Obesity Rehabilitation for Improving Walking Efficiency in Neurological Disease

肥胖康复可提高神经系统疾病患者的步行效率

基本信息

批准号：
10355462
负责人：
Brenda Jeng
金额：
$ 1.93万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-02-04 至 2022-05-01
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10355462
关键词：
Activities of Daily Living Adult Affect Anxiety Axon Body Composition Body Weight Body fat Body mass index Body measure procedure Bone Density Bone Mineral Contents Categories Communities Consumption Demyelinations Diagnosis Dietary Intervention Disease Educational Intervention Exercise Fatigue Fatty acid glycerol esters General Population Health Promotion Impairment Individual Injury Kilogram Lead Life Life Style Mental Depression Mental Health Multiple Sclerosis Neuraxis Neurologic Obesity Outcome Overweight Oxygen Oxygen Consumption Pain Pattern Persons Physical Function Physical activity Physiological Prevalence Quality of life Rehabilitation therapy Reporting Research Research Design Research Personnel Risk Roentgen Rays Severities Spastic Gait Specialist Subgroup Symptoms Thinness Time Tissues Walking Weight base cardiorespiratory fitness chronic neurologic disease cost deconditioning depressive symptoms design disability exercise training experience health related quality of life improved nervous system disorder neuron loss pain symptom physical inactivity programs standard measure symptom management

项目摘要

Project Summary/Abstract Multiple sclerosis (MS) is a chronic neurological disease characterized by demyelination and transection of axons as well as loss of neurons in the central nervous system with a prevalence of approximately 2.3 million people worldwide, and over 40% of these individuals are overweight or obese. Adults of the general population who are overweight or obese have symptoms including worse levels of fatigue, depression, pain, and anxiety, all of which are prevalent in persons with MS. Such a pattern suggests that the prevalence and severity of these symptoms might actually be worse in persons with MS who have poor body composition profiles. Furthermore, persons with MS who have poor body composition may have worse walking efficiency, indicated by elevated oxygen (O2) cost of walking. O2 cost of walking is defined as the amount of O2 consumed per kilogram of body weight per unit distance walked. Collectively, there is evidence that O2 cost of walking is higher in persons with MS compared with controls and may worsen as disability status progresses. With elevated O2 cost of walking, persons with MS may experience higher levels of fatigue and participate in less physical activity, impeding these individuals from engaging within the community. To date, there are few studies examining the relationship between body composition and O2 cost of walking in persons with MS. Body mass index (BMI) has been the primary measure of body composition in research on the O2 cost of walking in MS but significantly underestimates adiposity in persons with MS and cannot differentiate between different tissue types. Dual x-ray absorptiometry is the standard measure of body composition and has the capability to differentiate fat mass, fat-free mass, and bone mineral content of the overall body. To that end, the first aim of cross-sectional design study is to examine the relationship between body composition and the O2 cost of walking in persons with MS. We hypothesize that persons with MS who have more body fat, less lean tissue, and lower bone mineral content will demonstrate higher levels of O2 cost of walking. The second aim is to identify MS-related consequences (i.e., fatigue, depression, pain, and anxiety) of body composition and how O2 cost of walking affects this relationship. We hypothesize that persons with MS who have worse body composition will demonstrate elevated O2 cost of walking and worse consequences. This proposed research will provide preliminary evidence to better understand the relationship among body composition, O2 cost of walking, and MS-related consequences. These findings may guide researchers, clinicians, and exercise specialists in the design of targeted approaches, such as exercise training, for optimizing body composition to improve walking efficiency and manage its secondary consequences in MS with the aim to promote health and better overall quality of life, which aligns with the PI’s research agenda of helping persons with neurological conditions integrate or reintegrate into the community post-injury or post-diagnosis.

项目摘要/摘要多发性硬化症（MS）是一种慢性神经系统疾病，其特征是脱髓鞘和翻译轴突以及中枢神经系统中神经元的丧失，患病率约为230万全球人，其中40％以上的人超重或肥胖。一般人口的成年人超重或肥胖的人的症状包括疲劳，抑郁，疼痛和动画水平较差，所有这些都是在MS的人中普遍存在的。这种模式表明实际上，在MS的人体成分谱差的人中，这些症状实际上可能会更糟。此外，身体成分较差的MS的人的步行效率可能较差，表明通过升高的氧气（O2）步行成本。 o2步行成本定义为消耗的o2量单位距离行走的每公斤体重。总的来说，有证据表明O2步行成本是与对照组相比，MS的人更高，随着残疾状况的进展，可能会更糟。和升高的O2步行成本，MS的人可能会经历更高水平的疲劳和参与少体育锻炼，阻碍这些人参与社区。迄今为止，很少研究身体成分与MS人行走成本的O2成本之间的关系。身体质量指数（BMI）一直是人体组成的主要测量 MS，但显着低估了MS患者的肥胖，无法区分不同组织类型。双X射线绝对测定法是人体组成的标准测量，并且具有能力区分总体的脂肪质量，无脂肪质量和骨矿物质含量。为此，第一个目的横截面设计研究是为了检查身体成分与O2成本之间的关系与MS一起行走。我们假设患有MS的人体内脂肪越多，瘦肉组织较少，较低的骨矿物质含量将表现出更高水平的O2步行成本。第二个目标是确定身体成分的与MS相关的后果（即疲劳，抑郁，疼痛和动画）以及如何 O2步行成本会影响这种关系。我们假设患有MS的人身体较差组成将表明步行的成本升高，后果较差。这项拟议的研究将提供初步证据，以更好地了解身体成分之间的关系步行和与MS相关的后果。这些发现可能指导研究人员，临床医生和运动针对性方法设计的专家，例如运动训练，以优化身体成分提高步行效率并管理其在MS中的次要后果，目的是促进健康和更好的整体生活质量，这与PI的研究Agernda相吻合，以帮助神经学患者结合或重新融入受伤后或诊断后社区。