Fatigue and Fatigability in Veterans Following SARS-CoV-2 Infection

退伍军人感染 SARS-CoV-2 后的疲劳和容易疲劳

基本信息

批准号：
10703633
负责人：
JARED M. GOLLIE
金额：
--
依托单位：
U.S. DEPT/VETS AFFAIRS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-07-01 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10703633
关键词：
2019-nCoV Address Affective Anxiety Atrophic Award Awareness COVID-19 pandemic Chronic Clinical Clinical Trials Communities Data Dose Effectiveness Exercise Exhibits Extensor Fatigue Feeling Fiber Goals Health Home Individual Isometric Exercise Knee Measures Mental Depression Metabolic dysfunction Motor Muscle Near-Infrared Spectroscopy Neurobiology Oxygen Patients Performance Persons Physical Exercise Physical activity Physiological Population Prevalence Property Quarantine Randomized Rehabilitation therapy Reporting Risk SARS-CoV-2 infection Severities Skeletal Muscle Symptoms Testing Veterans appropriate dose base combat design exercise program experience feasibility trial functional outcomes health related quality of life improved insight neurobehavioral neuromuscular novel patient population post SARS-CoV-2 infection post-COVID-19 psychologic remote delivery resistance exercise response safety and feasibility sedentary lifestyle skeletal muscle weakness vastus lateralis

项目摘要

Project Summary/Abstract The chronic presence of elevations in fatigue suggests that individuals with post-COVID-19 fatigue (PCF) may be at risk for experiencing increased fatigability when engaging in physical activity. An individual’s level of fatigability is determined by the interactions between objective declines in performance (performance fatigability) and perceptual changes regulating activity performance (i.e., perceived fatigability). Skeletal muscle alterations including reduced force capacity, fiber atrophy, and metabolic dysfunction have been observed in patients following SARS-CoV-2 infection. In addition, depression and anxiety have been identified as common pre-existing conditions in patients with PCF. Thus, psychological as well as physiological consequences of SARS-CoV-2 may provide insight into co-occurring mechanisms by which increased fatigability occurs and persists following SARS-CoV-2 infection. While there have been widespread calls for the implementation of rehabilitation for individuals recovering from SARS-CoV-2 infection, relatively little is known about the potential benefits of physical exercise in this population. Home-based exercise programs maybe particularly advantageous due to its ability to provide an exercise option to combat sedentary behavior imposed by lockdowns, quarantines, and restrictions on community activity caused by the COVID-19 pandemic. To date, the safety and feasibility of home-based exercise has yet to be thoroughly investigated in people previously infected by SARS-CoV-2. The overall goal of this project is to advance our understanding of underlying mechanisms impacting performance fatigability and perceived fatigability in Veterans with PCF and explore the safety and feasibility of a home-based “minimal-dose” resistance exercise program in this population. The central hypothesis is that declines in force capacity, skeletal muscle oxygen extraction, and affective responses to physical activity offer potential mechanisms through which fatigability is increased in Veterans with PCF. Moreover, home-based resistance exercise delivered remotely may provide a safe and feasible treatment option for this population. To address this hypothesis, the following aims are proposed: Aim 1: Compare fatigability, and the underlying neuromuscular and neurobiological factors, in Veterans with post- COVID-19 fatigue to Veterans previously infected by SARS-CoV-2 without fatigue. Hypothesis 1a. Veterans with post-COVID-19 fatigue will exhibit greater performance fatigability and perceived fatigability compared to Veterans previously infected with SARS-CoV-2 not reporting post-COVID-19 fatigue. Hypothesis 1b. Veterans with post-COVID-19 fatigue will exhibit reductions in knee extensor force capacity, muscle oxygen extraction, and affective valence compared to Veterans previously infected with SARS-CoV-2 not reporting post-COVID-19 fatigue. Aim 2: Determine the safety and feasibility of an 8-week home-based “minimal-dose” resistance exercise program for Veterans with post-COVID-19 fatigue. Hypothesis 2a. 8 weeks of home-based minimal- dose resistance exercise will be safe and feasible in Veterans with post-COVID-19 fatigue. To test aim 2, we will use a randomized controlled feasibility trial. Skeletal muscle force will be assessed during isometric and dynamic knee extensor contractions using dynamometry and muscle oxygen extraction of the vastus lateralis will be estimated using near-infrared spectroscopy. Affective responses will be measured using the Feeling Scale. Secondary measures include motor unit properties, functional outcomes, and health-related quality of life.

项目摘要/摘要疲劳中长期存在的长期存在表明，弯曲后-19疲劳（PCF）的个体可能从事体育锻炼时，有可能会增加疲劳性的风险。一个人的水平疲劳性是由性能下降（性能）之间的相互作用决定的疲劳性）和感知变化调节活动性能（即可感知的疲劳性）。肌肉的改变，包括力量降低力能力，纤维萎缩和代谢功能障碍在SARS-COV-2感染后观察到的患者观察到。此外，已经确定了抑郁和动画作为PCF患者的常见病情。那是心理和生理 SARS-COV-2的后果可能会洞悉同时发生的机制，从而增加 SARS-COV-2感染后发生疲劳性并持续。尽管有广泛的电话从SARS-COV-2感染中恢复的个人实施康复，相对较少的IS 知道体育锻炼在这个人群中的潜在益处。家庭锻炼计划由于能够提供锻炼选择来打击久坐行为，因此可能特别有利由封锁，隔离和对Covid-19造成的社区活动的限制施加大流行。迄今为止，基于家庭锻炼的安全性和可行性尚未对以前被SARS-COV-2感染的人。该项目的总体目标是提高我们的理解 PCF和在此探索基于家庭的“最小剂量”抵抗运动计划的安全性和可行性人口。中心假设是，力量下降，骨骼肌氧气提取和情感对体育锻炼的反应提供了潜在的机制带有PCF的退伍军人。此外，远程提供的基于家庭的抵抗运动可能会提供安全和安全的该人群可行的治疗选择。为了解决这一假设，提出了以下目的：目标 1：比较患有后的退伍军人共同19岁的疲劳对先前被SARS-COV-2感染的退伍军人疲劳，而没有疲劳。假设1a。退伍军人与COVID后的疲劳一起，与相比先前感染了SARS-COV-2的退伍军人未报告199年后疲劳。假设1b。退伍军人随着弯曲后19的疲劳，将提取膝盖伸出力量的减少，肌肉氧气提取，与先前被SARS-COV-2感染的退伍军人相比疲劳。目标2：确定为8周家庭“最小剂量”阻力的安全性和可行性锻炼计划的锻炼计划，患有后期疲劳后的退伍军人。假设2a。 8周的家庭最小在19日疲劳后的退伍军人中，抗剂量耐药性运动将是安全且可行的。要测试目标2，我们将使用随机对照可行性试验。骨骼肌力将在等静电期间进行评估，并且动态膝盖扩展使用动态和肌肉氧气的股外侧提取将使用近红外光谱估计。情感的反应将使用这种感觉来衡量规模。次要措施包括运动单位特性，功能结果和与健康相关的质量生活。