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Functional Capacity Assessment in Hospitalized Bed-bound COPD Patients; Predicting Outcomes

住院卧床的慢性阻塞性肺病患者的功能能力评估；

基本信息

批准号：
10013118
负责人：
Martha Jane Mohler
金额：
$ 19.19万
依托单位：
UNIVERSITY OF ARIZONA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-15 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10013118
关键词：
Activities of Daily Living Acute Adult Age Aging Algorithms Ambulatory Care Area Arizona Assessment tool Beds Biomechanics Caring Cessation of life Chronic Chronic Bronchitis Chronic Disease Chronic Obstructive Airway Disease Clinical Clinical Research Communities Complex Consumption Data Development Diabetes Mellitus Diagnosis Elbow Elderly Electromyography Event Exercise Test Follow-Up Studies Forced expiratory volume function Funding Future Gait Gait abnormality Gait speed Gender Goals Health Heart failure Hospitalization Hospitals Impairment Inpatients Institutionalization Knowledge Legal patent Length of Stay Longitudinal Studies Measurement Measures Methods Modeling Motion Muscle Muscle function Muscular Atrophy Nature Outcome Outpatients Participant Patients Performance Plant Roots Pneumonia Protocols documentation Published Comment Publishing Pulmonary Function Test/Forced Expiratory Volume 1 Quality of life Research Research Design Research Personnel Respiratory physiology Risk Risk stratification Sampling Science Screening procedure Severities Speed Spirometry System Technology Testing Time Training Universities Upper Extremity Validity and Reliability Walking Work acute care adverse outcome base cost cost effective deconditioning design exhaustion fall risk falls flexibility frailty functional decline high risk hospital readmission improved indexing innovation kinematics laptop mortality multidisciplinary multiple chronic conditions muscle strength novel strategies outcome prediction patient oriented research predictive tools pressure primary outcome prospective pulmonary function reduced muscle strength respiratory response screening sensor stressor tool treatment risk ventilation wearable sensor technology

项目摘要

PROJECT SUMMARY/ABSTRACT This patient-oriented research R21 application will provide funding support for validating a novel approach for assessing functional capacity among hospitalized older adults with chronic obstructive pulmonary disease (COPD), an area of substantial and increasing significance. Our proposed innovative screening method is objective, quick, and based on muscle performance assessment of underlying systemic dynapenia. Within this project we will perform a 90-day longitudinal study to validate prediction of COPD exacerbations, hospitalizations, and mortality using the proposed method. The proposed functional capacity assessment method incorporates an upper-extremity function (UEF) test, to obviate the need for walking tasks in bed-bound hospitalized elders. The UEF test involves repetitive elbow flexion measured using low-cost sensors, which is easily performed (standing, sitting, or in bed) in less than one minute. Post-processing, and scoring will be performed in less than one minutes using an app on laptop or cellphone. We have patented and validated the UEF test for assessing frailty based on motion (kinematics) data, and its feasibility has previously been demonstrated in pilot outpatient and inpatient participants. Within this project, implementing the same hardware and measurement protocol, we will improve the algorithm to assess muscle deconditioning (dynapenia) using a new muscle model that will be added to our original UEF algorithm. The proposed approach builds upon pilot research among COPD patients, performed by an excellent group of interdisciplinary investigators at the University of Arizona Center on Aging and the Arizona Respiratory Science Center, demonstrating significant associations between UEF speed (and embedded strength parameters) with the 6-minute walk distance (6MWD) test, the most commonly used measure of functional capacity in COPD. The goal of this R21 project is to: 1) Develop and evaluate an upper-extremity muscle model; and 2: (Clinical Study): Longitudinally assess UEF validity for predicting 90-day adverse health events among 120 COPD-related hospitalized older adults (≥ 65 years) – Predictive Index development and assessment of UEF accuracy, feasibility, and reliability. We expect to extend scientific knowledge regarding the nature of muscle deconditioning (dynapenia) associated with COPD, focusing on an upper-extremity function measure (rather than gait assessment). From a clinical viewpoint, we expect to validate a quick and accurate objective tool for assessing functional capacity among COPD patients as an alternative to the 6MWD test, with the ultimate goal of providing a quick and cost-effective screening tool to support acute and outpatient elders’ risk stratification. If demonstrated effective, we expect that this tool could be used to predict those at highest risk, to enable personalized COPD care and support the quality of life and independence of older adults with COPD or multiple chronic conditions.

项目总结/文摘