Unraveling the mechanisms of a novel music intervention for physical activity promotion in older adults

揭示新型音乐干预促进老年人身体活动的机制

基本信息

批准号：
10766983
负责人：
JENNIFER L ETNIER
金额：
$ 32.84万
依托单位：
UNIVERSITY OF NORTH CAROLINA GREENSBORO
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：
2023-09-15 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10766983
关键词：
Accelerometer Accent Acclimatization Acoustic Stimulation Acute Adherence Adult Aerobic Exercise Affect Affective Age Alzheimer&apos s Disease Alzheimer&apos s disease risk Behavior Cardiac rehabilitation Dementia Ecological momentary assessment Elderly Exercise Exertion Expenditure Failure Feasibility Studies Fostering Frequencies Future Goals Guidelines Health Benefit Health Care Costs Home Impaired cognition Intervention Maintenance Measures Mediating Mediator Meta-Analysis Motivation Movement Music Outcome Participant Patient Self-Report Periodicity Persons Phase Physical activity Physiologic pulse Population Populations at Risk Psychological Tests Public Health Randomized Research Risk Risk Factors Risk Reduction Sampling Testing Theoretical model Training Translating Walking Withdrawal Work aged auditory stimulus behavior change behavioral response curative treatments design displeasure evidence base exercise intervention exercise program exercise training experience falls hedonic improved innovation lifestyle intervention middle age modifiable risk negative affect non-demented novel novel strategies older patient physical inactivity pleasure prevent programs psychologic response satisfaction strength training success treatment adherence

项目摘要

Project Summary It is predicted that 13.8 million US adults will live with Alzheimer’s disease (AD) by 2050. Physical activity (PA) is imperative to prevent or delay the onset of AD. However, adherence to the national PA guidelines steeply declines after ages 60-65. Fewer than 20% of US older adults adhere to the national guidelines for multicomponent PA - aerobic exercise (AE) at moderate intensity and strength training (ST). Thus, there is an urgent need to promote multicomponent PA among low-active older adults. A major challenge to promoting multicomponent PA is that most older adults experience a negative affective response to moderate-intensity AE and ST. This negative affective response is a critical barrier to maintenance of regular PA because, in general, people are unlikely to continue a behavior that results in immediate displeasure. Interestingly, listening to music during acute bouts of AE and ST increases positive affect and reduces perceived exertion. However, for these benefits to translate to long-term adherence, music alone is not sufficient. In a feasibility study (N=33), walking-for-exercise with a sonically enhanced music playlist in the form of Rhythmic Auditory Stimulation (RAS) – an application of pulsed, tempo-synchronous, auditory stimuli (e.g., beat-accented music) for the facilitation of rhythmic body movement – nearly doubled the weekly volume of PA and caloric expenditure in midlife-to-older patients undergoing cardiac rehabilitation whereas standard music without RAS had little effect on PA outcomes. To date, this proof-of-concept has not been fully tested and the underlying psychological mechanisms of RAS remain unknown. Thus, we propose to test whether RAS enhances affective responses to PA and thereby promotes long-term PA behaviors among older adults. In the R61 and R33 phases, participants will undergo an exercise intervention (EX) consisting of ST for 3 days/week and brisk walking for AE for >150 min/week over 6 months. The EX is designed to foster the independent maintenance of regular PA through a gradual withdrawal of supervised training (3 days/week for 2 months, 1 day/week for 2 months, and unsupervised for 2 months). The independent variable will be random assignment into the EX alone or EX+RAS. In the R61 phase, we will conduct an RCT to explore the preliminary effects of RAS on affective and behavioral responses to the EX among non-demented, low-active, older adults (N=40) aged 65- 79 (Aim 1). Using ecological momentary assessment (EMA), we will test the hypothesis that adding RAS to the EX leads to a more positive affective response to PA, lower perceived exertion, and greater weekly volumes of PA over 6 months. Treatment adherence and satisfaction will be assessed to determine the acceptability of the interventions. If milestones are met, we will proceed to the R33 phase and conduct a fully-powered RCT with the same design and population (N=130). We will retest Aim 1 with this second larger sample and will assess Aim 2 which is a test of the mechanistic hypothesis that the effects of RAS on the weekly volumes of PA are mediated by positive affective response to PA and lower perceived exertion.

项目概要据预测，到 2050 年，美国将有 1380 万成年人患有阿尔茨海默病 (AD)。体育活动 (PA) 对于预防或延缓 AD 的发生至关重要，但是，必须遵守国家 PA 指南。 60-65 岁之后急剧下降，只有不到 20% 的美国老年人遵守国家指导方针。多成分 PA - 中等强度的有氧运动 (AE) 和力量训练 (ST)。迫切需要在低活动老年人中推广多成分 PA，这是推广的一个主要挑战。多成分 PA 是大多数老年人对中等强度的情绪反应有负面反应 AE 和 ST 是维持常规 PA 的一个关键障碍，因为一般来说，人们不太可能继续采取立即引起不满的行为。在 AE 和 ST 急性发作期间听音乐会增加积极情绪并减少感知的努力。在可行性研究中，要将这些益处转化为长期坚持，仅靠音乐是不够的。 (N=33)，步行锻炼，并以节奏听觉形式提供声音增强的音乐播放列表刺激 (RAS) – 脉冲、节奏同步、听觉刺激的应用（例如，节奏重音的音乐）促进有节奏的身体运动 – 每周的 PA 和热量摄入量几乎增加了一倍接受心脏康复的中年至老年患者的支出，而没有 RAS 的标准音乐迄今为止，这一概念验证及其基础尚未得到充分测试。 RAS 的心理机制仍不清楚，因此，我们建议测试 RAS 是否增强。对 PA 的情感反应，从而促进老年人的长期 PA 行为。 R33阶段，参与者将接受为期3天/周的ST和Brisk运动干预（EX） 6 个月内每周步行 150 分钟以上进行 AE EX 旨在促进独立维护。通过逐步取消监督训练（2 个月每周 3 天，2 个月每周 1 天）来减少常规 PA 个月，并且无人监督 2 个月）。自变量将被随机分配到 EX 中。单独或EX+RAS 在R61阶段，我们将进行RCT来探索RAS对的初步影响。 65 岁以下非痴呆、低活跃老年人 (N=40) 对 EX 的情感和行为反应 79（目标 1）。使用生态瞬时评估（EMA），我们将检验将 RAS 添加到 EX 会导致对 PA 的更积极的情感反应、更低的感知消耗以及每周更大的运动量将评估 6 个月以上的治疗依从性和满意度，以确定治疗的可接受性。如果达到里程碑，我们将进入 R33 阶段并进行全面的 RCT 我们将使用第二个更大的样本重新测试目标 1 并进行评估。目标 2 是对 RAS 对每周 PA 量的影响的机制假设的检验由对 PA 的积极情感反应和较低的感知用力介导。