TRAINING PHYSICAL PERFORMANCE TO IMPROVE FUNCTION

我们目前的13周，高强度，基于实验室的平衡和/或 力量训练干预试验产生了一个有意义的， 平衡和力量持续改善（干预后6个月） 在一项针对110名平均年龄为79岁的健康受试者的研究中，作为 平衡和力量干预发展的下一步 旨在改善功能状态， 广泛使用，我们提出了一个基于社区中心的试验，使用小 针对70岁以上体弱和接近体弱者的团体， 以上我们最近完成了一项试验性研究， 查明和征聘有能力的老年人的可行性得到证明 干预措施的功能性能、安全性和有效性降低 以及主要结局指标的敏感性和可靠性。我们建议 招募142名受试者参加干预试验， 培训的流动性。它们是：机械性能 （肌肉力量和灵活性），神经控制（平衡，偏心 肌肉控制）和健身（耐力）。我们先来看看 为期3个月的力量，灵活性和耐力（SFE）计划， 性能和功能，然后评估3个月的效果， 平衡和功能训练，同时继续进行耐力训练 （BFE）。从SFE实现的增强的物理性能充当 第二个更复杂的3个月阶段（BFE）的基础， 强调在流动性，平衡和功能活动（例如， 步行和爬楼梯）。保持改善的体能 将在未来12年内通过后续锻炼计划实现 个月主要结局将根据对以下方面的影响来确定： 基线、3个月、6个月、12个月和18个月及之后的体能测试 完成干预。结果也将取决于 对平衡和力量的定量测量的影响。一 研究的第二个目的是开发一种动态的实验室测量方法， 平衡，这将促进我们对 平衡身体机能的变化。

Our current 13 week, high intensity, laboratory-based balance and/or strength training intervention trial has produced a meaningful and sustained (6 month post-intervention) improvement in balance and strength in a study using 110 healthy subjects with an average age of 79 years. As the next step in the development of a balance and strength intervention geared towards improving functional status with the potential for widespread use, we propose a community-center based trial using small groups which is directed at frail and near frail persons 70 years and above. We have recently completed a pilot study of 50 subjects which demonstrated feasibility of identifying and recruiting older persons with decreased functional performance, safety and efficacy of the intervention and sensitivity and reliability of primary outcome measures. We propose to enroll 142 subjects into an intervention trial which will target specific components of mobility for training. These are: mechanical performance (muscle force and flexibility), neurologic control (balance, eccentric muscle control), and fitness (endurance). We will first examine the effect of a 3-month strength, flexibility and endurance (SFE) program on performance and function, and then evaluate the effect of 3 months of balance and functional training, while continuing with endurance component (BFE). The augmented physical performance realized from SFE serves as the foundation for the 2nd, more complex, 3 month phase (BFE), which emphasizes training in mobility, balance and functional activities (e.g. walking and stair climbing). Maintenance of improved physical capability will be achieved with a follow-up exercise program over the next 12 months. The primary outcome will be determined in terms of the effects on physical performance tests at baseline, 3, 6, 12 and 18 months and after completion of the intervention. Outcome will also be determined in terms of the effect on quantitative measures of balance and strength. A secondary aim of the study is to develop a laboratory measure of dynamic balance which will advance our understanding of the contribution of balance to changes in physical performance.