Transforming Exercise Testing and Physical Activity Assessment in Children: New Approaches to Advance Clinical Translational Research in Child Health

改变儿童运动测试和体力活动评估：推进儿童健康临床转化研究的新方法

• 批准号: 10251868
• 负责人: DAN M COOPER
• 金额: $ 130.08万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-07-17 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10251868
• 关键词: Accelerometer; Address; American; Biological Markers; Blood; Body Composition; Brain imaging; California; Cardiopulmonary; Cardiovascular Diseases; Caregivers; Child; Child Health; Child health care; Childhood; Chronic Disease; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Communities; Cystic Fibrosis; Data; Data Analytics; Data Collection; Data Reporting; Development; Disease; Ensure; Evaluation Studies; Exercise; Exercise Test; Faculty; Functional disorder; Future; Gene Expression; Genes; Goals; Grant; Growth; Health; Health Personnel; Human; Impairment; Inflammation; Informatics; Institutes; Knowledge; Laboratories; Life; Link; Logistics; Longevity; Los Angeles; Measures; Medicine; Metabolism; Methods; Multicenter Studies; Multicenter Trials; Outcome; Participant; Pathologic; Pattern; Pediatric Hospitals; Personal Satisfaction; Physical Fitness; Physical activity; Physiological; Play; Prospective cohort study; Protocols documentation; Recording of previous events; Reference Values; Reproducibility; Research; Research Personnel; Rest; Role; Science; Semantics; Sickle Cell Anemia; Signal Transduction; Site; Societies; Sports Medicine; Technology; Test Result; Testing; Translational Research; Underserved Population; United States National Institutes of Health; Universities; Work; base; biomarker discovery; circulating biomarkers; clinical application; clinical practice; cohort; collaboratory; college; comparison group; critical period; data exchange; data harmonization; data repository; disorder prevention; disorder risk; early detection biomarkers; fitness; fitness test; improved; indexing; innovation; insight; interoperability; laboratory experiment; novel; novel strategies; prevent; recruit; syntax

Children are the most naturally physically active human beings; reduced physical activity is a cardinal sign of childhood disease, and exercise testing provides mechanistic insights into health and disease that are often hidden when the child is at rest. Despite this, and because data analytics and testing protocols have failed to keep pace with enabling technologies and computing capacity, biomarkers of fitness and physical activity have yet to be widely incorporated into translational research and clinical practice in child health. The goal of this project is to address the obstacles that have impeded optimal use of cardiopulmonary exercise testing (CPET) in children. Aim 1 is to rethink and transform current clinical research applications of typical CPET in children by novel implementation of breath-by-breath technologies and data analytic approaches. Aim 2 is to develop new exercise testing protocols (multiple brief exercise bouts) that more closely mimic real-life patterns of physical activity and, in so doing, better assess relevant pathophysiology. Aim 3 is to identify and overcome logistical issues that have limited multicenter studies involving exercise biomarkers. Our use-cases, sickle cell disease and cystic fibrosis, highlight how very different diseases can impair exercise and physical activity. The value of the new CPET approaches will be analyzed in a variety of ways, including by: 1) established indexes of health (e.g., body composition), 2) habitual physical activity, an emerging metric of overall health, and 3) novel exercise-responsive gene expression signals in the circulating blood. In combination with healthy children as comparisons, our project will delineate the use of CPET biomarkers across a broad spectrum of pediatric health and disease. We will take advantage of the grant cycle and study cohorts prospectively as our participants grow and mature from Tanner 2–3 to 5, roughly a 3-year interval. This provides the unique opportunity to study CPET longitudinally in health and disease over a critical period of growth. Our team represents the diverse and challenging array of academic health centers and affiliated stand-alone children’s hospitals often involved in multicenter pediatric translational research: 1) University of California at Irvine Institute for Clinical and Translational Science, 2) Northwestern University Clinical and Translational Sciences Institute, and 3) the Southern California Clinical and Translational Science Institute, Children’s Hospital of Los Angeles, University of Southern California. Each of these centers is committed to underserved populations. In addition, we will collaborate with the North American Society of Pediatric Exercise Medicine and the American College of Sports Medicine, each dedicated to advancing exercise-as-medicine in children. Through our proposed: 1) innovations in data analytics of commonly used CPET, 2) developing new testing paradigms, 3) providing the research community with essential data to determine statistical power and analytic approaches specific for exercise biomarkers, and 4) improving interoperability in multicenter trials, the project will stimulate child health clinical research in which exercise biomarkers are used as key outcome variables.

儿童是最自然的身体活跃的人。体育锻炼减少是基本的迹象 儿童疾病和运动测试提供了对健康和疾病的机理见解 当孩子休息时隐藏。尽管如此，并且由于数据分析和测试协议未能 跟上启示技术和计算能力，健身和体育锻炼的生物标志物具有 然而，将被广泛纳入儿童健康的翻译研究和临床实践中。目标的目标 项目是解决阻碍心肺运动测试（CPET）最佳使用的障碍 在儿童中。目标1是重新考虑和改变典型CPET在儿童中的当前临床研究应用 通过新的呼吸呼吸技术和数据分析方法的新实施。目标2是发展 新的练习测试协议（多次简短练习），更亲密地模仿现实生活模式 体育锻炼以及这样做，可以更好地评估相关的病理生理学。目标3是识别和克服 涉及运动生物标志物的多中心研究有限的后勤问题。我们的用例，镰状细胞 疾病和囊性纤维化突出显示了非常不同的疾病如何损害运动和体育锻炼。 新CPET方法的价值将通过多种方式进行分析，包括：1）已建立的索引 健康（例如，身体成分），2）习惯性体育锻炼，整体健康的新兴指标和3） 循环血液中新型运动响应基因表达信号。结合健康 儿童作为比较，我们的项目将描述CPET生物标志物在广泛的范围内的使用 小儿健康与疾病。我们将利用赠款周期，并前瞻性地研究同伙 参与者从坦纳（Tanner）2-3到5成熟，大约是3年的时间间隔。这提供了独特的 在关键的生长期间，有机会在健康和疾病中纵向研究CPET。我们的团队 代表了学术保健中心和会员独立儿童的潜水员和挑战阵列 医院经常参与多中心小儿翻译研究：1）加利福尼亚大学尔湾分校 临床与转化科学研究所，2）西北大学临床和转化科学 研究所和3）洛斯儿童医院南加州临床和转化科学研究所 南加州大学安吉利斯。这些中心中的每个中心都致力于服务不足的人群。在 此外，我们将与北美小儿运动医学学会和美国合作 运动医学学院，每个学院都致力于在儿童中推进运动中的运动。通过我们的 提议：1）常用CPET的数据分析中的创新，2）开发新的测试范例，3） 为研究社区提供基本数据，以确定统计能力和分析方法 专门针对运动生物标志物，以及4）改善多中心试验中的互操作性，该项目将刺激 儿童健康临床研究，其中运动生物标志物用作关键结果变量。