Multimodality Intervention to Improve Function and Metabolism in Spinal Cord Injury

多模式干预改善脊髓损伤的功能和代谢

基本信息

  • 批准号:
    9767249
  • 负责人:
  • 金额:
    $ 74万
  • 依托单位:
  • 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:
    2018-08-21 至 2023-04-30
  • 项目状态:
    已结题

项目摘要

Over 250,000 Americans are living with paralysis resulting from spinal cord injury (SCI), one of the most grievous events in a person's life. Inter-linked deficits in multiple physiologic organ systems in persons with SCI contribute to a vicious cycle of progressively declining musculoskeletal and cardiometabolic health, and wellbeing. In recognition of the profoundly deleterious effects of chronic SCI on an individual's health, the National Center for Medical Rehabilitation Research (NCMRR) has deemed “pharmaceutical, stimulation, and exercise…strategies to improve the motor function and health of SCI patients” a priority area of research. The NCMRR has further emphasized efficacy trials of multicomponent interventions, as this application proposes to accomplish. There is evidence - mostly from nonrandomized studies - that arm ergometry and functional electrical stimulation of the lower extremity during leg cycling (FES-LC) improve physical capacity of SCI patients. However, the aerobic demands and workloads achieved by arm ergometry or FES-LC alone are often not of sufficient intensity to induce optimal musculoskeletal and metabolic adaptations. SCI is associated with high prevalence of androgen deficiency, which further contributes to muscle loss, metabolic dysregulation, and low mood. By combining FES-LC with concurrent arm ergometry (“hybrid” training), substantially higher levels of exercise intensity can be achieved than with either intervention alone. The effects of hybrid exercise on muscle mass, strength, and function are augmented by androgen administration. Furthermore, androgen may have additional beneficial effects in improving mood, wellbeing, pain sensitivity, and metabolic outcomes. We hypothesize that a Home-Based Multimodality Functional Recovery and Metabolic Health Enhancement Program that includes concurrent FES-LC and arm ergometry, and an androgen (19-nortestosterone decanoate, 19ND) would be more efficacious than arm ergometry alone in improving aerobic capacity, muscle mass and strength, metabolic health, self-reported function and mobility, and wellbeing. This hypothesis will be tested in a randomized trial in 84 persons with C7 to T12 SCI, AIS grade A, B or C, 6 months or later after SCI. Participants will be randomized to either the multi-modality intervention or arm ergometry alone for 16 weeks. After 2-weeks of training in the exercise laboratory, the intervention will be conducted in the participant's home, using video monitoring of the home exercise. Primary outcome is peak aerobic capacity. Secondary outcomes include self-reported function and mobility assessed using computerized adaptive test version of Spinal Cord Injury-Functional Index; muscle mass, strength and fatigability; fat mass and distribution; metabolism (insulin sensitivity; lipids; inflammatory markers); wellbeing (mood, anxiety, pain, and life satisfaction). An inter- disciplinary team, access to a large patient pool, rigorous trial design, assiduous attention to patient safety and statistical power, and inclusion of performance-based and patient-reported outcomes should facilitate the accomplishment of the proposed aims, which have implications for improving the care of SCI patients.
超过25万美国人因脊髓损伤(SCI)而瘫痪,这是最严重的疾病之一

项目成果

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SHALENDER BHASIN其他文献

SHALENDER BHASIN的其他文献

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{{ truncateString('SHALENDER BHASIN', 18)}}的其他基金

NAD Augmentation to Treat Diabetic Kidney Disease: A Randomized Controlled Trial
NAD 增强治疗糖尿病肾病:一项随机对照试验
  • 批准号:
    10430705
  • 财政年份:
    2022
  • 资助金额:
    $ 74万
  • 项目类别:
NAD Augmentation to Treat Diabetic Kidney Disease: A Randomized Controlled Trial
NAD 增强治疗糖尿病肾病:一项随机对照试验
  • 批准号:
    10668324
  • 财政年份:
    2022
  • 资助金额:
    $ 74万
  • 项目类别:
A Proof of Concept Trial of a Sirtuin-NAD+ Activator in Alzheimer's Disease
Sirtuin-NAD 激活剂治疗阿尔茨海默病的概念验证试验
  • 批准号:
    10311161
  • 财政年份:
    2021
  • 资助金额:
    $ 74万
  • 项目类别:
A Proof of Concept Trial of a Sirtuin-NAD+ Activator in Alzheimer's Disease
Sirtuin-NAD 激活剂治疗阿尔茨海默病的概念验证试验
  • 批准号:
    10457489
  • 财政年份:
    2021
  • 资助金额:
    $ 74万
  • 项目类别:
A Proof of Concept Trial of a Sirtuin-NAD+ Activator in Alzheimer's Disease
Sirtuin-NAD 激活剂治疗阿尔茨海默病的概念验证试验
  • 批准号:
    10634622
  • 财政年份:
    2021
  • 资助金额:
    $ 74万
  • 项目类别:
Improving Quality of Life of Prostate Cancer Survivors with Androgen Deficiency
改善雄激素缺乏的前列腺癌幸存者的生活质量
  • 批准号:
    10398005
  • 财政年份:
    2018
  • 资助金额:
    $ 74万
  • 项目类别:
Multimodality Intervention to Improve Function and Metabolism in Spinal Cord Injury
多模式干预改善脊髓损伤的功能和代谢
  • 批准号:
    10159744
  • 财政年份:
    2018
  • 资助金额:
    $ 74万
  • 项目类别:
Multimodality Intervention to Improve Function and Metabolism in Spinal Cord Injury
多模式干预改善脊髓损伤的功能和代谢
  • 批准号:
    10398790
  • 财政年份:
    2018
  • 资助金额:
    $ 74万
  • 项目类别:
Improving Quality of Life of Prostate Cancer Survivors with Androgen Deficiency
改善雄激素缺乏的前列腺癌幸存者的生活质量
  • 批准号:
    9918241
  • 财政年份:
    2018
  • 资助金额:
    $ 74万
  • 项目类别:
Multimodality Intervention to Improve Function and Metabolism in Spinal Cord Injury
多模式干预改善脊髓损伤的功能和代谢
  • 批准号:
    10764596
  • 财政年份:
    2018
  • 资助金额:
    $ 74万
  • 项目类别:

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