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.

项目概要/摘要疲劳的长期存在表明，患有 COVID-19 后疲劳 (PCF) 的个体可能个人在进行体力活动时面临疲劳程度增加的风险。疲劳性是由客观表现下降之间的相互作用决定的（表现疲劳性）和调节活动表现的感知变化（即感知骨骼疲劳性）。肌肉改变，包括力量能力降低、纤维萎缩和代谢功能障碍此外，还发现 SARS-CoV-2 感染后的患者出现抑郁和焦虑症状。作为 PCF 患者常见的既往病症，因此，心理和生理方面都有影响。 SARS-CoV-2 的后果可能有助于深入了解同时发生的机制，通过这些机制增加 SARS-CoV-2 感染后会出现并持续疲劳，但人们普遍呼吁采取措施。对 SARS-CoV-2 感染康复者实施的康复治疗相对较少了解体育锻炼对该人群的潜在益处。由于它能够提供锻炼选择来对抗久坐行为，因此可能特别有利由于 COVID-19 造成的封锁、隔离和社区活动限制迄今为止，在家锻炼的安全性和可行性尚未得到彻底调查。该项目的总体目标是增进我们对以前感染过 SARS-CoV-2 的人的了解。影响 PCF 退伍军人表现疲劳和感知疲劳的潜在机制探索家庭“最小剂量”阻力锻炼计划的安全性和可行性核心假设是力量能力、骨骼肌摄氧量和能力的下降。对体力活动的情感反应提供了增加疲劳性的潜在机制此外，参加 PCF 的退伍军人可以远程进行在家进行的抵抗训练。为了解决这一假设，提出以下目标：目标 1：比较退伍军人与退役军人的疲劳程度以及潜在的神经肌肉和神经生物学因素以前感染过 SARS-CoV-2 的退伍军人没有疲劳的假设 1a。与新冠病毒 (COVID-19) 后的疲劳相比，具有更高的表现疲劳度和感知疲劳度之前感染过 SARS-CoV-2 的退伍军人没有报告 COVID-19 后的疲劳情况。在 COVID-19 后的疲劳中，膝关节伸肌力量、肌肉吸氧量都会降低，与以前感染过 SARS-CoV-2 的退伍军人相比，未报告 COVID-19 后的情况和情感效价目标 2：确定 8 周家庭“最小剂量”抵抗的安全性和可行性。假设 2a 为患有 COVID-19 后疲劳的退伍军人提供 8 周的居家锻炼计划。对于患有 COVID-19 后疲劳的退伍军人来说，剂量抵抗运动是安全可行的。为了测试目标 2，我们将进行测试。使用随机对照可行性试验将在等长和收缩过程中评估骨骼肌力量。使用测力法和股外侧肌氧提取进行动态膝伸肌收缩将使用近红外光谱来估计情感反应将使用感觉来测量。次要指标包括运动单位特性、功能结果和健康相关质量。生活。