Maintaining Resistance Training in Older Prediabetic Adults: Theoretical Approach

老年糖尿病前期患者维持阻力训练：理论方法

• 批准号: 7729633
• 负责人: BRENDA M DAVY
• 金额: $ 70.87万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7729633
• 关键词: Activities of Daily Living; Adherence; Adult; Aerobic; Affect; Age; Aging; Area; Behavior Therapy; Behavioral; Beta Cell; Body Weight decreased; C-Peptide; Cells; Clinical Trials; Communities; Data; Diabetes prevention; Disease; Elderly; Exercise; Exhibits; Family; Fatty acid glycerol esters; Generic Drugs; Glucose; Glycogen (Starch) Synthase; Health; Health Benefit; Healthy People 2010; Homeostasis; Impaired fasting glycaemia; Individual; Informal Social Control; Insulin; Intervention; Investments; Life Style; Maintenance; Measures; Mediating; Metabolic; Modality; Modeling; Modification; Muscle; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Oral; Outcome; Outcome Measure; Phase; Phase II Clinical Trials; Physical activity; Population; Prediabetes syndrome; Prevalence; Prevention Research; Prevention strategy; Property; Protocols documentation; Public Health; Randomized; Reporting; Research; Resistance; Risk; Self Efficacy; Specificity; Supervision; Time; Training; Woman; Work; base; blood glucose regulation; density; disability; disorder prevention; fasting glucose; fitness; glucose tolerance; impaired glucose tolerance; improved; inclusion criteria; indexing; insulin sensitivity; meetings; men; primary outcome; programs; public health relevance; sarcopenia; skills; social cognitive theory; strength training; theories

DESCRIPTION (provided by applicant): The aim of this Phase II Clinical Trial is to demonstrate the efficacy of social cognitive theory (SCT) based intervention for initiating, and most importantly, maintaining resistance training in older adults with pre-diabetes (i.e., impaired glucose tolerance or impaired fasting glucose) to improve glucose homeostatis. The overall aim is consistent with NIDDK's Behavioral/Prevetion Research Program's forcus on individual, family, and community-based strategies for prevention of diabetes and its complications. Resistance training is particularly applicable to older, prediabeteic adults given the loss of lean body mass and worsening of glucose tolerance with aging. The proposed research program evaluates a 15-month SCT based intervention for maintenance of resistance training with older adults. Men and women 50-69 (N=220) with pre-diabetes, defined as exhibiting either impaired glucose tolerance (IGT; 2-h glucose 140-199 mg/dl) or impaired fasting glucose (IFG; 100-125 mg/dl), will first follow the same standard, supervised 3-month initiation period with resistance training. All people completing the Initial Phase will be randomly assigned to 1 of 3 maintenance conditions: 1. a long-term SCT based, ASPIRE intervention, emphasizing self-regulation and other SCT strategies to optimize training, with faded contact; 2. a long-term Generic intervention lacking a number of SCT components but with the same faded contact, or, 3. a Standard intervention with more minimal contact. The primary outcome measures are indices of pre-diabetes (glucose tolerance and fasting glucose concentration) and strength. Secondary measures include adherence; ss-cell responsivity, insulin sensitivity, and disposition index, as determined by the oral glucose and C-peptide minimal model; fat free mass, other indicators of health and metabolic fitness, and SCT measures. Assessments will occur at baseline, at the end of the Initiation Phase (3 months), at the end of the different interventions (9 months) and 6 months after all contact has ended (15 months from baseline). It is hypothesized that SCT based resistance training with faded contact will produce better outcomes than Generic based training with faded contact, which in turn, will produce better outcomes than Standard-based resistance training at 9 month and 15 month assessments. It also is hypothesized that improvements in glucose homeostasis and in strength from resistance training will be mediated by adherence, self-efficacy, and use of self-regulation strategies. Resistance training has become an important component in the treatment and prevention of diseases and disabilites, and especially so for Type 2 diabetes. Critical to public health and a focus of NIDDK are theory-based interventions that enable, effective long-term resistance training with minimal supervision after an initiation phase and where improvements in adherence and outcomes are facilitated by theoretical constructs. PUBLIC HEALTH RELEVANCE: Pre-diabetes is present is more than half of adults aged 60-74 years. Resistance (strength) training appears to be another modality besides weight loss and physical activity that is effective for pre-diabetes prevention. Even though these health benefits can be accrued from a limited time investment, only 10-15 percent of people over 55 report performing any strengthening activities. Prior work suggests that resistance training (RT) can be effectively initiated in well-supervised settings, however there are very few theory-based studies showing effective maintenance of RT in minimally supervised settings. In the absence of such theoretically based efficacy studies on long-term maintenance, it is likely that although people such as those with pre-diabetes will initiate RT, a high percentage will soon discontinue RT. Therefore, we propose to demonstrate the efficacy of a social cognitive theory-based intervention for initiating and maintaining RT in older adults with pre-diabetes to improve glucose homeostasis.

