Home-based vs. Supervised Exercise for Claudicants

跛行者在家锻炼与监督锻炼

• 批准号: 7279455
• 负责人: Andrew W Gardner
• 金额: $ 29.16万
• 依托单位: UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7279455
• 关键词: Activities of Daily Living; Address; Adherence; Adopted; Affect; Age-Years; Attention; Blood Circulation; Blood Vessels; Blood flow; Buttocks; Clinical Management; Clinical Trials Design; Communities; Control Groups; Controlled Clinical Trials; Daily; Data Reporting; Elderly; Equilibrium; Event; Exercise; Expenditure; Functional disorder; Gait; Goals; High Prevalence; Home environment; Intermittent Claudication; Intervention; Life Style; Light; Lower Extremity; Measures; Mediating; Methods; Monitor; Morbidity - disease rate; Muscle; Numbers; Older Population; Outcome; Pain; Patients; Peripheral; Peripheral arterial disease; Physical Function; Physical activity; Physiological; Protocols documentation; Publishing; Quality of life; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Rehabilitation therapy; Research; Research Design; Research Personnel; Resistance; Resources; Sample Size; Standards of Weights and Measures; Technology; Therapeutic; Thigh structure; Time; Training; Treadmill Tests; Walking; Week; base; claudication; clinically significant; design; disorder control; falls; functional status; health related quality of life; improved; new technology; programs; prospective; sedentary

DESCRIPTION (provided by applicant): Broad, Long-Term Objective. To make a significant impact in the clinical management of PAD patients with intermittent claudication by determining whether home-based exercise can be used to treat symptomatology. Rationale. In contrast to supervised exercise programs, home-based exercise for PAD patients with intermittent claudication is poorly understood due to serious flaws in the research approach of previous trials. Specific Aims. (1) This trial will compare the changes in ambulatory function, vascular function, and health- related quality of life in PAD patients limited by intermittent claudication following a home-based exercise rehabilitation program, a supervised exercise program, and an attention-control group who perform light resistance training exercise, and (2) to determine whether changes in walking economy, calf muscle circulation, and calf muscle oxygenation are the major physiologic mechanisms by which both home-based and supervised exercise rehabilitation improve ambulatory function. Research Design and Methods. A prospective, randomized controlled clinical trial will compare a home-based exercise group (N = 37), a supervised exercise group (N = 37), and an attention-control group (N = 37). The two exercise programs will be matched on the estimated caloric expenditure during the training sessions. The 3-month supervised program will consist of graded treadmill walking 3 times per week, and the 3-month home-based program will consist of community-based walking 3 times per week. Walking duration will be longer for the home-based group because the intensity of walking will be lower than the supervised group. Matching on volume of exercise will be done using new technology (step activity monitor) to accurately record community-based ambulation on a minute-to-minute basis for up to a month, and then titrating the caloric expenditure against cadence for each patient during the home-based training sessions. Patients in the attention-control group will perform light-resistance training without any walking exercise. Clinical Significance. This randomized controlled clinical trial will support the notion that home-based exercise can be used to treat PAD patients with intermittent claudication, and will be generalizable to the vast majority of patients who do not have access to a supervised exercise program, but who can benefit from a home-based walking program with minimal intervention from clinicians and minimal use of resources.

描述（由申请人提供）：广泛的长期目标。通过确定是否可以使用基于家庭的运动来治疗症状学，对PAD患者的临床管理产生重大影响。理由。与受监督的运动计划相反，由于先前试验的研究方法中的严重缺陷，理解为间歇性lau不平的PAD患者的家庭锻炼知之甚少。具体目标。 (1) This trial will compare the changes in ambulatory function, vascular function, and health- related quality of life in PAD patients limited by intermittent claudication following a home-based exercise rehabilitation program, a supervised exercise program, and an attention-control group who perform light resistance training exercise, and (2) to determine whether changes in walking economy, calf muscle circulation, and calf muscle oxygenation are the major physiologic mechanisms by which both home-based and监督运动康复改善了门诊功能。研究设计和方法。前瞻性，随机对照临床试验将比较家庭运动组（n = 37），监督运动组（n = 37）和一个注意力控制组（n = 37）。这两个练习计划将与培训期间的估计热量支出相匹配。为期3个月的监督计划将包括每周3次的跑步机步行，为期3个月的家庭计划将包括基于社区的步行3次。对于家庭组的小组来说，步行持续时间将更长，因为步行的强度将低于监督组。将使用新技术（步骤活动监视器）进行锻炼数量的匹配，以每分钟至分钟的时间准确地记录一个基于社区的移动，以期最多一个月，然后在家庭培训期间滴定每个患者的节奏的热量支出。注意力控制组中的患者将在没有任何步行运动的情况下进行轻度抗性训练。临床意义。这项随机对照临床试验将支持以下观点：基于家庭的运动可用于治疗间歇性lau不平的PAD患者，并且可以推广到绝大多数无法获得监督运动计划的患者，但可以从临床医生的最小干预中受益于家庭步行计划，而临床医生的最小使用和最少的资源使用。