Complications and Restoration of Functional Mobility and Balance Impairment in NADCs (HIV/AIDS/Aging/Cancer)

NADC（艾滋病毒/艾滋病/衰老/癌症）中功能活动性和平衡障碍的并发症和恢复

基本信息

批准号：
10617574
负责人：
KEVIN J. CULLEN
金额：
$ 25.1万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-08-08 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10617574
关键词：
3-Dimensional AIDS/HIV problem Acceleration Address Adherence Administrative Supplement Adult Aging Area Attenuated Balance training Biological Markers Biomechanics Bone Density Cancer Burden Cancer Center Support Grant Cancer Survivor Cardiovascular system Chronic Clinical assessments Complex Data Diagnosis Disabled Persons Disease Elderly Engineering Equilibrium Fatigue Functional disorder Future Gait Geroscience HIV HIV Infections HIV diagnosis Impairment Incidence Individual Infection Intervention Investigation Knowledge Lead Link Malignant Neoplasms Malignant neoplasm of lung Malignant neoplasm of prostate Metabolic Methodology Modeling Muscle Muscular Atrophy Neurologic Older Population Osteopenia Osteoporosis Outcome Patients Performance Persons Physical Function Physical activity Population Posture Premature aging syndrome Process Public Health Randomized Controlled Trials Regimen Research Secondary to Skeletal Muscle Techniques Technology Time Training Programs Walking Weight adverse outcome age related antiretroviral therapy cancer diagnosis clinically relevant co-infection comorbidity design equilibration disorder evidence base exercise capacity fall risk falls feasibility testing fracture risk frailty functional independence functional restoration improved indexing instrumental activity of daily living multi-component intervention novel patient population programs ranpirnase recruit reduced muscle mass socioeconomics strength training walking speed

项目摘要

PROJECT SUMMARY Non–AIDS-defining cancers (NADC) are increasing rapidly and constitute the majority of cancers diagnosed in people living with HIV (PLWH). Accelerated aging in HIV and cancer lead to compromised skeletal muscle, which contribute to poor functional mobility and culminates in frailty and comorbidity. Frailty and balance impairment are common in patients with cancer and in PLWH. The insult to balance in the setting of a NADC diagnosis in conjunction with HIV infection, is very likely compounded, leading to greater frailty outcomes compared to PLWH as well as increased risk for fracture. Balance deficits impose limitations and can impede safe walking contributing to falls and falls-related complications. Our pilot data indicate that PLWH have highly impaired standing balance that is associated with inefficient weight transfer and an inability to regulate balance leading to greater fall risk. This study will use new quantitative methodologies including state-of-art technologies and engineering models to quantify functional balance, both the static and dynamic domains beyond established clinical assessment battery. These biomechanical indices may help predict frailty precursors to better understand how cancer, HIV infection and aging exacerbate each other, and could potentially inform management of mobility disorders in this patient population. Interventions to improve key aspects of balance control are likely to favorably impact safe functional mobility while performing everyday activities. A primary question at this juncture in our knowledge is whether a multi-component balance program can improve functional independence in those aging with NADC through attenuating the disabling consequences of frailty, which will inform future evidence-based multi-component interventions. This is an administrative supplement for P30 Cancer Centers Support Grants (CCSG) to stimulate research in NADCs in Aging Populations under a High Priority topic of research. Our overall objective is to comprehensively assess and compare balance and mobility in older NADC to older PLWH without NADC of similar socioeconomic background and to test the feasibility of a resistance and balance training program to improve balance, strength and physical activity. The proposed research has significant public health impact and will provide critical pilot data for a larger randomized controlled trial. Improvement of strength and postural stability is a significant and novel area of investigation in NADC.

项目摘要定义癌症（NADC）正在迅速增加，构成大多数癌症在艾滋病毒（PLWH）的患者中被诊断出。艾滋病毒和癌症加速衰老导致受损骨骼肌，导致功能性迁移率不佳，并在脆弱和合并症中达到顶峰。脆弱在癌症和PLWH患者中，平衡损伤很常见。在环境中平衡的伤害 NADC诊断与艾滋病毒感染结合的诊断很可能更复杂，导致更大的脆弱性与PLWH相比，结果以及骨折风险增加。平衡定义了局限性，并可能阻碍安全的步行，从而导致跌倒和跌倒有关并发症。我们的飞行员数据表明，PLWH具有与效率低下的体重转移和无法调节平衡，导致更大的跌倒风险。这项研究将使用新的定量方法，包括量化功能的最先进技术和工程模型平衡静态和动态域以外的临床评估电池。这些生物力学指数可能有助于预测脆弱的前体，以更好地了解癌症，艾滋病毒感染和衰老互相加剧，并有可能告知该患者的流动性障碍人口。改善平衡控制关键方面的干预措施可能会对安全功能产生有益的影响在每天的活动中进行流动性。在我们所知的这个关头，一个主要问题是多组分平衡计划可以通过NADC通过NADC衰老的人的功能独立性减轻脆弱的残疾后果，这将为未来的循证多组件提供信息干预措施。这是P30癌症中心支持补助金（CCSG）的行政补充，以刺激研究在较高的研究主题下，在NADC中的NADC。我们的总体目标是全面评估和比较较旧的NADC的平衡和流动性，而没有NADC 类似的社会经济背景，并测试抵抗和平衡培训计划的可行性改善平衡，力量和体育锻炼。拟议的研究具有重大的公共卫生影响并将为更大的随机对照试验提供关键的试点数据。力量和姿势的改善稳定性是NADC的重要且新颖的投资领域。