Obesity Rehabilitation for Improving Walking Efficiency in Neurological Disease

项目摘要/摘要 多发性硬化症(MS)是一种慢性神经系统疾病，其特征是脱髓鞘和横断性 轴突以及中枢神经系统神经元的丢失，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 超重或肥胖的人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患者中流行，这样的模式表明 这些症状实际上可能在身体成分特征较差的多发性硬化症患者中更严重。 此外，身体成分较差的多发性硬化症患者的步行效率可能会较差 由于步行的氧气(O2)成本上升。步行耗氧量定义为每次步行消耗的氧气量 每单位距离步行体重千克。总而言之，有证据表明，步行的氧气成本 多发性硬化症患者与对照组相比更高，并可能随着残疾状况的进展而恶化。使用 步行的氧气成本增加，多发性硬化症患者可能会经历更高水平的疲劳和更少的参与 身体活动，阻碍这些人参与社区活动。到目前为止，几乎没有 多发性硬化症患者的身体成分与步行氧耗之间关系的研究 体重指数(BMI)一直是人体成分的主要衡量标准，研究人员对步行的氧气消耗进行了研究。 但严重低估了多发性硬化症患者的肥胖度，并且不能区分不同的 组织类型。双x射线吸收测量法是身体成分的标准测量方法，它能够 区分全身的脂肪量、脱脂量和骨矿含量。为此，第一个目标是 横断面设计研究是为了检查身体成分和氧气成本之间的关系 与多发性硬化症患者同行我们假设多发性硬化症患者体内脂肪较多，组织较少， 而较低的骨矿物质含量将表明步行的氧气成本较高。第二个目标是 确定与多发性硬化症相关的身体成分的后果(如疲劳、抑郁、疼痛和焦虑)以及如何 O2步行的花费会影响这种关系。我们假设患有多发性硬化症的人身体更差 成分将显示步行的氧气成本增加和更糟糕的后果。这项拟议的研究 将为更好地理解人体成分、氧耗之间的关系提供初步证据。 行走，以及与多发性硬化症相关的后果。这些发现可能会指导研究人员、临床医生和锻炼 设计有针对性的方法的专家，如运动训练，以优化身体成分，以 提高步行效率并管理其在多发性硬化症中的次要后果，目的是促进健康和 更好的整体生活质量，这与PI帮助患有神经病的人的研究议程一致 在受伤或确诊后，病情会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.