Physical Activity Behavior Change for Older Veterans after Dysvascular Amputation

 描述（由申请人提供）： 目前有超过100万美国人患有下肢截肢，预计到2050年这一数字将增加一倍以上。超过80%的下肢截肢是由于严重糖尿病和/或严重外周动脉疾病等疾病引起的血管并发症，称为血管障碍性截肢。患有血管障碍性下肢截肢的退伍军人人数正在增加，高水平的死亡率和残疾突出了确定优化身体康复方法的重要性。血管障碍性截肢人群的特点是：1）体力活动水平低，2）残疾率高。这种不良的体力活动和残疾结果可能与退伍军人在血管障碍下肢截肢前采取的慢性体力活动行为有关，并在截肢后继续进行。因此，这项试点研究的主要目的是确定使用身体活动行为改变（PABC）干预的可行性，以增加身体活动和减少残疾的退伍军人1-5年后血管障碍下肢截肢。这项试点研究将是第一个评估使用PABC干预的可行性，老年退伍军人与血管障碍截肢。泛非理事会的干预为期三个月。测试将在基线（干预前）、3个月（干预结束）和6个月时进行。将使用以下指标确定可行性：1）受试者保留，2）剂量目标实现，3）受试者可接受性，4）安全性和5）初始效应量。效应量将基于基于加速度计的身体活动和使用晚年功能和残疾指数的自我报告残疾的结局指标。这项试点研究解决了一个研究不足和不断增长的人口老龄化退伍军人的特点是复杂的健康状况。该结果将通过提供与改善老年退伍军人群体所经历的慢性低体力活动和高水平残疾相关的关键可行性数据，显着推进当前的研究。

 DESCRIPTION (provided by applicant): Project Summary/Abstract Over 1 million Americans currently live with lower limb amputations and the number is expected to more than double by 2050. More than 80% of all lower limb amputations result from vascular complications due to diseases such as severe diabetes mellitus and/or severe peripheral artery disease, known as dysvascular amputation. The population of Veterans with dysvascular lower limb amputation is growing, and high levels of mortality and disability highlight the significance of identifying ways to optimize physical rehabilitation. The dysvascular amputation population is characterized by: 1) low levels of physical activity and 2) high rates of disability. Such poor physical activity and disability outcomes are likely linked to chronic physical activity behaviors that Veterans adopt before dysvascular lower limb amputation and carry over after amputation. Therefore, the primary aim of this pilot study is to determine the feasibility of using a physical-activity behavior-change (PABC) intervention for increasing physical activity and reducing disability in Veterans 1-5 years following dysvascular lower-limb amputation. This pilot study will be the first to assess the feasibility of using a PABC intervention for older adult Veterans with dysvascular amputation. The PABC intervention is three months in duration. Testing will occur at baseline (pre-intervention), three months (end of intervention), and six months. Feasibility will be determined using measures of 1) participant retention, 2) dose goal attainment, 3) participant acceptability, 4) safety, and 5) initial effect size. Effect size will be based on the outcome measures of accelerometer-based physical activity and self-report disability using the Late-Life Function and Disability Index. This pilot study addresses an understudied and growing population of older Veterans characterized by complex health conditions. The outcome will significantly advance current research by providing critical feasibility data related to improving the chronic low physical activity and high levels of disability experienced by this population of older Veterans.