Transforming Exercise Testing and Physical Activity Assessment in Children: New Approaches to Advance Clinical Translational Research in Child Health

改变儿童运动测试和体力活动评估：推进儿童健康临床转化研究的新方法

• 批准号: 10251868
• 负责人: DAN M COOPER
• 金额: $ 130.08万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-17 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10251868
• 关键词: Accelerometer; Address; American; Biological Markers; Blood; Body Composition; Brain imaging; California; Cardiopulmonary; Cardiovascular Diseases; Caregivers; Child; Child Health; Child health care; Childhood; Chronic Disease; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Communities; Cystic Fibrosis; Data; Data Analytics; Data Collection; Data Reporting; Development; Disease; Ensure; Evaluation Studies; Exercise; Exercise Test; Faculty; Functional disorder; Future; Gene Expression; Genes; Goals; Grant; Growth; Health; Health Personnel; Human; Impairment; Inflammation; Informatics; Institutes; Knowledge; Laboratories; Life; Link; Logistics; Longevity; Los Angeles; Measures; Medicine; Metabolism; Methods; Multicenter Studies; Multicenter Trials; Outcome; Participant; Pathologic; Pattern; Pediatric Hospitals; Personal Satisfaction; Physical Fitness; Physical activity; Physiological; Play; Prospective cohort study; Protocols documentation; Recording of previous events; Reference Values; Reproducibility; Research; Research Personnel; Rest; Role; Science; Semantics; Sickle Cell Anemia; Signal Transduction; Site; Societies; Sports Medicine; Technology; Test Result; Testing; Translational Research; Underserved Population; United States National Institutes of Health; Universities; Work; base; biomarker discovery; circulating biomarkers; clinical application; clinical practice; cohort; collaboratory; college; comparison group; critical period; data exchange; data harmonization; data repository; disorder prevention; disorder risk; early detection biomarkers; fitness; fitness test; improved; indexing; innovation; insight; interoperability; laboratory experiment; novel; novel strategies; prevent; recruit; syntax

Children are the most naturally physically active human beings; reduced physical activity is a cardinal sign of childhood disease, and exercise testing provides mechanistic insights into health and disease that are often hidden when the child is at rest. Despite this, and because data analytics and testing protocols have failed to keep pace with enabling technologies and computing capacity, biomarkers of fitness and physical activity have yet to be widely incorporated into translational research and clinical practice in child health. The goal of this project is to address the obstacles that have impeded optimal use of cardiopulmonary exercise testing (CPET) in children. Aim 1 is to rethink and transform current clinical research applications of typical CPET in children by novel implementation of breath-by-breath technologies and data analytic approaches. Aim 2 is to develop new exercise testing protocols (multiple brief exercise bouts) that more closely mimic real-life patterns of physical activity and, in so doing, better assess relevant pathophysiology. Aim 3 is to identify and overcome logistical issues that have limited multicenter studies involving exercise biomarkers. Our use-cases, sickle cell disease and cystic fibrosis, highlight how very different diseases can impair exercise and physical activity. The value of the new CPET approaches will be analyzed in a variety of ways, including by: 1) established indexes of health (e.g., body composition), 2) habitual physical activity, an emerging metric of overall health, and 3) novel exercise-responsive gene expression signals in the circulating blood. In combination with healthy children as comparisons, our project will delineate the use of CPET biomarkers across a broad spectrum of pediatric health and disease. We will take advantage of the grant cycle and study cohorts prospectively as our participants grow and mature from Tanner 2–3 to 5, roughly a 3-year interval. This provides the unique opportunity to study CPET longitudinally in health and disease over a critical period of growth. Our team represents the diverse and challenging array of academic health centers and affiliated stand-alone children’s hospitals often involved in multicenter pediatric translational research: 1) University of California at Irvine Institute for Clinical and Translational Science, 2) Northwestern University Clinical and Translational Sciences Institute, and 3) the Southern California Clinical and Translational Science Institute, Children’s Hospital of Los Angeles, University of Southern California. Each of these centers is committed to underserved populations. In addition, we will collaborate with the North American Society of Pediatric Exercise Medicine and the American College of Sports Medicine, each dedicated to advancing exercise-as-medicine in children. Through our proposed: 1) innovations in data analytics of commonly used CPET, 2) developing new testing paradigms, 3) providing the research community with essential data to determine statistical power and analytic approaches specific for exercise biomarkers, and 4) improving interoperability in multicenter trials, the project will stimulate child health clinical research in which exercise biomarkers are used as key outcome variables.

儿童是体力活动最活跃的人；体力活动减少是身体活动减少的一个重要标志。 儿童疾病和运动测试提供了对健康和疾病的机制见解，这些通常是 尽管如此，因为数据分析和测试协议未能做到这一点。 与支持技术和计算能力保持同步，健身和身体活动的生物标志物已经 尚未广泛纳入儿童健康的转化研究和临床实践中。 该项目旨在解决阻碍心肺运动测试（CPET）最佳使用的障碍 目标 1 是重新思考和转变当前典型 CPET 在儿童中的临床研究应用。 通过新颖地实施逐次呼吸技术和数据分析方法，目标 2 是开发。 新的运动测试方案（多次简短的运动）更接近地模仿现实生活模式 体力活动，并在此过程中更好地评估相关的病理生理学，目标 3 是识别和克服。 后勤问题限制了涉及生物标志物运动的多中心研究。 疾病和囊性纤维化，强调了不同的疾病如何损害运动和身体活动。 新 CPET 方法的价值将以多种方式进行分析，包括： 1) 既定指标 健康状况（例如身体成分），2) 习惯性身体活动，一种新兴的整体健康指标，以及 3) 循环血液中新的运动反应基因表达信号与健康相结合。 作为比较，我们的项目将描述 CPET 生物标志物在广泛领域的使用 我们将利用资助周期和前瞻性研究队列作为我们的研究对象。 参与者从坦纳 2-3 岁到 5 岁成长和成熟，大约有 3 年的时间间隔，这提供了独特的机会。 我们的团队有机会在成长的关键时期纵向研究 CPET 的健康和疾病。 代表了多样化且具有挑战性的学术健康中心和附属独立儿童中心 经常参与多中心儿科转化研究的医院： 1) 加州大学欧文分校 临床与转化科学研究所，2）西北大学临床与转化科学研究所 研究所，以及 3) 南加州临床和转化科学研究所、洛杉矶儿童医院。 南加州大学安吉利斯分校的每个中心都致力于服务服务不足的人群。 此外，我们将与北美儿科运动医学会和美国儿童运动医学会合作 运动医学学院，每个学院都致力于通过我们的运动医学来推进儿童运动。 建议：1) 常用 CPET 数据分析的创新，2) 开发新的测试范例，3) 为研究界提供基本数据以确定统计功效和分析方法 针对运动生物标志物，以及 4）提高多中心试验的互操作性，该项目将刺激 儿童健康临床研究，其中运动生物标志物被用作关键结果变量。