Low Magnitude Mechanical Stimulation to Increase Muscle Strength in Frail Adults

低强度机械刺激可增强体弱成人的肌肉力量

基本信息

批准号：
8300598
负责人：
Thuy-Tien Le Dam
金额：
$ 16.08万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-05-01 至 2016-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8300598
关键词：
Address Adipose tissue Adult Affect Aging Area Assisted Living Facilities Atrophic Biological Markers Body Composition Body fat Cessation of life Clinical Clinical Research Clinical Trials Clinical Trials Design Collaborations Commit Communities Complement Controlled Clinical Trials Data Development Devices Double-Blind Method Elderly Epidemiology Event Exercise Fatty acid glycerol esters Feasibility Studies Figs - dietary Fracture Frail Elderly Frail Older Adults Funding Gait Gender Geriatrics Goals Housing Image Infiltration Institutes Intervention Isometric Exercise Joints K-Series Research Career Programs Knee Laboratories Lead Learning Longitudinal Studies Lower Extremity Magnetic Resonance Imaging Measures Mechanical Stimulation Mechanics Mediator of activation protein Mentors Mentorship Methodology Muscle Muscle Fibers Muscle Weakness Muscle function Outcome Performance Peripheral Physiology Prevention Public Health Randomized Recruitment Activity Research Design Research Personnel Resources Risk Serious Adverse Event Skeletal Muscle Speed Syndrome Torque Training United States National Institutes of Health Universities Woman Work X-Ray Computed Tomography adverse outcome age related aged cohort combat disability economic impact experience falls frailty grasp high risk human old age (65+)improved men mortality multidisciplinary muscle form muscle strength novel open label osteoporosis with pathological fracture patient oriented population based prevent programs prospective sarcopenia skills social strength training treatment duration treatment strategy vibration

项目摘要

DESCRIPTION (provided by applicant): Sarcopenia, the age-related loss of skeletal muscle mass, contributes to impaired mobility, frailty and disability. However, there is a mismatch between the loss in muscle mass and loss in muscle strength, suggesting that muscle quality is impaired with aging. Infiltration of fat into skeletal muscle (myosteatosis) affects muscle quality and may be related to impaired mobility and disability. Muscle quantity and muscle quality are potentially early modifiable factors in the development of frailty. The goal of this proposal is to examine whether infiltration of fat into skeletal muscle, assessed by peripheral quantitative computed tomography, independently and interactively predicts decline in muscle strength, physical performance, frailty, disability and death in a prospective cohort of 1,172 community dwelling men aged 65 years and older. Furthermore, we hypothesize that interventions that improve both muscle mass and quality will prevent weakness and disability. Thus, our second aim is to study whether a low-impact, nonpharmacologic device providing low magnitude mechanical stimulation to the whole body improves muscle strength in low functioning adults. This proposal will also explore whether low magnitude mechanical increases muscle mass and decrease intermuscular fat. Subjects will be recruited from local assisted living communities, which provide congregate housing and social events for many older adults. We hypothesize that low magnitude mechanical stimulation will help combat sarcopenia and loss of independence among frail older adults who are at the highest risk of adverse outcomes. The candidate for this mentored Patient-Oriented Career Development Award aims to complement her previous training in geriatrics and epidemiology with additional expertise in muscle physiology, body composition imaging methodology, and interventional clinical research. Columbia University has committed abundant resource to support this proposal including the use of bionutrition, biomarkers laboratory in the NIH CTSA-funded Irving Institute. A multidisciplinary mentorship team comprised of experts in frailty, body composition, intermuscular fat and clinical trial design in the elderly supports the proposal. The proposed studies should provide novel information about the importance of intermuscular fat in the development of disability, and could lead to new strategies for the treatment and prevention of sarcopenia. PUBLIC HEALTH RELEVANCE: Frailty is a geriatric syndrome that identifies vulnerable adults at increased risk for adverse outcomes. Central to the multisystem dysregulation is sarcopenia and age-related loss in muscle strength. The economic impact of sarcopenia and its detrimental consequences are immense. Pharmacologic and nonpharmacologic treatment options are badly needed. Resistance training improves multiple outcomes, however, many older adults are unable to participate in high-intensity exercise programs. Low magnitude mechanical stimulation is an exciting and novel low impact intervention to combat the loss of muscle strength in older adults. This may have a large public health impact in preventing disability.

描述（由申请人提供）：肌肉减少症，与年龄相关的骨骼肌肉质量丧失，导致流动性，脆弱和残疾受损。但是，肌肉质量的损失与肌肉力量的损失之间存在不匹配，这表明肌肉质量会因衰老而受损。将脂肪浸润到骨骼肌（肌to骨）会影响肌肉质量并且可能与流动性和残疾受损有关。肌肉数量和肌肉质量可能是脆弱发展的早期修改因素。该提议的目的是检查脂肪将脂肪浸润到骨骼肌中是否通过外围定量计算机断层扫描评估，独立和互动地预测肌肉力量，身体性能，脆弱，残疾和死亡的下降，在1,172个社区居住的男性中，年龄在65岁及65岁以上。此外，我们假设改善肌肉质量和质量的干预措施将防止无力和残疾。因此，我们的第二个目的是研究为整个身体提供低幅度机械刺激的低影响，非药物装置是否可以改善低功能的成年人的肌肉力量。该提案还将探索低幅度的机械量是否增加肌肉质量并减少肌间脂肪。受试者将从当地的辅助生活社区招募，这些社区为许多老年人提供聚集的住房和社交活动。我们假设低幅度的机械刺激将有助于对抗肌肉减少症和失去不良后果风险的脆弱老年人的独立性丧失。这项受过指导的以患者为导向的职业发展奖的候选人旨在补充她先前在老年病和流行病学方面的培训，并在肌肉生理学，身体组成成像方法和介入临床研究方面提供其他专业知识。哥伦比亚大学（Columbia University）承诺了大量资源来支持该提案，包括使用Bionutrition，NIH CTSA资助的欧文研究所（NIH CTSA）资助的生物标志物实验室。一个多学科指导团队，由脆弱，身体成分，肌间脂肪和临床试验设计的专家组成在老年人中支持该提议。拟议的研究应提供有关肌间脂肪在残疾发展中重要性的新颖信息，并可能导致治疗和预防肌肉减少症的新策略。公共卫生相关性：脆弱是一种老年综合症，可以确定弱势成年人的不良后果风险。多系统失调的中心是肌肉减少症和与年龄相关的肌肉力量损失。肌肉减少症及其有害后果的经济影响是巨大的。急需药理和非药物治疗方案。抵抗训练可以改善多种结果，但是，许多老年人无法参加高强度的运动计划。低幅度的机械刺激是一种令人兴奋且新颖的低冲击干预措施，可打击老年人的肌肉力量的丧失。这可能会对预防残疾产生巨大的影响。