Promoting Physical Activity in Older Adults with Comorbidity

促进患有合并症的老年人的身体活动

基本信息

批准号：
8608435
负责人：
ELIZABETH Ann SCHLENK
金额：
$ 34.85万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-03-19 至 2016-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8608435
关键词：
Address Adoption Adult Adverse effects Affect Age American Arthralgia Arthritis Attention Blood Pressure Cardiovascular Diseases Chronic Disease Clinical Comorbidity Coronary heart disease Data Degenerative polyarthritis Diagnosis Disease Elderly Equilibrium Exercise Expectancy High Prevalence Home environment Hypertension Individual Intervention Knee Osteoarthritis Leg Life Lower Extremity Maintenance Measures Mediating Modeling Outcome Pain Performance Persons Physical activity Public Health Randomized Randomized Controlled Trials Regimen Research Personnel Risk Risk Factors Sampling Self Efficacy Stroke Testing Time Walking Work base clinically significant design experience fitness flexibility functional status health related quality of life heart disease risk improved intervention effect knee pain prevent programs public health relevance quadriceps muscle theories trend

项目摘要

DESCRIPTION (provided by applicant): Over 9 million Americans have symptomatic osteoarthritis (OA) of the knee, a chronic disease associated with frequent joint pain, functional limitations, and quadriceps weakness that intrude upon everyday life. At least half of those with OA of the knee are diagnosed with hypertension or high blood pressure (HBP), one of the most prevalent risk factors for cardiovascular disease. Many other individuals with OA of the knee unknowingly have HBP and remain untreated. Our own work and that of others suggest that persons with OA of the knee experience reductions in BP when they participate in a regular regimen of physical activity. Even small decreases in systolic and diastolic BP found with physical activity are clinically significant, e.g., a 2 mm Hg decrease reduces the risk of stroke by 14% - 17%, and the risk of coronary heart disease is reduced by 6% - 9%. Yet, only 15% of persons with OA and 47% with HBP engage in regular physical activity. The purpose of this study is to investigate how the individually delivered, home-based, 6-month modified Staying Active with Arthritis (STAR) intervention, guided by self-efficacy theory and modified to address comorbid HBP, affects lower extremity exercise (flexibility, strengthening, and balance), fitness walking, functional status, BP, quadriceps strength, pain, and health-related quality of life (HRQoL) in a convenience sample of 224 adults age 50 years or older with OA of the knee and HBP. Using a randomized controlled, 2-group design, we (1) hypothesize that at the end of the 6-month intervention period and 6 months after the intervention period ends those who receive the modified STAR intervention will be more likely to perform lower extremity exercise, participate in fitness walking, show improvements in objective functional status, and demonstrate reductions in BP than those who receive attention-control. Secondarily, we will (2) evaluate the impact of the modified STAR intervention, compared to attention- control, on subjective functional status, quadriceps strength, pain, and HRQoL at both time points; (3) explore the impact of the modified STAR intervention, compared to attention-control, on self-efficacy and outcome expectancy at both time points; (4) explore the relationship between self-efficacy and outcome expectancy; and (5) explore the extent to which self-efficacy and outcome expectancy mediate the relationship between the modified STAR intervention and performance of lower extremity exercise and participation in fitness walking. Data will be analyzed using repeated measures modeling.

描述（由申请人提供）：超过 900 万美国人患有有症状的膝关节骨关节炎 (OA)，这是一种与频繁关节疼痛、功能受限和股四头肌无力相关的慢性疾病，影响了日常生活。至少有一半膝关节骨关节炎患者被诊断患有高血压或高血压 (HBP)，这是心血管疾病最常见的危险因素之一。许多其他患有膝骨关节炎的人在不知情的情况下患有 HBP 并且仍未得到治疗。我们自己和其他人的工作表明，患有膝关节骨关节炎的人在参加定期的身体活动时血压会降低。即使体力活动导致的收缩压和舒张压小幅下降也具有临床意义，例如，下降 2 毫米汞柱，中风风险可降低 14% - 17%，冠心病风险可降低 6% - 9% 。然而，只有 15% 的 OA 患者和 47% 的 HBP 患者定期进行体力活动。本研究的目的是调查以自我效能理论为指导并针对合并的 HBP 进行修改的单独实施、以家庭为基础、为期 6 个月的改良型关节炎保持活跃 (STAR) 干预措施如何影响下肢运动（灵活性、 224 名 50 岁或患有膝关节 OA 和 HBP 的老年人。使用随机对照的 2 组设计，我们 (1) 假设在 6 个月干预期结束时以及干预期结束后 6 个月，接受改良 STAR 干预的人更有可能进行下肢锻炼，参加健身步行，客观功能状态有所改善，并且与接受注意力控制的人相比，血压有所降低。其次，我们将 (2) 与注意力控制相比，评估改良 STAR 干预对两个时间点的主观功能状态、股四头肌力量、疼痛和 HRQoL 的影响； (3) 探讨与注意力控制相比，改良的 STAR 干预对两个时间点的自我效能和结果预期的影响；（4）探讨自我效能感与结果期望之间的关系； (5) 探讨自我效能和结果预期在多大程度上介导改良的 STAR 干预与下肢运动表现和健身步行参与之间的关系。将使用重复测量建模来分析数据。