Physical Activity and Weight Loss to Improve Function and Pain after Total Knee Replacement

项目摘要/摘要 家长R01正在检查行为减肥计划的效果与慢性减肥计划的效果 关于体重、身体功能、疼痛和身体活动的疾病自我管理(CDSM)计划 成人全膝关节置换术(TKR)。拟议的补充项目旨在增加阿尔茨海默氏症 疾病及其相关痴呆症(AD/ADRD)关注我们的项目，通过检查行为体重 减重计划和体力活动可能通过以下方式对成人TKR患者的AD/ADRD具有保护作用 维持性认知。越来越多的人正在接受TKR，尽管手术有帮助 为了最初降低死亡率，在手术后的几十年里，大多数死亡来自AD/ADRD和 心血管疾病。AD/ADRD的医疗成本是美国最高的之一，使大量 给社会带来经济负担。尽管AD/ADRD在成人中死亡率过高的原因 TKR是未知的，需要战略来帮助降低这一人群发展的高风险 AD/ADRD以及这种手术和情况给社会带来的相应经济负担。 补充的第一个目的是检查多组分(饮食和体能)的初步效果 活动)减肥计划与CDSM对照组在6个月时的认知能力进行比较。第二个目标 我将在6岁时研究饮食、有氧运动和体重的变化与认知的关系 月份。最终目的是检验一轮短暂的步行对认知的尖锐影响。审视目标 1和2，参与者(n=60)将随机参加两个为期12个月的计划之一：(1)配速减肥 程序或(2)CDSM。基线和6个月的评估将包括认知、体重、 客观测量体力活动和饮食摄入量。为了检查目标3，将使用交叉设计 在基线评估中，参与者(n=60)将被随机分为立即或延迟 行走条件。被随机分组的参与者将首先完成6分钟的步行测试，而 被随机延迟的参与者将在6分钟的休息时间后完成步行测试。简短的认识 测试评估处理速度将在基线评估中完成3次，以检查效果 关于认知的一场激烈的竞走比赛。 这个补充项目的预期结果是确定以下项目的初步效果 成人TKR术后体重、有氧运动和膳食摄入量对认知的影响。如果一个行为 减肥计划和/或简短的活动可以维持老龄化人口的认知， 促进这些生活方式行为的改变有助于预防或推迟AD/ADRD的发病。

Project Summary/Abstract The Parent R01 is examining the effects of a behavioral weight loss program as compared to a chronic disease self-management (CDSM) program on weight, physical function, pain, and physical activity among adults after total knee replacement (TKR). The proposed supplemental project aims to add an Alzheimer’s disease and its related dementias (AD/ADRD) focus to our project by examining whether a behavioral weight loss program and physical activity may have a protective effect against AD/ADRD among adults with TKR by sustaining cognition. An increasing number of individuals are undergoing TKR, and although the surgery helps to initially reduce mortality, the majority of deaths in the decades after surgery are from AD/ADRD and cardiovascular disease. Healthcare costs from AD/ADRD are among the highest in the US, placing substantial economic burden on society. Although the reasons for the excess mortality from AD/ADRD among adults with TKR are unknown, strategies are needed to help reduce this population’s high risk for the development of AD/ADRD as well as the corresponding economic burden that this surgery and conditions place on society. The first Aim of the supplement is to examine the preliminary effects of a multicomponent (diet and physical activity) weight loss program as compared to a CDSM control group on cognition at 6 months. The second Aim will examine how changes in diet, aerobic physical activity, and weight are associated with cognition at 6 months. The final Aim is to examine the acute effects of a brief bout of walking on cognition. To examine aims 1 and 2, participants (n=60) will be randomized to one of two 12-month programs: (1) PACE weight loss program or (2) CDSM. Assessments at baseline and 6 months will include measures of cognition, weight, objectively-measured physical activity, and dietary intake. To examine aim 3, a cross-over design will be used at the baseline assessment, in which participants (n=60) will be randomized to either Immediate or Delayed walking conditions. Participants randomized to Immediate will complete the Six-min walking test first, whereas participants randomized to delayed will complete the walking test after a 6-min rest period. A brief cognitive test assessing processing speed will be completed 3 times at the baseline assessment to examine the effect of an acute walking bout on cognition. The expected outcome from this supplemental project is to determine the preliminary effects of changes in weight, aerobic physical activity, and dietary intake on cognition in adults after TKR. If a behavioral weight loss program and/or briefs bouts of activity can sustain cognition among an aging population, the promotion of changes in these lifestyle behaviors could help to prevent or delay the onset of AD/ADRD.