Improving health self-management using walking biobehavioral intervention for people with dysvascular lower limb amputation

项目摘要/摘要 这一研究的最终目标是优化人们的生活质量并将残疾降至最低。 通过改善体力活动自我管理，改善血管障碍患者的下肢截肢。首字母A 迈向这一目标的一步是测试我们行走的生物行为干预。我们最重要的假设是 对血管障碍肢体截肢康复者实施步行生物行为干预， 一种以多种慢性病为特征的疾病，将改善健康自我管理，通过 增加习惯性体力活动。血管障碍性截肢的复杂性和合并症需要 与因创伤原因截肢相比，愈合时间更长，恢复的方法也更独特。 截肢前存在的慢性久坐行为在与 肢体丧失的影响。因此，血管功能障碍截肢的人报告说残疾程度极高， 行走受限是他们的头号功能问题。集成的生物行为干预 传统的假肢康复是通过利用 变革的动力。然而，假肢训练指南不包括步行生物行为。 干预。因此，这项二期临床试验的目的是：1)测试步行的益处 改善日常习惯性步行活动的生物行为干预和2)确定潜力 康复中实施步行生物行为干预的初步研究 评估干预措施的覆盖范围、有效性、采用、实施和维护。这场审判 提出了一种在医疗服务不足的情况下提高生活质量和减少残疾的替代战略 复杂的慢性病人群。该试验与美国国立卫生研究院的资助机会直接相关 公告PA-18-146，寻求改善自我管理干预措施的临床研究 需要帮助以优化功能、预防/延迟残疾和导航的人的生活质量 环境。

PROJECT SUMMARY / ABSTRACT The ultimate goal of this line of research is to optimize quality of life and minimize disability for people with dysvascular lower limb amputation through improved physical activity self-management. An initial step toward that goal is to test our walking biobehavioral intervention. Our overarching hypothesis is that implementing walking biobehavioral intervention for people recovering from dysvascular lower limb amputation, a disease characterized by multiple chronic conditions, will improve health self-management, as measured by increased habitual physical activity. The complex, comorbid nature of dysvascular amputation requires extended healing time and unique approaches to recovery compared to amputation from traumatic causes. Chronic sedentary behaviors that are present before amputation become more obvious when compounded by the effects of limb loss. As a result, people with dysvascular amputation report extremely high disability and walking limitation as their number one functional problem. Biobehavioral intervention integrated within conventional prosthesis rehabilitation is an opportune time to address walking behaviors by capitalizing on motivation for change. However, prosthetic training guidelines do not include walking biobehavioral intervention. Therefore, the purposes of this Phase II clinical trial are to: 1) test the benefit of walking biobehavioral intervention for improving habitual daily walking activity and 2) determine the potential for implementing the walking biobehavioral intervention in rehabilitation by performing initial assessments of intervention reach, efficacy, adoption, implementation, and maintenance. This trial presents an alternative strategy for improving quality of life and reducing disability in an underserved, medically complex, chronic disease population. The trial is directly aligned with the NIH Funding Opportunity Announcement PA-18-146, which seeks clinical research on self-management interventions that improve quality of life in persons needing assistance to optimize function, prevent/delay disability, and navigate their environment.