛行者可以改善 功能独立并通过有利地改变来减少未来的发病率 通过 ARFM 评估心血管疾病和代谢危险因素 程序。