Locomotor adaptation training to prevent mobility disability

运动适应训练以防止行动障碍

• 批准号: 8892569
• 负责人: Christopher J. Hass
• 金额: $ 22.5万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8892569
• 关键词: Activities of Daily Living; Address; Aerobic; Age; Aging; American; Basal Ganglia; Biological Neural Networks; Biological Preservation; Biomechanics; Capsicum; Cardiovascular system; Cerebellum; Clinical; Cognitive; Communities; Complex; Control Groups; Data; Elderly; Electrophysiology (science); Enrollment; Environment; Equilibrium; Exercise; Feasibility Studies; Frequencies; Future; Gait; Goals; Health Status; Healthcare; Hospitalization; Impairment; Independent Living; Individual; Intervention; Learning; Left; Leg; Literature; Locomotor adaptation; Measures; Mechanics; Mediating; Methods; Modeling; Nature; Nervous system structure; Neuraxis; Outcome; Pattern; Performance; Phase; Physical Rehabilitation; Physically Handicapped; Physiological; Pilot Projects; Population; Prevalence; Process; Quality of life; Randomized; Randomized Clinical Trials; Recovery; Rehabilitation therapy; Reporting; Research; Resources; Risk; Sensory; Speed; Spinal; Staging; Stimulus; Testing; Therapeutic exercise; Time; Training; Walking; base; behavioral study; blind; clinically significant; control trial; disability; experience; fitness; functional decline; group intervention; improved; indexing; innovation; instrument; learned behavior; mortality; neuroimaging; novel; pre-clinical; prevent; public health relevance; rehabilitation technology; research study; sedentary; success; tool; treadmill training

 DESCRIPTION (provided by applicant): The ability to remain mobile is a fundamental contributor to quality of life and is essential for the preservation of independence in old age. Millions of Americans currently report mobility related impairments and these numbers will rise significantly with the aging of our populace. Self-selected walking speed highly correlates with quality of life, functional ability, balance capabilities and is predictive of future health status decline in functional capacity, hospitalization and mortality. As such, therapeutic exercise interventions for older adults with mobility limitations have focused on improving walking as a means to reduce or delay physical disability but with limited success. Herein we propose to explore the efficacy of an innovative advance in physical rehabilitation technology, dual belt treadmill, which is capable of imposing unique propulsive and stability demands independently on each leg during walking. Repetitive locomotor perturbations using the dual belt treadmill forces the central nervous system to solve/adapt (locomotor adaptation) to the challenge using both frontally-mediated locomotor and cognitive resources. Based on exciting preliminary data from our labs, we hypothesize that an intervention that can challenge the locomotor processes required for safe, efficient gait while concurrently providing an aerobic stimulus will produce favorable changes in both gait performance and functional capacity in older adults at risk for mobility disability. To investigate the effects of dual belt training on gait and functional capaciy in those at risk for mobility disability, a two year, single-center, rater-blind exploratory study s proposed. For this pilot feasibility study we will enroll 48 sedentary older adults at risk for disability (usual gait speed = 1.0 m/s and a summary score on the Short Physical Performance Battery (SPPB) 7 - 10) will be randomly assigned to either traditional treadmill exercise (N=16) or dual belt treadmill exercise (N=16) with matched cardiovascular intensities or a control group (N=16). Aim 1 will test the hypothesis that compared with a traditional treadmill intervention dual belt treadmill training will result in greater improvements in gait performance, as reflected by improvements in walking speed and gait variability. Aim 2, an exploratory aim, will test the hypothesis that compared with a traditional treadmill intervention a dual belt treadmill intervention will results in greater improvements in functional capacity (i.e. mobility disability, balance function, functional performance, walking efficiency, and aerobic capacity). To date, no experimental study has evaluated these propositions in a controlled trial. Therefore, results from the proposed pilot study have the potential to be both highly innovative and clinically significant while providing preliminary data for a larger randomized clinical trial.

 描述(由申请人提供)：保持机动性的能力是生活质量的一个基本因素，对老年保持独立性至关重要。目前，数以百万计的美国人报告了与行动不便有关的障碍，随着人口老龄化，这些数字将显著上升。自我选择的步行速度与生活质量、功能能力、平衡能力高度相关，并预测未来健康状况在功能能力、住院和死亡率方面的下降。因此，对行动不便的老年人的治疗性运动干预侧重于改善步行，以此作为减少或延迟身体残疾的一种手段，但收效甚微。在此，我们建议探索一种创新的身体康复技术--双带跑步机的有效性，它能够在步行过程中独立地对每条腿施加独特的推进和稳定性要求。使用双带跑步机的重复运动干扰迫使中枢神经系统利用额叶中介的运动和认知资源来解决/适应(运动适应)挑战。基于我们实验室令人兴奋的初步数据，我们假设，在提供有氧刺激的同时挑战安全、有效步态所需的运动过程的干预措施，将在有行动障碍风险的老年人的步态表现和功能能力方面产生有利的变化。为了研究双腰带训练对行动不便高危人群步态和功能能力的影响，S提出了一项为期两年的单中心盲评人探索性研究。在这项试点可行性研究中，我们将招募48名久坐不动的有残疾风险的老年人(通常步态速度=1.0m/S，短身体性能组合总分7-10)，随机分配到具有匹配心血管强度的传统跑步机运动(N=16)或双带跑步机运动(N=16)或对照组(N=16)。目标1将检验假设，与传统的跑步机干预双人 腰带跑步机训练将导致步态表现的更大改善，这反映在步行速度和步态可变性的改善上。作为一项探索性目标，Aim 2将检验这样一种假设，即与传统的跑步机干预相比，双带跑步机干预将导致功能能力的更大改善(即行动不便， 平衡功能、机能表现、步行效率和有氧能力)。到目前为止，还没有实验研究在对照试验中评估这些主张。因此，拟议的先导性研究的结果可能具有很高的创新性和临床意义。 同时为更大规模的随机临床试验提供初步数据。