Exercise, stress, and wound healing among older adults

老年人的运动、压力和伤口愈合

• 批准号: 7495518
• 负责人: CHARLES FISKE EMERY
• 金额: $ 46.56万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-15 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7495518
• 关键词: Acute; Address; Aerobic Exercise; Age; Alzheimer' s Disease; Area; Behavior; Behavioral; Biological; Cardiopulmonary; Clinical; Clinical Research; Condition; Control Groups; Data; Dental Students; Dermal; Disease regression; Distress; Elderly; Endocrine; Evaluation; Exercise; Exercise stress test; Family Caregiver; Healed; Health behavior; Hydrocortisone; Immune; Immune system; Immunologics; Impaired wound healing; Incidence; Individual; Infection; Inguinal Hernia; Insulin-Like Growth Factor Binding Protein 3; Insulin-Like Growth Factor I; Insulin-Like Growth-Factor Binding Protein 1; Insulin-Like Growth-Factor-Binding Proteins; Interleukin-6; Intervention; Investigation; Knowledge; Laboratories; Life Stress; Liquid substance; Measures; Mediator of activation protein; Modeling; Monitor; Neurosecretory Systems; Operative Surgical Procedures; Outcome Measure; Oxygen Consumption; Participant; Patient Self-Report; Patients; Pliability; Populations at Risk; Procedures; Process; Production; Psychological Stress; Punch Biopsy; Randomized; Range; Rate; Recruitment Activity; Regulation; Reporting; Research; Research Personnel; Rest; Risk; Salivary; Sampling; Site; Smoking; Social support; Somatropin; Staging; Stimulus; Stress; Stretching; Surgical wound; System; Testing; Time; Week; Woman; Wound Healing; caregiving; cytokine; design; diet and exercise; experience; healing; immune function; improved; men; mortality; programs; psychologic; psychological distress; repaired; wound

DESCRIPTION (provided by applicant): Prior studies have demonstrated that psychological distress delays wound healing. In addition, there is evidence that older adults are at risk for delayed wound healing. Thus, it is particularly important to evaluate strategies for reducing delayed wound healing among older adults who are experiencing distress. Physical exercise is a behavioral approach that may contribute to enhanced wound healing both via influences on psychological functioning and via influences on neuroendocrine and immune parameters relevant for wound healing. This study is designed to evaluate the effect of exercise on wound healing among distressed older adults using a randomized controlled design. Eighty-five men and women ranging in age from 65-85 will be recruited and will undergo a pre-baseline experimental punch biopsy wound. After the wound has healed participants will be randomly assigned to either an aerobic exercise condition (AE) or a stretching and flexibility control condition (SF). Participants will complete assessments of cardiopulmonary endurance, psychological functioning, endocrine function, and immune function at two times: baseline prior to random assignment (T1), and at the conclusion of the 12-week intervention period (T2). Two weeks after the T1 assessment, all participants will return to the study assessment site for a second experimental punch biopsy wound procedure as well as assessments of immune function and cortisol secretion (T1 A). Four weeks later (T1B), participants will complete an additional assessment of immune function and cortisol secretion. Participants will remain in their assigned conditions until completing the T2 assessment. Data will be analyzed with linear mixed modeling and hierarchical regression. It is hypothesized that participants assigned to the AE condition will achieve significant improvements in cardiorespiratory function, decreased psychological distress, and accelerated rates of wound healing compared to the SF participants. In addition, AE participants will experience enhanced regulation of neuroendocrine and immunologic parameters not observed in the SF participants. Results of the study will indicate the degree to which exercise influences wound healing as well as the psychological and biological mechanisms that contribute to the effect of exercise on wound healing. In turn, the results may have- implications for treating older adults who suffer dermal wounds or are recovering from surgery.

描述（由申请人提供）：先前的研究表明，心理困扰会延迟伤口愈合。此外，有证据表明，老年人有延迟伤口愈合的风险。因此，评估减少正在经历痛苦的老年人伤口愈合延迟的策略尤为重要。体育锻炼是一种行为方法，可以通过影响心理功能和影响与伤口愈合相关的神经内分泌和免疫参数来促进伤口愈合。本研究采用随机对照设计，旨在评估运动对痛苦的老年人伤口愈合的影响。将招募85名年龄在65-85岁之间的男性和女性，并将进行基线前实验性穿孔活检伤口。伤口愈合后，受试者将被随机分配到有氧运动条件（AE）或拉伸和灵活性控制条件（SF）。参与者将在两个时间点完成心肺耐力、心理功能、内分泌功能和免疫功能的评估：随机分配前的基线（T1）和12周干预期结束时（T2）。在T1评估后两周，所有参与者将返回研究评估地点进行第二次实验性穿刺活检伤口程序以及免疫功能和皮质醇分泌的评估（T1 A）。四周后（T1 B），参与者将完成对免疫功能和皮质醇分泌的额外评估。受试者将保持在指定条件下，直至完成T2评估。将采用线性混合建模和分层回归分析数据。假设与SF受试者相比，分配至AE状况的受试者将实现心肺功能的显著改善、心理困扰的减少和伤口愈合率的加速。此外，AE受试者将经历SF受试者中未观察到的神经内分泌和免疫学参数调节增强。研究结果将表明运动影响伤口愈合的程度，以及有助于运动对伤口愈合影响的心理和生物机制。反过来，这些结果可能对治疗遭受皮肤伤口或从手术中恢复的老年人有影响。