Walking Exercise Sustainability Through Telehealth for Veterans with Lower-LimbAmputation

通过远程医疗为下肢截肢退伍军人提供步行锻炼的可持续性

基本信息

项目摘要

Veterans living with lower-limb amputation have poor physical health outcomes, multiple chronic comorbidities, high medical service utilization, and high levels of disability. Self-reported disability for people living with lower- limb amputation is greater than 95% of the general population. One way to reduce disability for Veterans with lower-limb amputation is for them to participate in life-long sustained walking exercise. Regular exercise improves functional independence and mental well-being, and reduces adverse effects of common comorbidities associated with lower-limb amputation, such as diabetes and peripheral artery disease. However, most Veterans with lower-limb amputation do not regularly exercise. Only 50% of people with lower- limb amputation achieve levels of walking activity that support participation in their local community, creating a critical need to improve physical exercise participation after lower-limb amputation. Evidence suggests that clinician-supported exercise in a person’s home living environment that includes evidence-based promotion of patient self-management has promise for interrupting the cycle of elevated sedentary behavior and poor health outcomes. Therefore, the primary aim of this randomized controlled superiority trial is to determine if a telerehabilitation walking exercise self-management program produces clinically meaningful walking exercise sustainability compared to attention-control education. This novel, low-cost intervention includes a novel combination of piloted behavior-change methods and clinical resources, including VA multidisciplinary telehealth sessions, individual exercise self-management training, and VA Whole Health peer-group sessions. In addition, the intervention is integrated within an established VA Regional Amputation Center, using established VA clinical telerehabilitation and technology. Exercise and physical activity will be monitored as a continuous daily outcome, with secondary outcomes assessed at a baseline test and then after 6 and 18 months of intervention participation. The primary outcome will be accelerometer-assessed daily walking step count monitored continuously each day across the 18-month study period. Secondary outcomes are designed to assess the potential to assess how to best translate the walking exercise intervention into conventional VA amputation rehabilitation. These secondary outcomes include measures of intervention reach, intervention efficacy, likelihood of clinical adoption, potential for clinical implementation, and ability of participants to maintain long-term exercise behavior. The unique rehabilitation paradigm used in this study addresses the problem of chronic sedentary lifestyles following lower-limb amputation with a home-based exercise model of life-long exercise support from clinicians and peers. The trial results will advance rehabilitation knowledge and provide the necessary evidence for larger clinical translation of self-management intervention to sustain walking exercise for Veterans living with lower-limb amputation.
下肢截肢的退伍军人身体健康状况不佳,有多种慢性合并症,

项目成果

期刊论文数量(0)
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Cory L Christiansen其他文献

A Narrative Review of Prosthesis Design Decision Making After Lower-Limb Amputation for Developing Shared Decision-Making Resources
下肢截肢后假肢设计决策的叙述回顾,以开发共享决策资源

Cory L Christiansen的其他文献

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{{ truncateString('Cory L Christiansen', 18)}}的其他基金

Optimizing Gait Rehabilitation for Veterans with Non-Traumatic Lower Limb Amputation
优化非创伤性下肢截肢退伍军人的步态康复
  • 批准号:
    10531848
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
Improving health self-management using walking biobehavioral intervention for people with dysvascular lower limb amputation
通过步行生物行为干预改善下肢血管障碍截肢患者的健康自我管理
  • 批准号:
    10614536
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
Optimizing Gait Rehabilitation for Veterans with Non-Traumatic Lower Limb Amputation
优化非创伤性下肢截肢退伍军人的步态康复
  • 批准号:
    10261384
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
Improving health self-management using walking biobehavioral intervention for people with dysvascular lower limb amputation
通过步行生物行为干预改善下肢血管障碍截肢患者的健康自我管理
  • 批准号:
    10402923
  • 财政年份:
    2019
  • 资助金额:
    --
  • 项目类别:
Optimizing Physical Activity Outcomes for Veterans After Total Knee Arthroplasty
优化全膝关节置换术后退伍军人的身体活动结果
  • 批准号:
    10067376
  • 财政年份:
    2017
  • 资助金额:
    --
  • 项目类别:
Optimizing Physical Activity Outcomes for Veterans After Total Knee Arthroplasty
优化全膝关节置换术后退伍军人的身体活动结果
  • 批准号:
    10672175
  • 财政年份:
    2017
  • 资助金额:
    --
  • 项目类别:
Optimizing Physical Activity Outcomes for Veterans After Total Knee Arthroplasty
优化全膝关节置换术后退伍军人的身体活动结果
  • 批准号:
    10329916
  • 财政年份:
    2017
  • 资助金额:
    --
  • 项目类别:
Physical Activity Behavior Change for Older Veterans after Dysvascular Amputation
血管不良截肢后老年退伍军人的体力活动行为变化
  • 批准号:
    9274852
  • 财政年份:
    2016
  • 资助金额:
    --
  • 项目类别:
Physical Activity Behavior Change for Older Veterans after Dysvascular Amputation
血管不良截肢后老年退伍军人的体力活动行为变化
  • 批准号:
    9135095
  • 财政年份:
    2016
  • 资助金额:
    --
  • 项目类别:

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