Longitudinal Assessment of Mobility Outcomes in Glaucoma

青光眼活动结果的纵向评估

• 批准号: 9011531
• 负责人: Pradeep Yammanuru Ramulu
• 金额: $ 53.9万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9011531
• 关键词: Accelerometer; Accounting; Address; Affect; American; Calendar; Caring; Cessation of life; Clinical; Clinical Trials Design; Data; Devices; Disease; Environment; Environmental Risk Factor; Equilibrium; Eye; Fall prevention; Future; Glaucoma; Grant; Health; Home environment; Hospitalization; Illinois; Impairment; Individual; Injury; Intervention; Interview; Intrinsic factor; Lead; Lighting; Location; Lower Extremity; Measurement; Measures; Medical; Monitor; National Eye Institute; Outcome; Patient Self-Report; Patients; Pattern; Persons; Pharmaceutical Preparations; Physical activity; Population; Prevention program; Protocols documentation; Quality of life; Rest; Retrospective Studies; Risk; Risk Factors; Role; Severities; Severity of illness; Societies; Stroke; Technology; Testing; Time; Training; Travel; Universities; Visual Fields; Visual impairment; Walking; base; cohort; cost; design; experience; fall risk; falls; fear of falling; follow-up; hazard; high risk; improved mobility; information gathering; innovation; longitudinal design; medical attention; modifiable risk; nervous system disorder; new technology; novel; prevent; programs; prospective; public health priorities; rehabilitation strategy; remote sensing; tool

DESCRIPTION (provided by applicant): A stated priority of the National Eye Institute is to "Develop new technologies and rehabilitation strategies to minimize the impact of visual impairment". Glaucoma is a frequent cause of visual impairment, and affects over 2 million Americans. Falls are a major hazard in glaucoma patients, who have a falls rate two to four times higher than normal and a one in three risk of suffering an injurious fall over the course of year. This proposal is aimed at gathering data necessary for designing future falls prevention programs. Innovative aspects of the proposal include prospective, longitudinal assessment of falls over a 3 year period through the use of falls calendars, utilization of remote-sensing technology to evaluate real-world mobility outcomes, and direct assessment of the home environment to identify environmental risk factors. Aim 1 of the grant is to characterize the relationship of VF loss severity on fall rates in glaucoma patients. Fall rates will be measured a a rate over time, as well as a rate over steps taken. Steps will be measured in the subject's normal routine using a waistband accelerometer. Understanding the relationship between disease severity and fall rates will identify which glaucoma patients are at a particularly high rik of falling, and therefore merit interventions to prevent falls. Aim 2 of the proposal will identif potentially modifiable risk factors for falls in glaucoma patients. Risk factors to be evaluated wll include features of the patient (e.g. balance and lower extremity strength), features of the environment (e.g. the number of hazards noted in a direct assessment of the home), and activity patterns (e.g. the amount of accelerometer-defined walking and the amount of travel outside the home as measured through a cellular tracking device). Outcomes from aim 2 will guide which features of the person should be targeted in programs to prevent falls in glaucoma. Aim 3 of the proposal will characterize the downstream consequences of falls in glaucoma. Specifically, this aim will characterize whether higher fall rates are associated with increases in fear of falling, decreases in self-reported quality of life, decreases in daily walking and physica activity (measured through annual week-long accelerometer trials), and decrease in the number of excursions outside the home or the amount of time spent outside the home (measured through the use of annual week- long trials with a cellular tracking device. Outcomes from Aim 3 will guide which strategies should be used to prevent falls in glaucoma, while also addressing other aspects of mobility restriction.

描述（由申请人提供）：国家眼科研究所明确的优先事项是“开发新技术和康复策略，以尽量减少视力障碍的影响”。 青光眼是导致视力障碍的常见原因，影响超过 200 万美国人。 跌倒是青光眼患者的主要危险，他们的跌倒率比正常人高出两到四倍，并且在一年中遭受跌倒伤害的风险有三分之一。 该提案旨在收集设计未来跌倒预防计划所需的数据。 该提案的创新之处包括通过使用跌倒日历对三年内的跌倒进行前瞻性纵向评估，利用遥感技术评估现实世界的流动结果，以及直接评估家庭环境以识别环境风险因素。 该拨款的目的 1 是描述青光眼患者 VF 丧失严重程度与跌倒率之间的关系。 跌倒率将根据一段时间内的跌倒率以及所采取的步骤的跌倒率来衡量。 将使用腰带加速计在受试者的正常日常活动中测量步数。 了解疾病严重程度和跌倒率之间的关系将确定哪些青光眼患者跌倒的风险特别高，因此值得采取干预措施来预防跌倒。 该提案的目标 2 将确定青光眼患者跌倒的潜在可改变风险因素。 要评估的风险因素包括患者的特征（例如平衡和下肢力量）、环境特征（例如在对家庭的直接评估中注意到的危险数量）和活动模式（例如加速度计的数量）。定义的步行量和通过蜂窝跟踪设备测量的外出旅行量）。 目标 2 的结果将指导预防青光眼跌倒的计划应针对个人的哪些特征。 该提案的目标 3 将描述青光眼跌倒的下游后果。 具体来说，该目标将表征较高的跌倒率是否与跌倒率的增加有关 害怕跌倒、自我报告的生活质量下降、日常行走和身体活动减少（通过每年为期一周的加速度计试验测量）以及外出旅行次数或外出时间减少（通过使用蜂窝跟踪设备进行年度为期一周的试验进行测量。目标 3 的结果将指导应使用哪些策略来预防青光眼跌倒，同时还解决行动限制的其他方面。