Effects of Multi-Modal Exercise Intervention Post Hip Fracture

髋部骨折后多模式运动干预的效果

• 批准号: 8791800
• 负责人: JAY MAGAZINER
• 金额: $ 5.07万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8791800
• 关键词: Address; Aerobic; Affect; Amino Acids; Ancillary Study; Award; Baltimore; Bone Density; Bone Resorption; Cognition; Communities; Control Groups; Dependency; Development; Disabled Persons; Elderly; Enrollment; Equilibrium; Essential Amino Acids; Estradiol; Event; Exercise; Fatty acid glycerol esters; Feasibility Studies; Funding; Gait; Goals; Hip Fractures; Hip region structure; Home environment; Hormones; Hospitalization; Household; Inflammation; Instruction; Insulin-Like Growth Factor I; International; Intervention; Intervention Studies; Lower Extremity; Maryland; Measurement; Measures; Mediating; Muscle; Operative Surgical Procedures; Participant; Pathway interactions; Patients; Performance; Phase; Pilot Projects; Proteins; Randomized; Randomized Clinical Trials; Recovery; Recruitment Activity; Research; Safety; Sample Size; Sampling; Serum Markers; Site; Supplementation; Testing; Testosterone; Thigh structure; Walking; Work; attenuation; base; bone; bone strength; bone turnover; clinical research site; cytokine; depressive symptoms; effective intervention; experience; group intervention; inflammatory marker; intervention effect; member; muscle strength; post intervention; primary outcome; programs; response

This proposed Merit Extension will continue a line of research initiated In 1983 that has evolved into an internationally recognized program, the Baltimore Hip Studies (BHS), dedicated to identifying, developing, and evaluating strategies to optimize recovery following hip fracture. This Merit Extension, which has two components, will extend findings from prior Merit Award studies and other BHS projects demonstrating that hip fracture results In dramatic changes in muscle, fat mass and muscle strength, bone density and strength, bone turnover markers, serum levels of hormones and inflammatory markers, as well as walking ability and other aspects of function. The goals are to: 1) study some of the key mechanisms on the pathway to changes in community ambulation in response to a Multi-modal Exercise Intervention (MMEI) delivered to this frail and disabled group of older persons (Component I); and 2) test, in a preliminary manner through a pilot/feasibility study of a different sample of patients, the additional benefit of adding a protein supplement following MMEI sessions to determine if there are important changes in bone, muscle, inflammation, and function (Component II). The MMEI, being tested in a recently funded Phase III randomized clinical trial (1R01AG035009) of 300 patients In three centers, is a home-based program that addresses deficits in endurance, strength, balance and function through 40 supervised sessions. The primary outcome of that RCT is the ability to ambulate independently in the community. Component I of this Merit Extension will be conducted as an ancillary study to the Phase III RCT by adding mectianistic measurements to the patients recruited in the Baltimore, Maryland clinical site (Minimum number enrolled = 60; 30 per group). Component II wiil recruit 30 additional patients and provide a whey based protein and amino acid supplement immediately after completing each ofthe MMEI sessions to examine added mechanistic benefits and feasibility. Participants in both components will be assessed prior to randomization (within 2 months post hospitalization for hip fracture), and again 4 and 10 months later in order to examine the immediate effects (primary outcome) and the sustained benefits of interventions. We also will work with an international group of experts to identify strategies to accelerate development and testing of interventions for this group of older persons who experience this sudden disabling event.

该提出的优点扩展将继续于1983年启动一系列研究线，该研究已演变为 国际认可的计划，巴尔的摩髋关节研究（BHS），致力于识别，发展，发展， 并评估髋部骨折后优化恢复的策略。这个值得扩展，有两个 组件将扩展以前的优异奖研究和其他BHS项目的发现，证明 髋部骨折会导致肌肉，脂肪质量和肌肉力量，骨密度和力量的急剧变化， 骨转换标记，激素和炎症标记的水平以及步行能力和 功能的其他方面。目标是：1）研究通往途径的一些关键机制 响应多模式运动干预（MMEI）的社区移动变化已交付给 这个脆弱和残疾的老年人组（组成i）； 2）测试，以初步的方式 对不同患者样本样本的试验/可行性研究，添加蛋白质补充剂的额外好处 遵循MMEI会议，以确定骨骼，肌肉，炎症和 功能（组件II）。 MMEI在最近资助的III期随机临床试验中进行了测试 （1R01AG035009）在三个中心中有300名患者，是一个基于家庭的计划，可解决赤字 耐力，力量，平衡和功能通过40个监督会议。主要结果 RCT是在社区中独立行动的能力。 该优点扩展的组成部分将通过添加来作为对III期RCT的辅助研究 对马里兰州临床部位招募的患者的隔热测量 注册号= 60;每组30）。组件II Wiil招募30名患者，并提供乳清 完成每个MMEI课程后，基于基于的蛋白质和氨基酸补充剂 检查附加的机械优势和可行性。两个组件的参与者将在事先进行之前评估 进行随机分组（髋部骨折后2个月内），在4个月后再次 为了检查直接影响（主要结果）和干预措施的持续益处。 我们还将与国际专家小组合作，以确定加速发展和 对这组突然禁用事件的老年人进行干预措施的测试。