Remotely Monitored, Mobile health-supported High Intensity Interval Training after COVID-19 Critical Illness (REMM HIIT-Covid19)

COVID-19 危重疾病后远程监控、移动健康支持的高强度间歇训练 (REMM HIIT-Covid19)

• 批准号: 10688052
• 负责人: Amy M Pastva
• 金额: $ 78.97万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-17 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10688052
• 关键词: Accelerometer; Address; Adherence; Adipose tissue; Adult; Aging; American; Apple watch; Area; Award; Balance training; Biological Markers; Bone Marrow Transplantation; COVID-19; COVID-19 pandemic; COVID-19 survivors; Cancer Patient; Cardiopulmonary; Caring; Cellular Phone; Clinic; Clinical Research; Clinical Trials; Clinical Trials Design; Cognition; Cognitive deficits; Computer software; Critical Care; Critical Illness; Data; Development; Devices; Disease; Dose; Education; Elderly; Equilibrium; Exercise; Exercise Test; Funding; Future; Glycogen; Goals; Heart Rate; Home; Home environment; Hospitalization; Hospitals; Impairment; Individual; Inflammation; Intensive Care; Intensive Care Units; Interdisciplinary Study; Interval training; Intervention; Intramuscular; Kentucky; Knowledge; Leukocytes; Literature; Malignant Neoplasms; Measures; Medical center; Medicine; Mental Health; Mitochondria; Monitor; Multicenter Studies; Multicenter Trials; Muscle; Muscle function; Muscular Atrophy; Near-Infrared Spectroscopy; Ohio; Operative Surgical Procedures; Outcome; Outcomes Research; Oxygen Consumption; Patient Self-Report; Patients; Performance; Persons; Phase; Physical Exercise; Physical Function; Physical Performance; Physical Rehabilitation; Physiological; Pilot Projects; Population; Public Health; Quality of life; Randomized; Recommendation; Recovery; Rehabilitation therapy; Reporting; Research; Research Institute; Resistance; Societies; Structure; Survivors; Syndrome; Testing; United States National Institutes of Health; Universities; Videoconferencing; Walking; brain dysfunction; cardiorespiratory fitness; chemotherapy; comparison control; digital; disability; exercise capacity; exercise intervention; exercise prescription; exercise training; experience; fitness; functional outcomes; improved; innovation; mHealth; mitochondrial metabolism; muscle form; muscle strength; novel; novel strategies; older patient; pandemic disease; patient safety; physically handicapped; primary endpoint; programs; rehabilitation research; rehabilitation strategy; remote monitoring; safety and feasibility; severe COVID-19; strength training; survivorship; ultrasound

Severe disease from COVID-19 requires hospitalization in 20% of adults, with a third of those patients requiring intensive care unit (ICU) treatment. While a growing number of patients are surviving COVID-19 critical illness, like other ICU survivors, the majority will experience significant post-hospital disabilities in physical function and exercise capacity, new-onset disability, muscle wasting/weakness, and new cognitive deficits. These difficulties, which can persist for months to years post-ICU, are collectively known as post-intensive care syndrome (PICS) and may be more severe in COVID-19 survivors. Despite literature demonstrating the benefit of physical rehabilitation in COVID-19 and other ICU survivors, there are limited available options and data to support an optimal post-hospital physical rehabilitation strategy. Combined with the difficulties of delivering rehabilitation in- person after hospitalization during a pandemic, addressing this “rehabilitation pandemic” from COVID-19 represents an enormous public health challenge. Previous studies of home-based physical rehabilitation in ICU survivors have utilized unsupervised exercise training without a personalized exercise prescription, and none have done so while actively monitoring and targeting exercise via physiologic data such as heart rate or included strength and balance training. In debilitated older patients, high intensity interval training (HIIT) is safe and associated with significant improvements (in as little as two weeks) in cardiorespiratory fitness (CRF) that also correlates with self-reported physical function and disability. We have evaluated this approach in a successful NIH-funded phase 1 pilot study demonstrating safety and feasibility of HIIT in debilitated older adults with cancer. Adherence to exercise was 117% (meaning patients exercised more than recommended 3 sessions/week), compliance with heart rate goals was 98% (meaning patients were actually doing HIIT vs. less-intensive exercise), and on average patients improved CRF, as measured by VO2peak on cardiopulmonary exercise testing by 25%. The key to our approach is our mHealth platform, in which patients are given Apple Watches and iPhones preloaded with our software allowing us to remotely download data after each exercise session to provide personalized up-coaching via videoconferencing in home setting. As critical illness survivors, including COVID-19 ICU survivors, have impaired CRF (similar to patients in pilot study) and other manifestations of PICS, a similar monitored, personalized, structured, and progressive multi-domain physical rehabilitation intervention has significant potential for improving recovery, but has not yet been studied in COVID-19 survivors. To address this gap in knowledge, we will randomize 140 COVID-19 ICU survivors being discharged home to our REmotely Monitored, Mobile health-supported High Intensity Interval Training after COVID-19 Critical Illness (REMM-HIIT-Covid- 19) study to test the hypothesis that the REMM-HIIT exercise intervention, in contrast to exercise education alone, will improve CRF and muscle strength/mass (Aim 1); improve physical function and quality of life (Aim 2); and improve markers of mitochondrial function and inflammation (Aim 3) measured at 3-months after discharge.

20%的成年人患上COVID-19的严重疾病需要住院治疗，其中三分之一的患者需要住院治疗

项目成果

Automated versus manual analysis of body composition measures on computed tomography in patients with bladder cancer.

• DOI: 10.1016/j.ejrad.2022.110413
• 发表时间: 2022-09
• 期刊: EUROPEAN JOURNAL OF RADIOLOGY
• 影响因子: 3.3
• 作者: Rigiroli, Francesca;Zhang, Dylan;Molinger, Jeroen;Wang, Yingqi;Chang, Andrew;Wischmeyer, Paul E.;Inman, Brant A.;Gupta, Rajan T.
• 通讯作者: Gupta, Rajan T.

Nascent to novel methods to evaluate malnutrition and frailty in the surgical patient.

• DOI: 10.1002/jpen.2420
• 发表时间: 2023-02
• 期刊: JOURNAL OF PARENTERAL AND ENTERAL NUTRITION
• 影响因子: 3.4
• 作者: Prado, Carla M.;Ford, Katherine L.;Gonzalez, M. Cristina;Murnane, Lisa C.;Gillis, Chelsia;Wischmeyer, Paul E.;Morrison, Chet A.;Lobo, Dileep N.
• 通讯作者: Lobo, Dileep N.