Home Program to Enhance Mobility in Older Veteran Diabetics

描述（由申请人提供）： 这项拟议研究的目标是测试患有糖尿病的久坐不动的退伍军人的长期锻炼计划是否会持续改善活动能力和身体活动。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/体育活动（PA）增强计划，并提供行为支持。该计划的基本原理是基于：1）以前资助的VA RR & D对照试验的可行性（由本研究小组领导）在患有糖尿病的久坐老年人中，改善了移动性能，特别是通常的步态速度; 2）需要更长期和功能相关的干预措施（特别是针对老年糖尿病患者）; 3）使用电话护士支持来帮助克服运动障碍和处理并发疾病的可能性，在该共病患者组中是关键的因素;和4）增加对客观测量的身体活动的关注的潜力。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，主要是以家庭为基础的，以功能为导向的运动计划与护士支持干预（I）组与灵活性和色调，健康教育对照（C）组，并在4周，6个月和1年的功能活动和身体活动的测试结果。主要目标。确定家庭计划是否改善了活动能力假设：在老年糖尿病患者中，与基线和灵活性和调节健康教育对照组（C）相比，主要由功能性运动训练和增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活动能力的改善。探索性目的：确定家庭计划是否改善了身体活动假设：与C组相比，I组的身体活动（通过体动计上的加权活动计数测量）将从基线到一年不成比例地增加。这项研究可以导致一个运动/PA增强计划，可以与VA外展计划协调，针对老年退伍军人谁不是在一个主要的VA网站附近。最终，这将创建一个模型，医生和其他提供者可以参考共病糖尿病患者。

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.