Developing a Mindfulness Movement Intervention Program for Post-MI Patients

为心肌梗死后患者制定正念运动干预计划

• 批准号: 8584215
• 负责人: Laura S Redwine
• 金额: $ 20.34万
• 依托单位: VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-30 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8584215
• 关键词: Adherence; Aerobic Exercise; Affect; Aftercare; Age; American; American Heart Association; Angina Pectoris; Behavior Therapy; Behavioral; Bicycling; Biological Markers; Blood Pressure; Breathing; Calculi; Cardiac; Cardiovascular system; Chest Pain; Clinical assessments; Data; Development; Diet; Disease; Disease Progression; Distant; Echocardiography; Elderly; Enrollment; Equipment; Ergometry; Event; Exercise; Exploratory/Developmental Grant; Fatigue; Feasibility Studies; Frequencies; Future; Goals; Health behavior; Heart Rate; Heart failure; Home environment; Inflammatory; Intervention; Investigation; Lead; Light; Literature; Location; Measures; Mediation; Medical center; Mental Depression; Mental Health; Metabolic; Minority; Movement; Myocardial; Myocardial Infarction; Oxygen Consumption; Participant; Patient Recruitments; Patients; Personal Satisfaction; Physical Function; Physical activity; Protein C Inhibitor; Psychological Factors; Pump; Quality of life; Randomized; Recovery; Recruitment Activity; Recurrence; Rehabilitation therapy; Reporting; Research; Risk Factors; Shortness of Breath; Sleep; Special Equipment; Speed; Stress; Symptoms; Tai Ji; Task Performances; Techniques; Testing; Time; Training; Travel; Treatment Effectiveness; United States National Institutes of Health; Visit; Walking; Woman; Work; anakinra; arm; base; cardiovascular risk factor; clinical care; cohort; comorbidity; depressive symptoms; ethnic minority population; expectation; experience; fitness; follow-up; improved; innovation; interest; intervention program; medication compliance; meetings; men; mindfulness; outcome forecast; programs; psychologic; psychosocial; public health relevance; rehabilitation service; satisfaction; sedentary; standard of care; tool; treatment adherence; trend

DESCRIPTION (provided by applicant): Each year around 785,000 Americans endure a first myocardial infarction (MI) and 470,000 will have a recurrent event. The American Heart Association (AHA) recommends exercise-based cardiac rehabilitation (CR) for reductions in subsequent cardiac events. Despite the benefits of CR, only 14-35% of eligible MI patients participate in CR. Patients with co-morbidities, women, older adults, and ethnic minorities are least likely to utilize CR services. Many medical centers do not have CR programs and patients have to travel to distant locations to undergo CR. In turn, many Tai Chi interventions, have been studied in elderly cohorts, require no expensive equipment, can be practiced at home, and is well tolerated across fitness levels, and co-morbidities. Tai Chi increases heart rate (56% to 65% of maximum), oxygen consumption and lactate accumulation, signifying that Tai Chi serves as an aerobic exercise of low to moderate intensity. However, no Tai Chi studies in post-MI patients have employed state-of-the-art measures of cardiac function and exercise capacity and therefore it is unclear whether Tai Chi has similar benefits as CR during a period of myocardial recovery. The proposed study would employ tools including echocardiograms, heart rate recovery, and bicycle ergometry, which have been used in many CR studies to assess the effectiveness of treatment. This study is also innovative in that it specifically targets patients who have not opted to participate in a formal CR program within 30 days of a first-time MI and emphasizes recruitment of patients spanning an older age range, physical function ability, women and minorities. A total of 75 men and women with a first time MI will be randomly assigned to 4 months of Tai Chi training composed of 20 meditative movements or to standard of care (SOC). Clinical assessments will be performed over a six-month period, with testing occurring before, mid-way, and after 4 months of treatments, and at an 8 week follow-up. Our current goal is to gather preliminary data on study feasibility, acceptability and to find indicatins of improvements in physical, cardiac and psychological/behavioral factors. If the aims are met from this exploratory/development study, a future large scale study will be undertaken to confirm Tai Chi's efficacy in post-MI patients. Such research is critically needed so adequate rehabilitative interventions can be developed for diverse MI patients.

描述（由申请人提供）：每年约有785,000名美国人忍受第一个心肌梗塞（MI），而470,000人将发生反复发生的事件。美国心脏协会（AHA）建议在随后的心脏事件中减少基于运动的心脏康复（CR）。尽管有CR的好处，但只有14-35％的合格MI患者参加了CR。合并症，妇女，老年人和少数民族的患者最不可能利用CR服务。许多医疗中心没有CR计划，患者必须前往遥远的地方进行CR。反过来，许多太极拳干预措施已经在老年人群中进行了研究，不需要昂贵的设备，可以在家中实践，并且在健身水平和合并症的范围内耐受性良好。太极拳增加了心率（最大最大的56％至65％），氧气消耗和乳酸积累，这表明太极汽车是低至中等强度的有氧运动。但是，在MI后患者中，没有达到最先进的心脏功能和运动能力的措施，因此尚不清楚Tai Chi在心肌恢复期间是否具有与CR相似的好处。拟议的研究将采用包括超声心动图，心率恢复和自行车测量法在内的工具，这些工具已在许多CR研究中用于评估治疗的有效性。这项研究也具有创新性，因为它专门针对未选择在首次使用MI的30天内参加正式CR计划的患者，并强调招募跨越年龄段，身体功能能力，妇女和少数群体的患者。共有75名MI的男女将随机分配给4个月的太极训练，由20种冥想运动或标准护理（SOC）组成。临床评估将在六个月的时间内进行，在治疗4个月之前，中间和4个月后进行测试，并进行8周的随访。我们目前的目标是收集有关研究可行性，可接受性的初步数据，并找到改善身体，心理和心理/行为因素的指示素。如果从这项探索/发展研究中实现了目标，将进行未来的大规模研究，以确认Tai Chi在MI后患者中的功效。这种研究至关重要，因此可以为多种MI患者开发适当的康复干预措施。