Polestriding versus Walking for PAD Rehabilitation

跨步与步行进行 PAD 康复

• 批准号: 7072730
• 负责人: Eileen G Collins
• 金额: $ 44.37万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7072730
• 关键词: biomechanics; blood pressure; body physical activity; claudication; clinical research; clinical trials; computer data analysis; electrocardiography; exercise; gait; human subject; human therapy evaluation; infrared spectrometry; limb movement; longitudinal human study; medical rehabilitation related tag; muscle function; musculoskeletal circulation; outcomes research; oxygen transport; pain; peripheral blood vessel disorder; questionnaires; rehabilitation; statistics /biometry

DESCRIPTION (provided by applicant): Peripheral arterial disease (PAD) is a debilitating condition affecting between 8 and 12 million people in the United States. Patients with PAD of the lower extremities are subject to periods of intermittent claudication pain. Gait changes such as reduced stride length, cadence and walking speed are reported in patients with PAD. Walking exercise has been prescribed as the primary mode of rehabilitative treatment in patients with PAD. An enhanced form of walking exercise, polestriding, has been found to improve rehabilitation outcomes for patients with PAD. Walking with poles also increases stride length, cadence and walking speed and decreases ground reaction forces on the joints. Changes in walking mechanics secondary to walking pole use may allow more time for perfusion of the leg muscles thus delaying the onset of and decreasing the severity of ischemic pain. Thus, we hypothesize that polestriding may be superior to walking exercise in the rehabilitation of persons with PAD. The two therapies however, have never been compared in a randomized trial in this population. Specific Aims: The primary specific aim is to compare the effects of a 24-week walking versus polestriding exercise in patients with PAD on exercise endurance, perceived physical function and walking abilities. The secondary aim is to explore biomechanical and physiologic mechanisms to explain the expected differences observed in the polestriding and walking groups. Mechanistic variables include perceived claudication pain, gait biomechanics, tissue oxygenation in the most severely affected leg and daily physical activity. Design: A randomized, controlled clinical trial will be used to compare the effects of polestriding and walking exercise. 180 patients will be enrolled in the study to randomize 126 (n=63 in each group). Baseline testing will consist of treadmill exercise, completion of functional assessment questionnaires, gait analysis, and physical activity measurement. Subjects will then be randomized to a 24-week walking or polestriding program. Subjects will exercise three times weekly for 30-60 minutes. Duration and intensity of exercise will be systematically increased. Subjects will be re-tested at 6, 12, and 24 weeks. A final testing battery will be completed at 32 weeks to assess how well subjects have maintained fitness gains. Analysis: Data will be analyzed using descriptive statistics, repeated measures ANOVA and linear regression analysis. Potential co-variates such as smoking and medication use will be monitored and analyzed.

描述（由申请人提供）：外周动脉疾病 (PAD) 是一种使人衰弱的疾病，影响着美国 8 至 1200 万人。下肢 PAD 患者会出现一段时间的间歇性跛行疼痛。据报道，PAD 患者会出现步态变化，例如步幅、步频和步行速度缩短。步行锻炼已被规定为 PAD 患者康复治疗的主要方式。研究发现，步行运动的一种增强形式——钢管跨步可以改善外周动脉疾病（PAD）患者的康复效果。持杖行走还可以增加步幅、节奏和行走速度，并减少关节上的地面反作用力。继发于使用拐杖后的行走力学变化可能会为腿部肌肉的灌注提供更多时间，从而延迟缺血性疼痛的发作并减轻其严重程度。因此，我们推测，对于 PAD 患者的康复来说，撑竿踏步可能优于步行运动。然而，这两种疗法从未在该人群的随机试验中进行比较。具体目标：主要具体目标是比较 PAD 患者 24 周步行与撑竿运动对运动耐力、感知身体功能和步行能力的影响。第二个目标是探索生物力学和生理机制，以解释在钢管跨步组和步行组中观察到的预期差异。机械变量包括感知的跛行疼痛、步态生物力学、受影响最严重的腿部的组织氧合和日常身体活动。设计：将使用一项随机对照临床试验来比较钢管踏步和步行运动的效果。 180 名患者将被纳入该研究，其中 126 名患者被随机分组​​（每组 n=63）。基线测试将包括跑步机锻炼、完成功能评估问卷、步态分析和身体活动测量。然后受试者将被随机分配参加为期 24 周的步行或钢管跨步计划。受试者每周锻炼 3 次，每次 30-60 分钟。运动的持续时间和强度将有系统地增加。受试者将在第 6、12 和 24 周时重新接受测试。最终测试将在 32 周时完成，以评估受试者保持健康状况的情况。分析：将使用描述性统计、重复测量方差分析和线性回归分析来分析数据。将监测和分析潜在的协变量，例如吸烟和药物使用。