Improving outcomes from cardiac rehabilitation among older adults through exercise testing and individualized exercise intensity prescriptions
通过运动测试和个性化运动强度处方改善老年人心脏康复的结果
基本信息
- 批准号:10672281
- 负责人:
- 金额:$ 59.07万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-08-01 至 2027-07-31
- 项目状态:未结题
- 来源:
- 关键词:AccelerometerAcuteAddressAgeAgingAnxietyBenchmarkingCardiacCardiac healthCardiac rehabilitationCardiologyCessation of lifeClinicalCounselingCoupledDataEffectivenessElderlyEventExerciseExercise PhysiologyExercise TestExertionExpert OpinionFaceFailureFemaleFrightGeriatricsGoalsGuidelinesHeartHeart DiseasesHeart RateHospitalizationIschemiaKnowledgeLifeLife StyleMeasuresMediatingMetabolicMethodsMyocardial InfarctionOperative Surgical ProceduresOutcomeOutpatientsPatientsPerceptionPersonsPharmaceutical PreparationsPhysical FunctionPhysical PerformancePhysical activityPhysiciansPositioning AttributePrevention programProceduresPrognosisPsychological FactorsPsychologyQuality of lifeRandomized, Controlled TrialsRecommendationRecoveryRehabilitation CentersRestRoleSF-36ScientistSecondary PreventionSelf EfficacyStrenuous ExerciseStress TestsStrokeTechniquesTestingTimeTrainingUnited StatesWalkingWorkloadacceptability and feasibilityeconomic outcomeeffectiveness outcomeefficacy evaluationefficacy testingevidence baseexercise adherenceexercise intensityexercise prescriptionexercise trainingexperiencefitnesshealthy agingimplementation outcomesimprovedimproved outcomeindexingindividual patientindividual responseloss of functionmortalitymultidisciplinarypatient responsepilot trialprogramspsychologicpsychological outcomesrandomized trialrecruitresponsesecondary outcomesextreatment as usualtrial comparing
项目摘要
PROJECT SUMMARY
Heart disease and its treatments, including hospitalization, surgery, and procedures, can result in devastating
loss of function, particularly in inactive older adults, who often face a prolonged recovery. Maximizing fitness
and promoting adequate physical activity (PA) are critical targets for healthy aging and recovery after a cardiac
event. Cardiac rehabilitation (CR) provides up to 36 supervised exercise training sessions and lifestyle
counseling to these patients and is thus ideally positioned to promote full recovery, encourage regular PA,
optimize cardiac health, and support more successful aging for these patients. However, many CR programs
fail to meet established benchmarks for improving fitness among their patients. This failure is likely attributable
to marked differences in exercise intensity prescription practices across CR programs, which have recently
been identified.
Specifically, the most common method for prescribing exercise intensity in CR is the use of ratings of
perceived exertion (RPE) coupled with a “rule of thumb” approach to achieve an exercise training heart rate
(HR) that is 20-30 bpm higher than resting HR. While easy to implement, these usual care (UC) techniques
often result in a self-selected and suboptimal exercise intensity. This, in turn, leads to lower gains in fitness and
failure to reach established benchmarks. Instead, societal guidelines recommend patients undergo a graded
exercise test (GXT) to measure a peak exercise HR and be prescribed exercise intensity using a computed
target heart rate range (THRR). This approach (GXT-THRR) allows tailoring of exercise based on the
individual patient’s response to acute exercise. However, no studies to date have tested the efficacy of GXT-
THRR compared to UC, and this critical knowledge gap is likely responsible for the marked differences in
exercise intensity prescription techniques across programs. Our preliminary data suggest GXT-THRR will lead
to greater gains in fitness in CR, boost self-efficacy, reduce fear of exercise, and improve outcomes.
To address this fundamental question, we will perform a 320-person randomized trial comparing GXT-
THRR to UC among older adults with heart disease attending CR. In Aim 1, we will measure improvements in
fitness during CR. In Aim 2, we will assess the impact of GXT-THRR on psychological factors associated with
exercise adherence (self-efficacy and fear). In Aim 3, we will evaluate how the use of GXT-THRR impacts
long-term PA, quality of life, fitness, and clinical outcomes.
Our multi-disciplinary team has broad experience in all aspects of this proposal, including exercise
physiology, CR, cardiology, geriatrics, and psychology. Our approach is informed by a successful pilot trial
which demonstrated the clear feasibility and potential effectiveness of GXT-THRR. Ultimately, we anticipate
our results will promote evidence-based exercise intensity practices in CR programs, leading to greater
improvements in fitness, PA, and exercise self-efficacy, and more successful aging.
