Exercise, stress, and wound healing among older adults

描述（由申请人提供）：先前的研究表明，心理困扰会延迟伤口愈合。此外，有证据表明，老年人有伤口愈合延迟的风险。因此，评估在经历痛苦的老年人中减少延迟伤口愈合的策略尤为重要。体育锻炼是一种行为方法，可以通过影响心理功能和影响与伤口愈合相关的神经内分泌和免疫参数来促进伤口愈合。本研究采用随机对照设计，旨在评估运动对痛苦老年人伤口愈合的影响。85名年龄在65-85岁之间的男性和女性将被招募，并将接受基线前的实验性穿孔活检。伤口愈合后，参与者将被随机分配到有氧运动条件（AE）或拉伸和柔韧性控制条件（SF）。参与者将在两次完成心肺耐力、心理功能、内分泌功能和免疫功能的评估：随机分配前的基线（T1）和12周干预期结束时（T2）。T1评估两周后，所有参与者将返回研究评估地点进行第二次实验性穿孔活检伤口程序，并评估免疫功能和皮质醇分泌（T1 a）。四周后（T1B），参与者将完成免疫功能和皮质醇分泌的额外评估。参加者在完成T2评核前，将维持在指定的条件下。数据将用线性混合建模和层次回归进行分析。假设与SF组相比，AE组的受试者在心肺功能、心理困扰和伤口愈合速度方面有显著改善。此外，AE参与者将经历神经内分泌和免疫参数的增强调节，这在SF参与者中没有观察到。研究结果将表明运动对伤口愈合的影响程度，以及运动对伤口愈合影响的心理和生物学机制。反过来，该结果可能对治疗皮肤受伤或正在从手术中恢复的老年人有启示。

DESCRIPTION (provided by applicant): Prior studies have demonstrated that psychological distress delays wound healing. In addition, there is evidence that older adults are at risk for delayed wound healing. Thus, it is particularly important to evaluate strategies for reducing delayed wound healing among older adults who are experiencing distress. Physical exercise is a behavioral approach that may contribute to enhanced wound healing both via influences on psychological functioning and via influences on neuroendocrine and immune parameters relevant for wound healing. This study is designed to evaluate the effect of exercise on wound healing among distressed older adults using a randomized controlled design. Eighty-five men and women ranging in age from 65-85 will be recruited and will undergo a pre-baseline experimental punch biopsy wound. After the wound has healed participants will be randomly assigned to either an aerobic exercise condition (AE) or a stretching and flexibility control condition (SF). Participants will complete assessments of cardiopulmonary endurance, psychological functioning, endocrine function, and immune function at two times: baseline prior to random assignment (T1), and at the conclusion of the 12-week intervention period (T2). Two weeks after the T1 assessment, all participants will return to the study assessment site for a second experimental punch biopsy wound procedure as well as assessments of immune function and cortisol secretion (T1 A). Four weeks later (T1B), participants will complete an additional assessment of immune function and cortisol secretion. Participants will remain in their assigned conditions until completing the T2 assessment. Data will be analyzed with linear mixed modeling and hierarchical regression. It is hypothesized that participants assigned to the AE condition will achieve significant improvements in cardiorespiratory function, decreased psychological distress, and accelerated rates of wound healing compared to the SF participants. In addition, AE participants will experience enhanced regulation of neuroendocrine and immunologic parameters not observed in the SF participants. Results of the study will indicate the degree to which exercise influences wound healing as well as the psychological and biological mechanisms that contribute to the effect of exercise on wound healing. In turn, the results may have- implications for treating older adults who suffer dermal wounds or are recovering from surgery.