Unraveling the mechanisms of a novel music intervention for physical activity promotion in older adults

揭示新型音乐干预促进老年人身体活动的机制

• 批准号: 10766983
• 负责人: JENNIFER L ETNIER
• 金额: $ 32.84万
• 依托单位: UNIVERSITY OF NORTH CAROLINA GREENSBORO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-15 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10766983
• 关键词: Accelerometer; Accent; Acclimatization; Acoustic Stimulation; Acute; Adherence; Adult; Aerobic Exercise; Affect; Affective; Age; Alzheimer' s Disease; Alzheimer' s disease risk; Behavior; Cardiac rehabilitation; Dementia; Ecological momentary assessment; Elderly; Exercise; Exertion; Expenditure; Failure; Feasibility Studies; Fostering; Frequencies; Future; Goals; Guidelines; Health Benefit; Health Care Costs; Home; Impaired cognition; Intervention; Maintenance; Measures; Mediating; Mediator; Meta-Analysis; Motivation; Movement; Music; Outcome; Participant; Patient Self-Report; Periodicity; Persons; Phase; Physical activity; Physiologic pulse; Population; Populations at Risk; Psychological Tests; Public Health; Randomized; Research; Risk; Risk Factors; Risk Reduction; Sampling; Testing; Theoretical model; Training; Translating; Walking; Withdrawal; Work; aged; auditory stimulus; behavior change; behavioral response; curative treatments; design; displeasure; evidence base; exercise intervention; exercise program; exercise training; experience; falls; hedonic; improved; innovation; lifestyle intervention; middle age; modifiable risk; negative affect; non-demented; novel; novel strategies; older patient; physical inactivity; pleasure; prevent; programs; psychologic; response; satisfaction; strength training; success; treatment adherence

Project Summary It is predicted that 13.8 million US adults will live with Alzheimer’s disease (AD) by 2050. Physical activity (PA) is imperative to prevent or delay the onset of AD. However, adherence to the national PA guidelines steeply declines after ages 60-65. Fewer than 20% of US older adults adhere to the national guidelines for multicomponent PA - aerobic exercise (AE) at moderate intensity and strength training (ST). Thus, there is an urgent need to promote multicomponent PA among low-active older adults. A major challenge to promoting multicomponent PA is that most older adults experience a negative affective response to moderate-intensity AE and ST. This negative affective response is a critical barrier to maintenance of regular PA because, in general, people are unlikely to continue a behavior that results in immediate displeasure. Interestingly, listening to music during acute bouts of AE and ST increases positive affect and reduces perceived exertion. However, for these benefits to translate to long-term adherence, music alone is not sufficient. In a feasibility study (N=33), walking-for-exercise with a sonically enhanced music playlist in the form of Rhythmic Auditory Stimulation (RAS) – an application of pulsed, tempo-synchronous, auditory stimuli (e.g., beat-accented music) for the facilitation of rhythmic body movement – nearly doubled the weekly volume of PA and caloric expenditure in midlife-to-older patients undergoing cardiac rehabilitation whereas standard music without RAS had little effect on PA outcomes. To date, this proof-of-concept has not been fully tested and the underlying psychological mechanisms of RAS remain unknown. Thus, we propose to test whether RAS enhances affective responses to PA and thereby promotes long-term PA behaviors among older adults. In the R61 and R33 phases, participants will undergo an exercise intervention (EX) consisting of ST for 3 days/week and brisk walking for AE for >150 min/week over 6 months. The EX is designed to foster the independent maintenance of regular PA through a gradual withdrawal of supervised training (3 days/week for 2 months, 1 day/week for 2 months, and unsupervised for 2 months). The independent variable will be random assignment into the EX alone or EX+RAS. In the R61 phase, we will conduct an RCT to explore the preliminary effects of RAS on affective and behavioral responses to the EX among non-demented, low-active, older adults (N=40) aged 65- 79 (Aim 1). Using ecological momentary assessment (EMA), we will test the hypothesis that adding RAS to the EX leads to a more positive affective response to PA, lower perceived exertion, and greater weekly volumes of PA over 6 months. Treatment adherence and satisfaction will be assessed to determine the acceptability of the interventions. If milestones are met, we will proceed to the R33 phase and conduct a fully-powered RCT with the same design and population (N=130). We will retest Aim 1 with this second larger sample and will assess Aim 2 which is a test of the mechanistic hypothesis that the effects of RAS on the weekly volumes of PA are mediated by positive affective response to PA and lower perceived exertion.

项目摘要 据预测，到2050年，将有1380万美国成年人患有阿尔茨海默病（AD）。身体活动 (PA)预防或延缓AD的发生是必要的。然而，遵守国家PA准则 在60-65岁之后急剧下降。只有不到20%的美国老年人遵守国家指南， 多组分PA -中等强度有氧运动（AE）和力量训练（ST）。因此， 迫切需要在低活动的老年人中推广多组分PA。促进发展的一个主要挑战是 多成分PA是大多数老年人对中等强度的 AE和ST。这种负面情感反应是维持定期PA的关键障碍，因为，在 一般来说，人们不太可能继续一种导致立即不快的行为。有趣的是， 在急性发作的AE和ST期间听音乐会增加积极的影响，减少感知的努力。然而，在这方面， 要使这些益处转化为长期坚持，单靠音乐是不够的。在可行性研究中 （N=33），以节奏听觉形式的声音增强音乐播放列表进行步行锻炼 刺激（RAS）-脉冲的、时间同步的、听觉刺激的应用（例如，节拍重音音乐） 促进有节奏的身体运动-几乎是每周PA和热量的两倍 接受心脏康复的中年至老年患者的支出，而没有RAS的标准音乐 对PA结果几乎没有影响。到目前为止，这一概念验证尚未得到充分测试， RAS的心理机制仍不清楚。因此，我们建议测试RAS是否增强 对PA的情感反应，从而促进老年人的长期PA行为。在R61和 R33阶段，参与者将接受运动干预（EX），包括每周3天的ST和轻快的 AE步行>150分钟/周，持续6个月。EX旨在促进独立维护 通过逐渐退出监督培训（每周3天，持续2个月，每周1天，持续2个月）， 2个月，无人监管）。自变量将被随机分配到EX 单独或EX+RAS。在R61阶段，我们将进行一项RCT，以探索RAS对 情感和行为反应的EX之间的非痴呆，低活动，老年人（N=40），年龄65- 79（目标1）。使用生态瞬时评估（EMA），我们将测试的假设，增加RAS到 EX导致对PA的更积极的情感反应，更低的感知消耗，以及更大的每周量。 PA超过6个月。将评估治疗依从性和满意度，以确定 干预措施。如果达到里程碑，我们将进入R33阶段，并进行全功率RCT， 相同的设计和人群（N=130）。我们将用第二个更大的样本重新测试目标1， 目的2是检验RAS对PA每周量的影响的机制假设， 通过对PA的积极情感反应和较低的自感知努力来介导。