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The Effect of High Intensity Walking on Frailty

高强度步行对虚弱的影响

基本信息

批准号：
9767004
负责人：
Margaret K Danilovich
金额：
$ 33.97万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2019-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9767004
关键词：
Accelerometer Address Adopted Adult Adverse event Affect Age Ambulatory Monitoring Animal Model Balance training Body Weight decreased Categories Cessation of life Clinical Cluster randomized trial Communities Data Dependence Diagnosis Elderly Equilibrium Fatigue Frail Elderly Gait speed Guidelines Health Health Benefit Health Care Costs High Prevalence Hospitalization Hour Impairment Individual Institutionalization Intervention Knowledge Maximum Heart Rate Measures Mus Nursing Homes Outcome Participant Phase Physical Exercise Physical Function Physical Performance Physical activity Pilot Projects Population Prevalence Ramp Randomized Randomized Controlled Trials Recommendation Reporting Retirement Risk Site Speed Strenuous Exercise Supervision Syndrome Testing Therapeutic Therapeutic Intervention Vulnerable Populations Walking Woman Work base dementia risk experience fall risk falls frailty health care service utilization healthy aging high risk improved improved functioning improved mobility instrument low socioeconomic status mortality multi-component intervention primary outcome public health priorities response secondary outcome sedentary lifestyle skills treatment strategy walking intervention walking program walking speed

项目摘要

PROJECT SUMMARY Frailty impacts up to 60% of older adults and is a leading cause of dependency among older adults. Frail older adults experience physical problems such as balance difficulties, weakness, decreased endurance, and reduced walking speed that increase risk for falls, hospitalizations, institutionalization, and death. Physical activity has multi-system health benefits and is the most recommended frailty management intervention, but guidelines regarding the specific intensity of physical activity remain unclear. High intensity physical activity is an established and safe therapeutic approach in other populations, but it is unclear as to the extent to which high intensity activity can reduce or reverse frailty. This cluster-randomized study will compare a high intensity walking (HIW) intervention to a self-selected, casual speed walking (CSW) intervention implemented within retirement communities for pre-frail and frail older adults. We will randomize 10 retirement communities with 20 participants at each site (200 total participants) to either a 4-month HIW or CSW intervention. All participants will receive 48, individually supervised overground walking sessions occurring within their retirement community. At the beginning and end of the study, we will measure participants’ frailty, mobility, physical functioning, balance, and total physical activity measured via an ActivPal accelerometer worn for a 1-week observation period to compare which treatment strategy, HIW or CSW, worked better to reduce frailty (aim #1). We will use the SHARE-Frailty Instrument to evaluate frailty as both a categorical (e.g. non-frail, pre-frail, or frail) and a continuous outcome. This approach will allow us to determine how participants move between frailty categories as well as within frailty categories in response to intervention. In aim #2, we will determine the effect of walking intensity on mobility, physical functioning, balance, and total physical activity. We hypothesize that HIW participants will show decreased frailty and improved mobility, physical functioning, balance, and physical activity at 4 months. Currently, the optimal physical activity guidelines for older adults with frailty are uncertain. Results from this study will provide important knowledge to inform activity guidelines for older adults with frailty and information on a transformative approach to reducing frailty, improving function, and increasing physical activity among a growing segment of the older adults population.

项目摘要虚弱影响高达60%的老年人，是老年人依赖的主要原因。虚弱老年人经历身体问题，如平衡困难，虚弱，耐力下降，降低行走速度，增加福尔斯、住院、机构化和死亡的风险。物理活动具有多系统健康益处，是最推荐的虚弱管理干预措施，但关于体力活动具体强度的指导方针仍不明确。高强度的体力活动是在其他人群中，这是一种既定的安全治疗方法，但尚不清楚在多大程度上高强度活动可以减轻或逆转虚弱。这项随机分组研究将比较高强度步行（HIW）干预，以自我选择，休闲速度步行（CSW）干预内实施为体弱和体弱的老年人建立退休社区。我们将随机选择10个退休社区，每个研究中心的参与者（共200名参与者）接受4个月的HIW或CSW干预。所有参与者将在退休期间接受48次单独监督的地上行走社区在研究的开始和结束时，我们将测量参与者的虚弱程度、活动能力、身体状况、功能、平衡和总身体活动，通过佩戴1周的Activitative加速计测量观察期，比较HIW或CSW哪种治疗策略在减少虚弱方面效果更好（目的1）。我们将使用SHARE-Frailty仪器来评估虚弱程度，无论是作为分类（例如，非虚弱、虚弱前期或 #21453;，并有持续的结果。这种方法将使我们能够确定参与者如何在脆弱类别以及脆弱类别内的响应干预。在目标#2中，我们将确定步行强度对活动性、身体功能、平衡和总身体活动的影响。我们假设 HIW参与者将表现出虚弱程度降低，活动性、身体功能、平衡和 4个月的体力活动。目前，老年人身体虚弱的最佳体力活动指南是不确定这项研究的结果将提供重要的知识，为老年人提供活动指南与脆弱和信息的变革性方法，以减少脆弱，改善功能，并增加越来越多的老年人参加体育活动。