Maintaining Resistance Training in Older Prediabetic Adults: Theoretical Approach

老年糖尿病前期患者维持阻力训练：理论方法

• 批准号: 8531226
• 负责人: BRENDA M DAVY
• 金额: $ 56万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8531226
• 关键词: Activities of Daily Living; Adherence; Adult; Aerobic; Affect; Aging; Area; Behavior Therapy; Behavioral; Beta Cell; Body Weight decreased; C-Peptide; Cells; Clinical Trials; Communities; Data; Diabetes Mellitus; Diabetes prevention; Digestive System Disorders; Disease; Elderly; Exercise; Exhibits; Family; Fatty acid glycerol esters; Generic Drugs; Glucose; Glycogen (Starch) Synthase; Health; Health Benefit; Healthy People 2010; Homeostasis; Impaired fasting glycaemia; Individual; Informal Social Control; Institutes; Insulin; Intervention; Investments; Kidney Diseases; Maintenance; Measures; Mediating; Metabolic; Modality; Modeling; Muscle; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Oral; Outcome; Outcome Measure; Phase; Phase II Clinical Trials; Physical activity; Population; Prediabetes syndrome; Prevalence; Prevention Research; Prevention strategy; Property; Protocols documentation; Public Health; Randomized; Reporting; Research; Resistance; Risk; SLC2A1 gene; Self Efficacy; Specificity; Supervision; Time; Training; Woman; Work; aged; base; blood glucose regulation; density; disability; disorder prevention; fasting glucose; fitness; glucose tolerance; impaired glucose tolerance; improved; inclusion criteria; indexing; insulin sensitivity; meetings; men; primary outcome; programs; sarcopenia; skills; social cognitive theory; strength training; theories

DESCRIPTION (provided by applicant): The aim of this Phase II Clinical Trial is to demonstrate the efficacy of social cognitive theory (SCT) based intervention for initiating, and most importantly, maintaining resistance training in older adults with pre-diabetes (i.e., impaired glucose tolerance or impaired fasting glucose) to improve glucose homeostatis. The overall aim is consistent with NIDDK's Behavioral/Prevetion Research Program's forcus on individual, family, and community-based strategies for prevention of diabetes and its complications. Resistance training is particularly applicable to older, prediabeteic adults given the loss of lean body mass and worsening of glucose tolerance with aging. The proposed research program evaluates a 15-month SCT based intervention for maintenance of resistance training with older adults. Men and women 50-69 (N=220) with pre-diabetes, defined as exhibiting either impaired glucose tolerance (IGT; 2-h glucose 140-199 mg/dl) or impaired fasting glucose (IFG; 100-125 mg/dl), will first follow the same standard, supervised 3-month initiation period with resistance training. All people completing the Initial Phase will be randomly assigned to 1 of 3 maintenance conditions: 1. a long-term SCT based, ASPIRE intervention, emphasizing self-regulation and other SCT strategies to optimize training, with faded contact; 2. a long-term Generic intervention lacking a number of SCT components but with the same faded contact, or, 3. a Standard intervention with more minimal contact. The primary outcome measures are indices of pre-diabetes (glucose tolerance and fasting glucose concentration) and strength. Secondary measures include adherence; ss-cell responsivity, insulin sensitivity, and disposition index, as determined by the oral glucose and C-peptide minimal model; fat free mass, other indicators of health and metabolic fitness, and SCT measures. Assessments will occur at baseline, at the end of the Initiation Phase (3 months), at the end of the different interventions (9 months) and 6 months after all contact has ended (15 months from baseline). It is hypothesized that SCT based resistance training with faded contact will produce better outcomes than Generic based training with faded contact, which in turn, will produce better outcomes than Standard-based resistance training at 9 month and 15 month assessments. It also is hypothesized that improvements in glucose homeostasis and in strength from resistance training will be mediated by adherence, self-efficacy, and use of self-regulation strategies. Resistance training has become an important component in the treatment and prevention of diseases and disabilites, and especially so for Type 2 diabetes. Critical to public health and a focus of NIDDK are theory-based interventions that enable, effective long-term resistance training with minimal supervision after an initiation phase and where improvements in adherence and outcomes are facilitated by theoretical constructs.

