Exercise, stress, and wound healing among older adults

描述(由申请者提供)：先前的研究表明，心理困扰会延迟伤口愈合。此外，有证据表明，老年人有延迟伤口愈合的风险。因此，评估减少遭受痛苦的老年人伤口延迟愈合的策略尤为重要。体育锻炼是一种行为方式，可能通过影响心理功能和影响与伤口愈合相关的神经内分泌和免疫参数来促进伤口愈合。本研究采用随机对照设计，旨在评价运动对痛苦的老年人伤口愈合的影响。85名年龄在65岁至85岁之间的男性和女性将被招募，并将接受预先基线的实验性穿孔活检伤口。伤口愈合后，参与者将被随机分配到有氧运动条件(AE)或伸展和灵活性控制条件(SF)。参与者将在两个时间段完成心肺耐力、心理功能、内分泌功能和免疫功能的评估：随机分配前的基线(T1)和12周干预期结束时(T2)。T1评估两周后，所有参与者将返回研究评估现场进行第二次实验性穿孔活组织检查伤口程序以及免疫功能和皮质醇分泌(T1 A)的评估。四周后(T1B)，参与者将完成另一项免疫功能和皮质醇分泌的评估。参与者将保持在指定的条件下，直到完成T2评估。数据将采用线性混合建模和分层回归进行分析。据推测，与SF参与者相比，被分配到AE条件下的参与者将在心肺功能方面取得显著改善，减少心理困扰，并加快伤口愈合的速度。此外，AE参与者将体验到SF参与者没有观察到的神经内分泌和免疫参数的增强调节。这项研究的结果将表明运动对伤口愈合的影响程度，以及有助于运动对伤口愈合效果的心理和生物机制。反过来，这一结果可能会对治疗遭受皮肤创伤或正在从手术中恢复的老年人产生影响。

DESCRIPTION (provided by applicant): Prior studies have demonstrated that psychological distress delays wound healing. In addition, there is evidence that older adults are at risk for delayed wound healing. Thus, it is particularly important to evaluate strategies for reducing delayed wound healing among older adults who are experiencing distress. Physical exercise is a behavioral approach that may contribute to enhanced wound healing both via influences on psychological functioning and via influences on neuroendocrine and immune parameters relevant for wound healing. This study is designed to evaluate the effect of exercise on wound healing among distressed older adults using a randomized controlled design. Eighty-five men and women ranging in age from 65-85 will be recruited and will undergo a pre-baseline experimental punch biopsy wound. After the wound has healed participants will be randomly assigned to either an aerobic exercise condition (AE) or a stretching and flexibility control condition (SF). Participants will complete assessments of cardiopulmonary endurance, psychological functioning, endocrine function, and immune function at two times: baseline prior to random assignment (T1), and at the conclusion of the 12-week intervention period (T2). Two weeks after the T1 assessment, all participants will return to the study assessment site for a second experimental punch biopsy wound procedure as well as assessments of immune function and cortisol secretion (T1 A). Four weeks later (T1B), participants will complete an additional assessment of immune function and cortisol secretion. Participants will remain in their assigned conditions until completing the T2 assessment. Data will be analyzed with linear mixed modeling and hierarchical regression. It is hypothesized that participants assigned to the AE condition will achieve significant improvements in cardiorespiratory function, decreased psychological distress, and accelerated rates of wound healing compared to the SF participants. In addition, AE participants will experience enhanced regulation of neuroendocrine and immunologic parameters not observed in the SF participants. Results of the study will indicate the degree to which exercise influences wound healing as well as the psychological and biological mechanisms that contribute to the effect of exercise on wound healing. In turn, the results may have- implications for treating older adults who suffer dermal wounds or are recovering from surgery.