Task Specific Exercise for the Clinically Disabled

临床残疾人的特定任务练习

基本信息

批准号：
7927011
负责人：
Todd Manini
金额：
$ 14.87万
依托单位：
UNIVERSITY OF FLORIDA
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：
2009-09-15 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7927011
关键词：
Adult Aerobic Aerobic Exercise Affect Aging Automobile Driving Data Development Devices Disabled Persons Distal Educational Intervention Elderly Elements Energy Metabolism Exercise Financial compensation Future Gait Goals Incidence Individual Intervention Knowledge Lead Life Light Masks Measures Mediating Modeling Modification Movement Muscle Neuromechanics Outcome Pathway interactions Patients Performance Phase Physiological Physiological Adaptation Process Property Protocols documentation Psychological Factors Public Health Randomized Randomized Controlled Trials Regimen Research Research Personnel Resistance Scientist Self Efficacy Signal Transduction Speed Staging System Task Performances Testing Training Training Programs Work aged base combat design disability executive function improved insight lens muscle strength neuroregulation non-invasive monitor novel pre-clinical prevent programs psychologic public health relevance response

项目摘要

DESCRIPTION (provided by applicant): Pre-clinical disability is an early warning system in the disablement process as it is characterized by selecting to perform everyday tasks less often and compensating for those tasks still being performed. This phase serves as an ideal target for preventative strategies because treatments can be designed for individuals on the verge of disability thus interrupting the occurrence of outright disability. One such strategy that optimizes the transfer of adaptations to real-life situations is task-specific exercise (TSE). This type of intervention holds promise to determine how pre-clinically disabled older adults might interrupt the disablement process and instead begin an enablement process and thus lead us to better interventions to treat and prevent disability from occurring. However, because of the complexity of the disablement process, it has been extremely challenging to objectively identify outcomes that represent changes in selection, optimization, and compensation of tasks (the SOC domains). The objective of the current application is first, to ask what are the short and long-term responses of TSE in the pre-clinically disabled older adults (aged 60+ years) using a single-masked randomized controlled design. Second we seek to refine and validate our outcomes using non-invasive monitoring of SOC domains with the Intelligent Device for Energy Expenditure and Activity (IDEEA). Thirdly, we will shed exciting new light on whether TSE alters neuromechanical and psychological factors. We want to know this, in part, from a mechanistic perspective to gain insight into the processes by which TSE improves disablement outcomes. Also, this will help us to better understand how to enhance the TSE intervention to treat pre-clinically disabled patients. Thus, we offer two hypotheses: Hypothesis #1: TSE increases selection and optimization of everyday tasks, while reducing compensation to achieve task performance. Hypothesis #2: TSE mediates changes in SOC domains through both neuromechanical (decrease variability of movement and increase muscle work capacity) and psychological (increased confidence to perform tasks and increased executive function) properties. These data are expected to guide us in designing a randomized controlled trial that will test whether TSE in the pre-clinically disabled can reduce future incidence of outright disability. PUBLIC HEALTH RELEVANCE: The proposed project will develop a trajectory of research that will identify individuals on the version of physical disability and intervene with exercises specifically designed to improve everyday task performance. This research is highly relevant to the public health as it will build evidence for extending the capacity to live independently.

描述（由申请人提供）：临床前残疾是残疾过程中的预警系统，因为它的特征是选择较少执行日常任务并补偿仍在执行的那些任务。该阶段是预防策略的理想目标，因为可以为残疾边缘的个体设计治疗，从而中断了彻底的残疾发生。优化适应现实情况转移的一种策略是特定于任务的练习（TSE）。这种干预措施有望确定前链临界残疾人可能会中断残障过程，而是开始一个启示过程，从而使我们做出更好的干预措施，以治疗和防止残疾发生。但是，由于残疾过程的复杂性，客观地识别代表任务变化，优化和补偿（SOC域）的结果的结果非常具有挑战性。当前应用的目的是首先询问TSE在临时残疾的老年人（60岁以上）使用单掩护的随机控制设计中的短期和长期反应。其次，我们寻求使用对能源消耗和活动的智能设备（IDEEA）对SOC域的非侵入性监测来完善和验证结果。第三，我们将对TSE是否改变神经力学和心理因素的新启发。我们希望从机械的角度部分地知道这一点，以深入了解TSE改善残疾结果的过程。此外，这将有助于我们更好地了解如何增强TSE干预措施以治疗前链接残疾患者。因此，我们提供了两个假设：假设1：TSE增加了日常任务的选择和优化，同时减少补偿以实现任务绩效。假设2：TSE通过神经力学（减少运动的变异性和增加肌肉工作能力）和心理（提高执行任务的信心和提高执行功能）的特性来介导SOC结构域的变化。预计这些数据将指导我们设计一项随机对照试验，该试验将测试在链式链接前残疾中是否可以减少彻底的残疾发生率。公共卫生相关性：拟议的项目将开发研究的轨迹，该研究将确定个人在身体残疾的版本上，并干预专门为改善日常任务绩效而设计的练习。这项研究与公共卫生高度相关，因为它将为扩大独立生活的能力提供证据。