Safe & Effective Yoga Prescription for Older Adults: Biomechanical Considerations

安全的

基本信息

批准号：
7881380
负责人：
GAIL A GREENDALE
金额：
$ 67.41万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-01 至 2011-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7881380
关键词：
Activities of Daily Living Address Adherence Adverse effects Adverse event Age-Years Arthralgia Arthritis Articular Range of Motion Biomechanics Cardiovascular system Characteristics Clinical Trials Communities Data Degenerative polyarthritis Diabetes Mellitus Eating Elderly Emotional Equilibrium Exercise Functional disorder Gait Hyperkyphosis Individual Injury Institutes Intervention Investigation Joints Kidney Diseases Knee Knowledge Lateral Learning Length Longevity Lower Extremity Measures Mechanics Medial Modeling Modification Muscle Musculoskeletal Musculoskeletal Diseases Neurologic Outcome Measure Pain Participant Patient Self-Report Performance Phase Physical Capacity Physical activity Physiological Posture Prevalence Publications Publishing Quality of life Quality-of-Life Assessment Randomized Randomized Controlled Trials Reaction Recording of previous events Recreation Relaxation Reporting Risk Safety Solutions Speed Spinal Canal Sprains and Strains Stenosis Structure Students System Techniques Testing United States Dept. of Health and Human Services Upper Extremity Walking Work Yoga aged bone health collateral ligament design dosage evidence base experience fitness flexibility follow-up improved improved functioning indexing instructor instrument joint loading muscle strength performance tests physical conditioning programs psychologic psychosocial public health relevance quadriceps muscle response social strength training therapy design therapy development web site young adult

项目摘要

DESCRIPTION (provided by applicant): The U.S. Department of Health & Human Services and the National Recreation & Park Association both recommend Yoga as a form of total-solution exercise for older adults, capable of providing cardiovascular fitness, resistance training for muscle strength & bone health, and flexibility for functional range of motion as well as relaxation... Despite these dramatic claims of improved function across a variety of physiological & psychological systems/little is understood regarding the physical demands, program efficacy, and overall safety of Yoga for older adults. Our clinical trial experiences suggest that without proper evidenced-based prescription, Yoga participation can be ineffective or even injurious for elders. Thus, this application proposes an intervention development study (IDS) that will use biomechanical investigation (high-speed cameras, force platforms and musculoskeletal modeling) to quantify the physical demands of Yoga performance by older adults. In addition, the IDS will use physical-performance testing, muscle-performance testing, flexibility & balance assessments, and self-reports/to quantify the efficacy and safety of a 32-week Yoga program for ambulatory seniors. The Yoga program is divided into introductory and advanced phases/each lasting 16 weeks. The participants (N=24; 65-90 years of age) will learn the associated Yoga poses (asanas) from Yoga instructors with expertise working with seniors. In order to quantify the dosage (physical demands) of the program, the participants will perform the asanas at the beginning and termination of each phase/while instrumented for biomechanical analysis. Follow-up physical performance, balance, and quality of life, assessments will be conducted at the end of each phase in order to determine the efficacy of the program. Outcome measures will include biomechanical indices of the physical demands associated with Yoga (joint range-of-motion, reaction forces, & moments), measures of muscular & functional performance (stair climb, chair stand, gait, strength, static & dynamic balance), adherence, and safety. Data from the IDS will be used to develop evidenced-based Yoga prescriptions, which we postulate will be associated with fewer musculoskeletal side effects compared to non-evidence based Yoga programs. We also postulate that evidenced-based tailoring of Yoga for seniors will enhance adherence and efficacy. The programs developed from this IDS will be tested in an expanded, Phase II, Randomized Controlled Trial. PUBLIC HEALTH RELEVANCE. Yoga is currently being recommended to restore and preserve strength, flexibility, balance, & physical capacity in older adults; however, our clinical trial experiences suggest that without proper evidenced-based prescription, Yoga participation can be ineffective or even injurious for seniors. To address this lack of evidence-based knowledge, the proposed IDS will: 1) quantify the physical demands of a 32-wk Yoga program designed for independent ambulatory seniors; 2) characterize the relations between these demands and participant physical characteristics; 3) examine the adherence, efficacy, & safety of the program; and 4) characterize the relations among reported adverse events, baseline participant characteristics, and Yoga physical demands.

描述（由申请人提供）：美国卫生与公共服务部和国家休闲与公园协会均推荐瑜伽作为老年人的一种全面解决方案运动，能够提供心血管健康、肌肉力量和骨骼的阻力训练健康、功能性运动范围的灵活性以及放松...尽管这些声称可以改善各种生理和心理系统的功能，但人们对老年人瑜伽的身体需求、计划功效和整体安全性知之甚少成年人。我们的临床试验经验表明，如果没有适当的循证处方，参与瑜伽可能对老年人无效，甚至有害。因此，本申请提出了一项干预发展研究（IDS），该研究将使用生物力学研究（高速摄像机、力平台和肌肉骨骼模型）来量化老年人瑜伽表现的身体需求。此外，IDS 将使用身体性能测试、肌肉性能测试、灵活性和平衡评估以及自我报告来量化针对流动老年人的 32 周瑜伽计划的功效和安全性。瑜伽课程分为入门阶段和高级阶段/每个阶段持续 16 周。参与者（N=24；65-90 岁）将从具有与老年人合作的专业知识的瑜伽教练那里学习相关的瑜伽姿势（体式）。为了量化计划的剂量（身体需求），参与者将在每个阶段开始和结束时/同时进行生物力学分析时执行体式。每个阶段结束时将进行后续身体表现、平衡和生活质量评估，以确定该计划的效果。结果测量将包括与瑜伽相关的身体需求的生物力学指数（关节运动范围、反作用力和力矩）、肌肉和功能表现的测量（爬楼梯、椅子站立、步态、力量、静态和动态平衡）、依从性和安全性。 IDS 的数据将用于开发基于证据的瑜伽处方，我们假设与非基于证据的瑜伽项目相比，该处方将与更少的肌肉骨骼副作用相关。我们还假设，基于证据的针对老年人的瑜伽定制将提高依从性和功效。根据该 IDS 开发的程序将在扩大的第二阶段随机对照试验中进行测试。公共卫生相关性。目前建议通过瑜伽来恢复和保持老年人的力量、灵活性、平衡和身体能力；然而，我们的临床试验经验表明，如果没有适当的循证处方，参与瑜伽可能对老年人无效，甚至有害。为了解决缺乏循证知识的问题，拟议的 IDS 将： 1) 量化专为独立行走老年人设计的 32 周瑜伽课程的身体需求； 2）描述这些需求与参与者身体特征之间的关系； 3) 检查计划的依从性、有效性和安全性； 4) 描述报告的不良事件、基线参与者特征和瑜伽身体需求之间的关系。