描述（由申请人提供）：这项II期临床试验的目的是证明基于社会认知理论（SCT）的干预措施的有效性，以及最重要的是，在患有糖尿病前的老年人中维持耐药性耐受性培训（即，葡萄糖耐受性或损害的禁食性gllucsed glucsed gluc）以提高糖含量的速度。总体目的与NIDDK的行为/预科研究计划的促进有关的个人，家庭和社区预防糖尿病及其并发症的策略是一致的。鉴于瘦体重的损失以及随着衰老的衰老而导致葡萄糖耐受性恶化，耐药训练尤其适用于年龄较大的前糖前成年人。拟议的研究计划评估了15个月的基于SCT的干预措施，以维持老年人的抵抗训练。男性和女性50-69（n = 220）具有前糖尿病前，定义为表现出受损的葡萄糖耐受性（IGT； 2-H葡萄糖140-199 mg/dl），或者禁食性葡萄糖（IFG; IFG; 100-125 mg/dl）首先遵循相同的标准，具有相同标准的监督3个月训练。所有完成初始阶段的人将被随机分配到3个维护条件中的1个：1。基于SCT的长期，ASPIRE干预，强调自我调节和其他SCT策略，以优化培训，并通过褪色的接触； 2。长期的通用干预措施缺乏许多SCT组件，但接触相同，或3。一种标准干预措施，具有更少的接触。主要结果度量是糖尿病前的指数（葡萄糖耐受性和空腹葡萄糖浓度）和强度。次要措施包括依从性；由口服葡萄糖和C肽最小模型确定的SS细胞反应性，胰岛素敏感性和处置指数；无脂肪质量，健康和代谢健身的其他指标以及SCT措施。评估将在启动阶段结束时（3个月），不同干预措施（9个月）和所有接触结束后6个月结束时进行评估（距基线15个月）。假设基于SCT的阻力训练与淡入淡出的接触将产生更好的结果，而基于褪色的接触的仿制药培训将比在9个月和15个月评估时产生比标准的阻力训练更好的结果。还可以假设，葡萄糖稳态和抵抗训练的力量的改善将由依从性，自我效能感和自我调节策略的使用来介导。耐药训练已成为治疗和预防疾病和不稳定物的重要组成部分，尤其是对于2型糖尿病。对公共卫生的关键和NIDDK的重点是基于理论的干预措施，这些干预措施能够在开始阶段后最少的有效的长期抵抗训练，并通过理论结构来促进依从性和结果的改善。公共卫生相关性：糖尿病前是60-74岁的成年人中有一半以上。耐药性（力量）训练似乎是另一种方式，除了体重减轻和体育锻炼，这对于预防前糖尿病是有效的。即使这些健康福利可以从有限的时间投资中产生，但只有55多名报告的人中只有10-15％的人进行任何加强活动。先前的工作表明，可以在精心审查的环境中有效地启动抵抗训练（RT），但是基于理论的研究很少显示在微型监督环境中对RT的有效维护。在没有关于长期维护的理论上基于这种基于理论上的疗效研究的情况下，尽管糖尿病前的人会启动RT，但很快就会暂停RT。因此，我们建议证明基于社会认知理论的干预措施在患有糖尿病前的老年人中启动和维持RT以改善葡萄糖稳态的功效。