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早期预警系统，其特点是选择较少执行日常任务并补偿仍在执行的那些任务。这一阶段是预防策略的理想目标，因为可以为处于残疾边缘的个人设计治疗方法，从而阻止彻底残疾的发生。优化适应现实生活情况的转移的策略之一是特定任务练习（TSE）。这种类型的干预有望确定临床前残疾老年人如何中断残疾过程，转而开始启用过程，从而引导我们采取更好的干预措施来治疗和预防残疾的发生。然而，由于禁用过程的复杂性，客观地识别代表任务（SOC 域）选择、优化和补偿变化的结果非常具有挑战性。当前应用的目的首先是，使用单盲随机对照设计来询问 TSE 对临床前残疾老年人（60 岁以上）的短期和长期反应是什么。其次，我们寻求通过能源消耗和活动智能设备 (IDEEA) 对 SOC 域进行非侵入式监控来完善和验证我们的结果。第三，我们将揭示 TSE 是否改变神经机械和心理因素的令人兴奋的新线索。我们想从部分机制的角度了解这一点，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加强 TSE 干预来治疗临床前残疾患者。因此，我们提出两个假设：假设#1：TSE 增加日常任务的选择和优化，同时减少实现任务绩效的报酬。假设#2：TSE 通过神经机械（减少运动的变异性并增加肌肉工作能力）和心理（增加执行任务的信心和增强执行功能）特性来介导 SOC 领域的变化。这些数据预计将指导我们设计一项随机对照试验，该试验将测试临床前残疾患者的 TSE 是否可以减少未来彻底残疾的发生率。公共健康相关性：拟议项目将制定一个研究轨迹，识别个人的身体残疾情况，并进行专门旨在提高日常任务表现的锻炼干预。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。