Obesity Rehabilitation for Improving Walking Efficiency in Neurological Disease

项目总结/摘要 多发性硬化症（MS）是一种慢性神经系统疾病，其特征在于脱髓鞘和神经纤维横断。 轴突以及中枢神经系统神经元的丧失，患病率约为230万 这些人中有超过40%的人超重或肥胖。一般人口中的成年人 超重或肥胖者的症状包括更严重的疲劳、抑郁、疼痛和焦虑， 所有这些都在MS患者中普遍存在。这种模式表明， 这些症状在身体成分不佳的MS患者中可能更严重。 此外，身体成分较差的MS患者可能具有较差的行走效率， 氧气（O2）消耗量增加。步行的O2成本被定义为每次步行消耗的O2量。 每单位行走距离的体重。总的来说，有证据表明，步行的O2成本是 与对照组相比，MS患者的患病率更高，并可能随着残疾状态的进展而恶化。与 步行的O2成本升高，MS患者可能会经历更高水平的疲劳， 身体活动，阻碍这些人参与社区活动。迄今为止， 研究了MS患者的身体成分和步行时的O2消耗之间的关系。 体重指数（BMI）一直是研究步行过程中O2消耗的主要身体成分指标。 MS，但显著低估了MS患者的肥胖， 组织类型。双X射线吸收测定法是身体成分的标准测量方法， 区分脂肪量、无脂肪量和全身的骨矿物质含量。为此，第一个目标是 一项横断面设计研究旨在研究身体成分与O2成本之间的关系， 我们假设患有MS的人有更多的身体脂肪，更少的瘦肉组织， 而骨矿物质含量越低，行走时的耗氧量越高。第二个目标是 识别MS相关后果（即，疲劳，抑郁，疼痛和焦虑）的身体成分，以及如何 步行的O2成本影响这种关系。我们假设，身体状况较差的MS患者 组合物将表现出步行的O2消耗升高和更坏的后果。这项拟议的研究 将提供初步的证据，以更好地了解身体组成，O2成本之间的关系， 行走和MS相关的后果。这些发现可能会指导研究人员，临床医生和运动 设计有针对性的方法，如运动训练，以优化身体成分， 提高行走效率并管理MS的继发性后果，旨在促进健康， 更好的整体生活质量，这与PI帮助神经系统疾病患者的研究议程相一致 在受伤后或诊断后融入或重新融入社区。

Project Summary/Abstract Multiple sclerosis (MS) is a chronic neurological disease characterized by demyelination and transection of axons as well as loss of neurons in the central nervous system with a prevalence of approximately 2.3 million people worldwide, and over 40% of these individuals are overweight or obese. Adults of the general population who are overweight or obese have symptoms including worse levels of fatigue, depression, pain, and anxiety, all of which are prevalent in persons with MS. Such a pattern suggests that the prevalence and severity of these symptoms might actually be worse in persons with MS who have poor body composition profiles. Furthermore, persons with MS who have poor body composition may have worse walking efficiency, indicated by elevated oxygen (O2) cost of walking. O2 cost of walking is defined as the amount of O2 consumed per kilogram of body weight per unit distance walked. Collectively, there is evidence that O2 cost of walking is higher in persons with MS compared with controls and may worsen as disability status progresses. With elevated O2 cost of walking, persons with MS may experience higher levels of fatigue and participate in less physical activity, impeding these individuals from engaging within the community. To date, there are few studies examining the relationship between body composition and O2 cost of walking in persons with MS. Body mass index (BMI) has been the primary measure of body composition in research on the O2 cost of walking in MS but significantly underestimates adiposity in persons with MS and cannot differentiate between different tissue types. Dual x-ray absorptiometry is the standard measure of body composition and has the capability to differentiate fat mass, fat-free mass, and bone mineral content of the overall body. To that end, the first aim of cross-sectional design study is to examine the relationship between body composition and the O2 cost of walking in persons with MS. We hypothesize that persons with MS who have more body fat, less lean tissue, and lower bone mineral content will demonstrate higher levels of O2 cost of walking. The second aim is to identify MS-related consequences (i.e., fatigue, depression, pain, and anxiety) of body composition and how O2 cost of walking affects this relationship. We hypothesize that persons with MS who have worse body composition will demonstrate elevated O2 cost of walking and worse consequences. This proposed research will provide preliminary evidence to better understand the relationship among body composition, O2 cost of walking, and MS-related consequences. These findings may guide researchers, clinicians, and exercise specialists in the design of targeted approaches, such as exercise training, for optimizing body composition to improve walking efficiency and manage its secondary consequences in MS with the aim to promote health and better overall quality of life, which aligns with the PI’s research agenda of helping persons with neurological conditions integrate or reintegrate into the community post-injury or post-diagnosis.