CAN EXERCISE TRAINING REVERSE PHYSICAL FRAILTY?

描述：(改编自申请人的摘要)。主要研究成果 OAIC的重点是减少身体虚弱，从而 丧失独立性和养老院的风险降低 入场。这项干预研究的目标是：a) 确定78岁以上身体虚弱的女性和男性 年限可与心血管、骨骼的运动训练反应 肌肉，和中枢神经系统的适应，已经被证明 发生在较年轻的个体中；以及b)如果显著的适应 以评估这些适应的程度是否 足够大，在功能上足够重要，以导致改进 在日常生活能力(ADL)表演中，工具性ADL (IADL)、高级ADL(AADL)和客观体能测试 与执行IADL和AADL的能力相关，并且是 丧失独立性、入住疗养院和矮小的预测因素 足月死亡率。长期目标是获得能够 用于设计实用的、个性化的锻炼计划， 可在社区环境中使用，以防止或扭转物理 脆弱并保持功能独立。这项运动训练将 有三个阶段，包括三个月的物理治疗练习， 3个月的举重和理疗锻炼， 在物理治疗的基础上进行3个月的有氧运动 举重练习。这项研究的目的是确定： A)物理治疗练习在改善 柔韧性、步态、平衡性、协调性、力量和倒车 虚弱；b)虚弱的老年人是否能适应举重 所有主要肌肉群、全身力量的显著增加 和骨骼肌蛋白质合成代谢，以及肌肉质量，以及进一步 减少虚弱；c)虚弱的老年人是否能适应有氧运动 运动训练，增加氧摄取能力 进一步降低脆弱性，并评估 通过测定最大心脏摄氧量的增加 心输出量、左心室每搏量和外周血氧 提取；d)运动训练是否降低动脉 僵硬；e)运动训练是否降低受试者的血压 轻度高血压；f)运动是否增加骨矿物质 股骨近端、脊柱和骨骼其他区域的密度； G)运动是否改善认知功能和中枢神经系统 处理速度；以及h)锻炼是否提高了生活质量。 这项研究的一个重要组成部分是确定 从该项目毕业的学生在功能方面保持了改进 容量。在研究出院前，参与者将被给予 在家中遵循个性化运动处方，并将 帮助建立家庭健身房或介绍方便的锻炼 设施。与毕业生的联系将通过以下方式保持 每月的电话，他们将被带回演习 每月一次的培训课程和定期评估 功能能力，使用简单的措施，如标准化 体能测试。成本效益和成本效用分析 将被用来评估 锻炼身体。

DESCRIPTION: (Adapted from applicant's abstract). The major research focus of this OAIC is on the reduction of physical frailty resulting in a decrease in the risk of loss of independence and nursing home admission. The goals of this intervention study, IS-1, are: a) to determine the extent to which frail women and men over the age of 78 years can respond to exercise training with the cardiovascular, skeletal muscle, and central nervous system adaptations that have been shown to occur in younger individuals; and b) if significant adaptations do occur, to assess whether or not the magnitudes of these adaptations are sufficiently large and functionally important to result in improvements in performance of activities of daily living (ADL), instrumental ADL (IADL), advanced ADL (AADL) and in objective physical performance tests that correlate with the ability to perform IADL and AADL and are predictors of loss of independence, nursing home admission, and short- term mortality. The long-term goal is to obtain information that can be used to design practical, individualized programs of exercise that can be utilized in community settings to prevent or reverse physical frailty and maintain functional independence. The exercise training will have three phases consisting of 3 months of physical therapy exercises, 3 months of weight lifting superimposed on physical therapy exercises, and 3 months of aerobic exercise superimposed on physical therapy and weight lifting exercise. The aims of this research are to determine: a) the effectiveness of physical therapy exercises in improving flexibility, gait, balance, coordination, and strength and in reversing frailty; b) whether frail old people can adapt to weight lifting with significant increases in strength of all major muscle groups, whole body and skeletal muscle protein anabolism, and muscle mass, and a further reduction in frailty; c) whether frail old people can adapt to aerobic exercise training with increases in oxygen uptake capacity with a further decrease in frailty, and to evaluate the mechanisms involved in any increase in oxygen uptake capacity by determining maximal cardiac output, left ventricular stroke volume, and peripheral oxygen extraction; d) whether the exercise training decreases arterial stiffness; e) whether exercise training lowers blood pressure in subjects with mild hypertension; f) whether the exercise increases bone mineral density in the proximal femur, spine, and other regions of the skeleton; g) whether the exercise improves cognitive function and central processing speed; and h) whether the exercise improves quality of life. An important component of this research is to determine the extent to which the graduates from the program maintain improvements in functional capacity. Before discharge from the study, participants will be given individualized exercise prescriptions to follow at home and will be helped to put together home gyms or referred to a convenient exercise facility. Contact with the graduates will maintained by means of monthly phone calls and they will be brought back to the exercise facility once per month for a training session and periodic evaluations of functional capacity, using simple measures such as the standardized Physical Performance Test. Cost-effectiveness and cost-utility analysis will be used to evaluate the relative costs and benefits of the exercise.