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有意义的和 持续(干预后6个月)平衡和力量改善 这项研究使用了110名平均年龄为79岁的健康受试者。AS 发展平衡和力量干预的下一步 旨在改善功能状态，具有潜在的 广泛使用，我们提出了一个基于社区中心的试验，使用Small 针对体弱者和接近体弱者70岁和 上面。我们最近完成了一项对50名受试者的初步研究， 证明了识别和招募老年人的可行性 功能表现下降，干预的安全性和有效性降低 以及主要结果指标的敏感性和可靠性。我们建议 将142名受试者纳入干预试验，该试验将针对特定的 培训的机动性组成部分。它们是：机械性能 (肌肉力量和柔韧性)、神经控制(平衡、偏心 肌肉控制)和健身(耐力)。我们将首先检查其效果 为期3个月的力量、灵活性和耐力(SFE)计划 然后评估3个月的治疗效果。 平衡和机能训练，同时继续耐力部分 (BFE)。通过SFE实现的增强物理性能可作为 为更复杂的第二个3个月阶段(BFE)奠定基础 强调活动能力、平衡能力和功能活动方面的培训(例如 步行和爬楼梯)。保持更好的体能 将在接下来的12年内通过后续演习计划实现 月份。主要结果将根据以下方面的影响来确定 基线、3个月、6个月、12个月和18个月以及之后的体能测试 完成干预。结果也将在以下方面确定 对平衡和力量的定量测量的影响。一个 这项研究的次要目标是开发一种动态的实验室测量方法 平衡，这将促进我们对 平衡体能表现的变化。

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.