项目摘要
心脏病及其治疗,包括住院治疗,手术和程序,可导致毁灭性的后果。
功能丧失,特别是在不活跃的老年人中,他们往往面临长期的恢复。最大化健身
和促进足够的体力活动(PA)是健康老龄化和心脏病后恢复的关键目标。
活动心脏康复(CR)提供多达36个监督运动训练课程和生活方式
为这些患者提供咨询,因此非常适合促进完全康复,鼓励定期PA,
优化心脏健康,并支持这些患者更成功的衰老。然而,许多CR方案
未能达到改善患者健康的既定基准。这种失败可能是由于
CR项目中运动强度处方实践的显著差异,最近
被识别。
具体来说,在CR中规定运动强度的最常见方法是使用
感知用力(RPE)结合“经验法则”方法来实现运动训练心率
(HR)比静息心率高20-30 bpm。虽然易于实施,但这些常规护理(UC)技术
经常导致自我选择的和次优的锻炼强度。这反过来又会导致健身的收益降低,
未能达到既定基准。相反,社会指南建议患者接受分级的
运动测试(GXT),以测量峰值运动HR,并使用计算的
目标心率范围(THRR)。这种方法(GXT-THRR)允许根据运动量定制运动。
个体患者对急性运动的反应。然而,迄今为止还没有研究测试GXT的功效-
THRR与UC相比,这一关键的知识差距可能是造成
运动强度处方技术跨程序。我们的初步数据表明GXT-THRR将导致
在CR中获得更大的健身收益,提高自我效能,减少对运动的恐惧,并改善结果。
为了解决这个基本问题,我们将进行一项320人的随机试验,比较GXT-
在接受CR治疗的心脏病老年人中,THR与UC的关系。在目标1中,我们将衡量
CR期间的健身。在目标2中,我们将评估GXT-THRR对与以下相关的心理因素的影响:
锻炼坚持性(自我效能和恐惧)。在目标3中,我们将评估GXT-THRR的使用如何影响
长期PA、生活质量、健身和临床结局。
我们的多学科团队在此提案的各个方面都有广泛的经验,包括运动
生理学、CR、心脏病学、老年病学和心理学。我们的方法是由一个成功的试点试验告知
这证明了GXT-THRR的明确可行性和潜在有效性。最终,我们预计
我们的研究结果将促进CR项目中基于证据的运动强度实践,
健身,PA和运动自我效能的改善,以及更成功的衰老。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Quinn Russell Pack其他文献
Quinn Russell Pack的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Quinn Russell Pack', 18)}}的其他基金
Implementing Effective Smoking Cessation Pharmacotherapy for Hospitalized Smokers with Cardiopulmonary Disease
对患有心肺疾病的住院吸烟者实施有效的戒烟药物治疗
- 批准号:
10588125 - 财政年份:2022
- 资助金额:
$ 59.07万 - 项目类别:
Implementing Effective Smoking Cessation Pharmacotherapy for Hospitalized Smokers with Cardiopulmonary Disease
对患有心肺疾病的住院吸烟者实施有效的戒烟药物治疗
- 批准号:
10367000 - 财政年份:2022
- 资助金额:
$ 59.07万 - 项目类别:
Identifying Effective Strategies to Improve Participation in Cardiac Rehabilitation after an Acute Cardiac Hospitalization
确定有效策略以提高急性心脏病住院后心脏康复的参与度
- 批准号:
9386305 - 财政年份:2017
- 资助金额:
$ 59.07万 - 项目类别:
Identifying Effective Strategies to Improve Participation in Cardiac Rehabilitation after an Acute Cardiac Hospitalization
确定有效策略以提高急性心脏病住院后心脏康复的参与度
- 批准号:
9980205 - 财政年份:2017
- 资助金额:
$ 59.07万 - 项目类别:
相似海外基金
Transcriptional assessment of haematopoietic differentiation to risk-stratify acute lymphoblastic leukaemia
造血分化的转录评估对急性淋巴细胞白血病的风险分层
- 批准号:
MR/Y009568/1 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Fellowship
Combining two unique AI platforms for the discovery of novel genetic therapeutic targets & preclinical validation of synthetic biomolecules to treat Acute myeloid leukaemia (AML).
结合两个独特的人工智能平台来发现新的基因治疗靶点
- 批准号:
10090332 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Collaborative R&D
Acute senescence: a novel host defence counteracting typhoidal Salmonella
急性衰老:对抗伤寒沙门氏菌的新型宿主防御
- 批准号:
MR/X02329X/1 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Fellowship
Cellular Neuroinflammation in Acute Brain Injury
急性脑损伤中的细胞神经炎症
- 批准号:
MR/X021882/1 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Research Grant
KAT2A PROTACs targetting the differentiation of blasts and leukemic stem cells for the treatment of Acute Myeloid Leukaemia
KAT2A PROTAC 靶向原始细胞和白血病干细胞的分化,用于治疗急性髓系白血病
- 批准号:
MR/X029557/1 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Research Grant
Combining Mechanistic Modelling with Machine Learning for Diagnosis of Acute Respiratory Distress Syndrome
机械建模与机器学习相结合诊断急性呼吸窘迫综合征
- 批准号:
EP/Y003527/1 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Research Grant
FITEAML: Functional Interrogation of Transposable Elements in Acute Myeloid Leukaemia
FITEAML:急性髓系白血病转座元件的功能研究
- 批准号:
EP/Y030338/1 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Research Grant
STTR Phase I: Non-invasive focused ultrasound treatment to modulate the immune system for acute and chronic kidney rejection
STTR 第一期:非侵入性聚焦超声治疗调节免疫系统以治疗急性和慢性肾排斥
- 批准号:
2312694 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Standard Grant
ロボット支援肝切除術は真に低侵襲なのか?acute phaseに着目して
机器人辅助肝切除术真的是微创吗?
- 批准号:
24K19395 - 财政年份:2024
- 资助金额:
$ 59.07万 - 项目类别:
Grant-in-Aid for Early-Career Scientists
Acute human gingivitis systems biology
人类急性牙龈炎系统生物学
- 批准号:
484000 - 财政年份:2023
- 资助金额:
$ 59.07万 - 项目类别:
Operating Grants