描述（由申请人提供）：这项II期临床试验的目的是证明基于社会认知理论（SCT）干预的有效性，以启动，最重要的是，维持糖尿病前期老年人（即糖耐量受损或空腹血糖受损）的阻力训练，以改善葡萄糖稳态。总体目标与NIDDK的行为/预防研究项目的重点是个人、家庭和社区预防糖尿病及其并发症的策略一致。抗阻训练特别适用于年龄较大的糖尿病前期成年人，因为他们的瘦体重会随着年龄的增长而下降，葡萄糖耐量也会随着年龄的增长而恶化。拟议的研究项目评估了15个月的基于SCT的干预，以维持老年人的阻力训练。50-69岁（N=220）患有糖尿病前期的男性和女性，定义为表现出葡萄糖耐量受损（IGT； 2小时葡萄糖140-199 mg/dl）或空腹葡萄糖受损（IFG; 100-125 mg/dl），将首先遵循相同的标准，在监督下进行3个月的阻力训练。所有完成初始阶段的人将被随机分配到三种维护条件中的一种：长期以SCT为基础，采用ASPIRE干预，强调自我调节等SCT策略优化训练，与消退接触；2. 一种长期的通用干预，缺乏一些SCT成分，但有相同的褪色接触；标准干预，尽量减少接触。主要结局指标是糖尿病前期指标（葡萄糖耐量和空腹葡萄糖浓度）和强度。次要措施包括依从性；通过口服葡萄糖和c肽最小模型测定的细胞反应性、胰岛素敏感性和处置指数；无脂肪量，其他健康和代谢适应度指标，以及SCT测量。评估将在基线、启动阶段结束时（3个月）、不同干预措施结束时（9个月）和所有接触结束后6个月（距基线15个月）进行。假设在9个月和15个月的评估中，基于SCT的接触消失的阻力训练将比基于通用的接触消失的训练产生更好的结果，而后者将比基于标准的阻力训练产生更好的结果。也有假设认为，葡萄糖稳态的改善和阻力训练的力量将通过坚持、自我效能和使用自我调节策略来调节。抗阻训练已成为治疗和预防疾病和残疾的重要组成部分，特别是对2型糖尿病。对公共卫生至关重要和NIDDK的重点是基于理论的干预措施，这些干预措施能够在启动阶段后进行有效的长期阻力训练，并在最小的监督下，通过理论构建促进依从性和结果的改善。

项目成果

Questionnaires for outcome expectancy, self-regulation, and behavioral expectation for resistance training among young-old adults: development and preliminary validity.

年轻老年人阻力训练的结果预期、自我调节和行为预期问卷：发展和初步有效性。

• DOI: 10.1123/japa.2013-0184
• 发表时间: 2015
• 期刊: Journal of aging and physical activity
• 影响因子: 1.5
• 作者: Williams,DavidM;Savla,Jyoti;Davy,BrendaM;Kelleher,SarahA;Marinik,ElainaL;Winett,RichardA
• 通讯作者: Winett,RichardA

Uncomplicated resistance training and health-related outcomes: evidence for a public health mandate.

• DOI: 10.1249/jsr.0b013e3181e7da73
• 发表时间: 2010-07
• 期刊: Current sports medicine reports
• 影响因子: 1.8
• 作者: Phillips SM;Winett RA
• 通讯作者: Winett RA

Adapting the "Resist Diabetes" Resistance Training Intervention for Veterans.

• DOI: 10.1249/tjx.0000000000000118
• 发表时间: 2020-03
• 期刊: Translational journal of the American College of Sports Medicine
• 影响因子: 0.9
• 作者: VanDerBrink E;Boshra S;Harden SM;Oursler KK;Winett R;Davy B
• 通讯作者: Davy B

Theory-based approach for maintaining resistance training in older adults with prediabetes: adherence, barriers, self-regulation strategies, treatment fidelity, costs.

用于维持老年糖尿病前期患者阻力训练的基于理论的方法：依从性、障碍、自我调节策略、治疗保真度、成本。

• DOI: 10.1007/s13142-015-0304-5
• 发表时间: 2015
• 期刊: Translational behavioral medicine
• 影响因子: 3.6
• 作者: Winett,RichardA;Davy,BrendaM;Savla,Jyoti;Marinik,ElainaL;Kelleher,SarahA;Winett,SheilaG;Halliday,TanyaM;Williams,DavidM
• 通讯作者: Williams,DavidM

Resistance training is associated with spontaneous changes in aerobic physical activity but not overall diet quality in adults with prediabetes.

阻力训练与有氧运动的自发变化相关，但与糖尿病前期成人的整体饮食质量无关。

• DOI: 10.1016/j.physbeh.2017.04.013
• 发表时间: 2017
• 期刊: Physiology & behavior
• 影响因子: 2.9
• 作者: Halliday,TanyaM;Savla,Jyoti;Marinik,ElainaL;Hedrick,ValisaE;Winett,RichardA;Davy,BrendaM
• 通讯作者: Davy,BrendaM