Home Program to Enhance Mobility in Older Veteran Diabetics

增强老年退伍糖尿病患者活动能力的家庭计划

• 批准号: 8089145
• 负责人: Neil Alexander
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8089145
• 关键词: Adherence; Age; Behavioral; Blood Pressure; Blood Vessels; Clinical; Comorbidity; Dependency; Diabetes Mellitus; Discipline of Nursing; Disease; Doctor of Philosophy; Elderly; Exercise; Funding; Gait; Goals; Health; Health education; Home environment; Impairment; Intervention; Intervention Studies; Lead; Lipids; Measurement; Measures; Metabolic; Metabolic Control; Modeling; Neuropathy; Nurses; Obesity; Outcome; Outpatients; Patient Self-Report; Patients; Performance; Physical activity; Physicians; Provider; Public Health; Quality of life; Randomized Controlled Trials; Research; Self Management; Site; Speed; Testing; Training; Veterans; Weight; Weights and Measures; actigraphy; aged; base; control trial; design; diabetic; disability; fitness; flexibility; improved; improved mobility; outreach program; population based; programs; sedentary; success

DESCRIPTION (provided by applicant): The goal of the proposed research is to test whether a long-term exercise program in sedentary veterans with diabetes will produce sustained improvement in mobility performance and physical activity. To facilitate adherence to a long-term program, we plan an individualized, home exercise/physical activity (PA) enhancement program with behavioral support. The rationale for this program is based on: 1) the feasibility of a previously funded VA RR&D controlled trial (led by the present research team) in sedentary older adults with diabetes that improved mobility performance, specifically usual gait speed; 2) the need for longer term and functionally-relevant interventions (specifically mobility-oriented) for older adult diabetics; 3) the potential to use telephonic nurse support to assist in overcoming barriers to exercise and in dealing with intercurrent illness, factors that are key in this comorbid patient group; and 4) the potential to increase the focus on objectively measured physical activity. In this proposed research, 240 sedentary older adult diabetics (aged 60 and over) will be randomly allocated into a customized, primarily home-based, functionally-oriented exercise program with nurse support intervention (I) group versus a flexibility and toning, health education control (C) group, and test outcomes in functional mobility and physical activity at 4 weeks, 6 months and one year. Primary Aim. Determine whether a home program improves mobility Hypothesis: In older adults with diabetes, a primarily home intervention consisting of functional exercise training and enhanced physical activity with nurse telephonic behavioral support will result in improved mobility performance at one year, compared to baseline and a flexibility and toning, health education control (C) group. Exploratory Aim: Determine whether a home program improves physical activity Hypothesis: Physical activity, as measured by weighted activity counts on actigraphy, will increase disproportionately from baseline to one year, in the I group as compared to the C group. This research can lead to an exercise/PA enhancement program that can coordinate with VA outreach programs, targeting older veterans who are not in the immediate vicinity of a major VA site. Ultimately, this should create a model to which physicians and other providers could refer comorbid diabetes patients. PUBLIC HEALTH RELEVANCE: The goal of the proposed research is to test whether a long-term exercise program in sedentary veterans with diabetes will produce sustained improvement in mobility performance and physical activity. In this proposed research, 240 sedentary older adult diabetics (aged 60 and over) will be randomly allocated into a customized, primarily home- based, functionally-oriented exercise program with nurse support intervention (I) group versus a flexibility and toning, health education control (C) group, and test outcomes in functional mobility and physical activity at 4 weeks, 6 months and one year. This research can lead to an exercise/PA enhancement program that can coordinate with VA outreach programs, targeting older veterans who are not in the immediate vicinity of a major VA site. Ultimately, this should create a model to which physicians and other providers could refer comorbid diabetes patients.

描述（由申请人提供）： 拟议研究的目的是测试患有糖尿病的久坐退伍军人的长期锻炼计划是否会对行动能力和身体活动产生持续改善。为了促进长期计划的坚持，我们计划了一个个性化的家庭锻炼/身体活动 (PA) 增强计划，并提供行为支持。该计划的基本原理是基于：1）先前资助的 VA RR&D 对照试验（由目前的研究团队领导）在患有糖尿病的久坐老年人中进行，该试验可改善行动能力，特别是通常的步态速度； 2）老年糖尿病患者需要长期和功能相关的干预措施（特别是针对活动性的干预措施）； 3) 使用电话护士支持来协助克服运动障碍和处理并发疾病的潜力，这些因素是该共病患者群体的关键因素； 4）有可能增加对客观测量的身体活动的关注。在这项拟议的研究中，240 名久坐的老年糖尿病患者（60 岁及以上）将被随机分配到一个定制的、主要以家庭为基础、以功能为导向的锻炼计划中，其中有护士支持干预 (I) 组与灵活性和塑性、健康教育控制 (C) 组，并在 4 周、6 个月和一年时测试功能活动度和体力活动的结果。主要目标。确定家庭计划是否可以改善行动能力 假设：对于患有糖尿病的老年人，与基线组和灵活性和强健健康教育对照组 (C) 组相比，主要由功能锻炼训练和加强体力活动以及护士电话行为支持组成的家庭干预将导致一年后行动能力的改善。探索性目标：确定家庭计划是否可以改善身体活动 假设：与 C 组相比，I 组的身体活动（通过体动记录仪上的加权活动计数来测量）将从基线到一年不成比例地增加。这项研究可以制定一项运动/公共活动增强计划，该计划可以与退伍军人事务部外展计划相协调，针对不在退伍军人事务部主要地点附近的老年退伍军人。最终，这应该创建一个模型，医生和其他提供者可以将共病糖尿病患者转介给该模型。 公共卫生相关性： 拟议研究的目的是测试患有糖尿病的久坐退伍军人的长期锻炼计划是否会对行动能力和身体活动产生持续改善。在这项拟议的研究中，240 名久坐的老年糖尿病患者（60 岁及以上）将被随机分配到一个定制的、主要以家庭为基础、以功能为导向的锻炼计划中，其中有护士支持干预（I）组与灵活性和塑性、健康教育控制（C）组，并在 4 周、6 个月和一年时测试功能活动度和体力活动的结果。这项研究可以制定一项运动/公共活动增强计划，该计划可以与退伍军人事务部外展计划相协调，针对不在退伍军人事务部主要地点附近的老年退伍军人。最终，这应该创建一个模型，医生和其他提供者可以将共病糖尿病患者转介给该模型。