CAN EXERCISE TRAINING REVERSE PHYSICAL FRAILTY?

运动训练可以逆转身体虚弱吗？

• 批准号: 6336218
• 负责人: JOHN O. HOLLOSZY
• 金额: $ 13.13万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2002-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6336218
• 关键词: aerobic exercise; balance; behavioral /social science research tag; blood pressure; body composition; body physical activity; bone density; cardiac output; cognition; exercise; frail elderly; functional ability; gait; geriatrics; health care cost /financing; human old age (65+); human subject; human therapy evaluation; medical rehabilitation related tag; muscle proteins; muscle strength; oxygen consumption; physical fitness; physical therapy; protein metabolism; quality of life

DESCRIPTION: (Adapted from applicant's abstract). The major research focus of this OAIC is on the reduction of physical frailty resulting in a decrease in the risk of loss of independence and nursing home admission. The goals of this intervention study, IS-1, are: a) to determine the extent to which frail women and men over the age of 78 years can respond to exercise training with the cardiovascular, skeletal muscle, and central nervous system adaptations that have been shown to occur in younger individuals; and b) if significant adaptations do occur, to assess whether or not the magnitudes of these adaptations are sufficiently large and functionally important to result in improvements in performance of activities of daily living (ADL), instrumental ADL (IADL), advanced ADL (AADL) and in objective physical performance tests that correlate with the ability to perform IADL and AADL and are predictors of loss of independence, nursing home admission, and short- term mortality. The long-term goal is to obtain information that can be used to design practical, individualized programs of exercise that can be utilized in community settings to prevent or reverse physical frailty and maintain functional independence. The exercise training will have three phases consisting of 3 months of physical therapy exercises, 3 months of weight lifting superimposed on physical therapy exercises, and 3 months of aerobic exercise superimposed on physical therapy and weight lifting exercise. The aims of this research are to determine: a) the effectiveness of physical therapy exercises in improving flexibility, gait, balance, coordination, and strength and in reversing frailty; b) whether frail old people can adapt to weight lifting with significant increases in strength of all major muscle groups, whole body and skeletal muscle protein anabolism, and muscle mass, and a further reduction in frailty; c) whether frail old people can adapt to aerobic exercise training with increases in oxygen uptake capacity with a further decrease in frailty, and to evaluate the mechanisms involved in any increase in oxygen uptake capacity by determining maximal cardiac output, left ventricular stroke volume, and peripheral oxygen extraction; d) whether the exercise training decreases arterial stiffness; e) whether exercise training lowers blood pressure in subjects with mild hypertension; f) whether the exercise increases bone mineral density in the proximal femur, spine, and other regions of the skeleton; g) whether the exercise improves cognitive function and central processing speed; and h) whether the exercise improves quality of life. An important component of this research is to determine the extent to which the graduates from the program maintain improvements in functional capacity. Before discharge from the study, participants will be given individualized exercise prescriptions to follow at home and will be helped to put together home gyms or referred to a convenient exercise facility. Contact with the graduates will maintained by means of monthly phone calls and they will be brought back to the exercise facility once per month for a training session and periodic evaluations of functional capacity, using simple measures such as the standardized Physical Performance Test. Cost-effectiveness and cost-utility analysis will be used to evaluate the relative costs and benefits of the exercise.

描述：（改编自申请人的摘要）。主要研究 这种OAIC的重点是减少身体脆弱，导致 失去独立和疗养院的风险降低 入场。这项干预研究的目标是：a） 确定78岁以上脆弱的男女的程度 多年可以通过心血管骨骼来应对运动训练 肌肉和中枢神经系统适应已被证明 发生在年轻人中； b）如果重大改编 发生，评估这些适应的幅度是否 足够大且功能很重要，可以改善 在日常生活活动（ADL）的表现中，乐器ADL （IADL），高级ADL（AADL）和客观的身体性能测试 这与执行IADL和AADL的能力相关，并且 预测失去独立性，疗养院入学和短暂的预测因素 术语死亡率。长期目标是获取可以 用于设计实用的个性化锻炼程序 可以在社区环境中使用以防止或逆转物理 脆弱并保持功能独立性。运动训练将 有三个阶段，包括3个月的物理治疗练习， 在物理治疗练习中叠加3个月的举重， 和3个月的有氧运动叠加在物理疗法上和 举重运动。这项研究的目的是确定： a）物理治疗练习在改善的有效性 灵活性，步态，平衡，协调和力量以及逆转 脆弱； b）脆弱的老年人是否可以适应举重 所有主要肌肉组的强度显着提高，整个身体 和骨骼肌蛋白合成物和肌肉质量，然后进一步 减少脆弱； c）脆弱的老年人是否可以适应有氧运动 锻炼训练，增加氧气吸收能力 脆弱的进一步减少，并评估涉及的机制 通过确定最大心脏的氧气吸收能力的任何增加 输出，左心室中风和外周氧 萃取; d）运动训练是否减少动脉 刚性; e）运动训练是否降低受试者的血压 轻度高血压； f）运动是否增加骨矿物质 骨骼近端股骨，脊柱和其他区域的密度； g）练习是否改善认知功能和中央 处理速度； h）练习是否改善了生活质量。 这项研究的重要组成部分是确定 该计划的毕业生保持功能的改进 容量。在退出研究之前，将给予参与者 个性化的锻炼处方要在家中，将是 帮助他们组建家庭体育馆或提取方便的运动 设施。与毕业生接触将通过 每月电话，他们将被带回练习 每月一次设施进行培训和定期评估 功能能力，使用简单的措施，例如标准化 身体绩效测试。成本效益和成本效益分析 将用于评估相对成本和收益 锻炼。