Safe & Effective Yoga Prescription for Older Adults: Biomechanical Considerations

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• 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
• 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; 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

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娱乐与公园协会都建议瑜伽作为老年人的全面练习形式，能够提供心血管健身，对肌肉力量和骨骼健康的抵抗力训练，以及灵活的运动范围和运动范围的灵活性，尽管这些范围的运动范围很少，但在这些范围内的范围很难理解，这些方法是在这些方面的综合要求，这些方法是在物理方面的不足程度的，多种功能性的，各种各样的功能，各种各样的物理学，以及各种各样的功能，并且是各种各样的方法，并且具有多种功能性，并且是多种多样的，并且具有多种功能性的能力，并且是多种功能性的，并且是多种功能性的，并且是多种功能性的，并且是多种功能性的。疗效和瑜伽的总体安全性。我们的临床试验经验表明，如果没有适当的基于经验的处方，瑜伽的参与可能对长者无效甚至是有害的。因此，该应用提出了一项干预开发研究（IDS），该研究将使用生物力学研究（高速相机，力平台和肌肉骨骼建模）来量化老年人对瑜伽表现的身体需求。此外，IDS将使用身体绩效测试，肌肉绩效测试，灵活性和平衡评估以及自我报告/来量化为期32周的门诊老年人的瑜伽计划的功效和安全性。瑜伽计划分为入门和高级阶段/每个持续16周。参与者（n = 24; 65-90岁）将从瑜伽教练那里学习相关的瑜伽姿势（asanas），并具有与老年人合作的专业知识。为了量化程序的剂量（物理需求），参与者将在每个阶段的开始和终止时执行体式，以进行生物力学分析。随访的身体绩效，平衡和生活质量，将在每个阶段结束时进行评估，以确定程序的功效。结果指标将包括与瑜伽相关的物理需求的生物力学指数（关节运动范围，反作用力和力矩），肌肉和功能性能的度量（楼梯攀爬，椅子支架，步态，步态，力量，静态和动态平衡），依从性和安全性。与基于非证据的瑜伽程序相比，来自ID的数据将用于开发基于证据的瑜伽处方，我们认为这将与较少的肌肉骨骼副作用相关。我们还假设，基于证据的老年人瑜伽裁缝将提高依从性和功效。从该ID开发的程序将在扩展的，第二阶段的随机对照试验中进行测试。公共卫生相关性。目前，建议瑜伽恢复和保留老年人的力量，灵活性，平衡和身体能力；但是，我们的临床试验经验表明，如果没有适当的基于基于证据的处方，瑜伽的参与可能对老年人无效甚至有害。为了解决这种缺乏循证知识，提议的ID将：1）量化专为独立门诊老年人设计的32 WK瑜伽计划的身体需求； 2）表征这些需求与参与者身体特征之间的关系； 3）检查该计划的依从性，功效和安全性； 4）表征所报告的不良事件，基线参与者特征和瑜伽身体需求之间的关系。