Improving physical function and quality of life in older adults with prediabetes utilizing interactive small-group resistance training through video conference technology

Vivo是一个虚拟的小团体锻炼计划，专为55岁及以上的成年人设计， 越来越受欢迎的数字健身市场。Vivo提供3个关键的市场差异化：1）个性化和 个性化的现场培训体验，并从认证培训师那里获得反馈，2）老年人社区 锻炼者，增强动力和社会支持，增加责任感和乐趣，以及3）Vivo 训练经验的重点是改善身体功能，使用性能反馈，目标设定， 系统来衡量感知的努力。大多数老年人经历了30%的肌肉质量损失之间的年龄 50-70.阻力训练是改善肌肉质量和功能的最有效策略， 控制肌肉减少症Vivo的编程是基于科学证据，即使在没有 慢性疾病，阻力训练是定制，以满足个人的需求和水平的运作， 一个可行的和循证的方法，以改善身体功能，调节葡萄糖处理，减少 风险为福尔斯，并延长独立生活和老化的地方。到目前为止，已有92人参加了Vivo (age范围44-93）。在我们对34名老年人（74%为女性;平均年龄70.9岁;范围60- 84岁）进行的初步研究中， 我们观察到，在经过认证的培训师（平均每人12小时的培训）的帮助下， 上肢力量提高+25.8%，通过30秒手臂弯曲测试测量; +25.9% 通过30秒椅子站立测试测量的下半身力量改善; 通过2分钟膝关节抬高试验测量的耐力。该SBIR快速通道的目标如下： 第一阶段目标1：评价当前Vivo原型在久坐状态下的可接受性、可行性和保真度 里程碑1：评估a）糖尿病前期老年人的出勤率、益处和障碍/促进因素 参与度; B）易用性;以及c）总体满意度。里程碑2：评估培训师的忠诚度。 目的2 ：设计 并为Vivo 2.0开发多功能平台原型里程碑1：创建功能规范 以客户为中心的方法（结果，目标，坚持，即将到来的锻炼），社会参与和 支持.里程碑2：开发可点击的平台原型。第二阶段目标1：设计和建造 Vivo 2.0平台-统一的web/移动的应用程序。里程碑1：评估原型可用性。里程碑二： 迭代软件和硬件的设计，以提高使用率，准确性和可用性。里程碑3： 根据新的原型和功能设计开发和测试最小可行软件产品， 包括移动的前端和web前端应用程序以及后端数据库。目标2：开展RCT， 确定Vivo 2.0 v.等待列表控制的有效性。主要结局为下肢变化 12周后的力量通过30秒内站立椅子的次数和平均血糖水平来测量 （HgA1c）。次要结局将包括生活质量的改善，以及依从性和社会影响 参与身体功能的结果。

Vivo is a virtual small group exercise program designed for adults 55 and over that is unique in the increasingly popular digital fitness market. Vivo offers 3 key market differentiators: 1) a personalized and individualized live training experience with feedback from a certified trainer, 2) a community of older adult exercisers which enhances motivation and social support, and increase accountability and fun, and 3) the Vivo training experience focuses on improving physical function using performance feedback, goal setting, and a system to measure perceived exertion. Most older adults experience a 30% loss in muscle mass between ages 50–70. Resistance training is the most effective strategy for improving both muscle mass and function and managing sarcopenia. Vivo’s programming is based on the scientific evidence that even in the absence of chronic disease, resistance training that is customized to meet the individual’s needs and level of functioning is a feasible and evidence-based approach to improve physical function, regulate glucose handling, reduce the risk for falls, and prolong independent living and aging in place. To date 92 people have participated in Vivo (age range 44-93). In our pilot study of 34 older adults (74% women; mean age 70.9 y; range 60-84y) after 8 weeks of participating in Vivo with a certified trainer (average of 12 hours of training per person) we observed +25.8% improvement in upper body strength as measured by the 30 second arm curl test; +25.9% improvement in lower body strength as measured by the 30 second chair stand test; and +28% improvement in endurance as measured by the 2-minute knee raise test. The aims for this SBIR FastTrack are as follows: Phase I Aim 1: Evaluate the acceptability, feasibility, and fidelity of current Vivo prototype in sedentary older adults with prediabetes Milestone 1: Assess a) attendance, benefits and barriers/facilitators of participation; b) ease of use; and c) overall satisfaction. Milestone 2: Assess trainer fidelity. Aim 2 : Design and develop a multifunctional platform prototype for Vivo 2.0 Milestone 1: Create functional specifications of the client-centered approach (results, goals, adherence, upcoming workouts), and social engagement and support. Milestone 2: Develop a clickable prototype of the platform. Phase II Aim 1: Design and build the Vivo 2.0 platform – a unified web/mobile application. Milestone 1: Assess prototype usability. Milestone 2: Iterate the design on the software and hardware to increase usage, accuracy and usability. Milestone 3: Develop and test a minimum viable software product based on the new prototype and functional design to include a mobile front-end and web front-end app and a backend database. Aim 2: Conduct a RCT to determine effectiveness of Vivo 2.0 v. wait list control. Primary outcomes will be change in lower extremity strength after 12 weeks measured by the number of chair stands in 30 seconds and average glycemic level (HgA1c). Secondary outcomes will include improvements in quality of life, and effect of adherence and social engagement on physical function outcomes.