KAATSU Training to Enhance Physical Function of Older Adults with Osteoarthritis

描述（由申请人提供）：随着美国人口老龄化和老年人骨关节炎（OA）患病率的上升，预防OA相关残疾是一个重要的公共卫生优先事项。因此，需要有效的干预措施来控制老年OA患者的疼痛和维持身体功能。由于骨骼肌无力是OA患者疼痛进展和功能下降的主要因素，因此最佳干预措施是那些能够改善骨骼肌力量的措施。高强度阻力运动是最著名的提高肌肉力量的方法；然而，高压缩负荷通常会引起OA患者明显的关节疼痛。因此，目前的建议包括进行低强度或中等强度的体育锻炼——尽管事实上这些训练模式对于增强肌肉力量并不是最佳的。本申请建议进行一项试点研究，以调查一种创新训练模式的潜力，该模式有可能在利用低强度负荷的情况下刺激骨骼肌力量的改善。这种模式被称为KAATSU训练，包括进行低强度的运动，同时外部施加的压力会轻微地限制血液流向活跃的骨骼肌。本研究的主要目的是评估慢性KAATSU训练对60 ~ 60岁症状性膝关节炎患者骨骼肌力量和身体功能改善的有效性和可行性。总共将招募60名参与者参加为期三个月的干预研究。参与者将被随机分配到两种干预条件中的一种：(1)标准运动干预，包括以中心为基础的中等强度阻力训练，或(2)与总工作量相匹配的KAATSU训练计划。本研究将提供关于KAATSU训练在改善这些个体的力量和功能以及减轻疼痛方面的治疗潜力的新信息。该研究还将通过评估参与者的安全性、不适感和接受治疗的意愿，提供有关该范式的长期临床可行性的关键信息

DESCRIPTION (provided by applicant): As the U.S. population ages and the prevalence of osteoarthritis (OA) among older adults rises, the prevention of OA-associated disability is an important public health priority. Accordingly, efficacious interventions are needed to manage pain and maintain physical function among older adults with OA. Because skeletal muscle weakness is a primary contributory factor to the progression of pain and functional decline among persons with OA, optimal interventions are those capable of improving skeletal muscle strength. High-intensity resistance exercise is the best-known method of improving muscle strength; however high-compressive loads typically induce significant joint pain among persons with OA. Accordingly, current recommendations include the performance of low- or moderate-intensity physical exercise - despite the fact that these training paradigms are sub-optimal for enhancing muscle strength. This application proposes conduct a pilot study to investigate the potential of an innovative training paradigm with potential to stimulate improvements in skeletal muscle strength while utilizing low-intensity loads. This paradigm, known as KAATSU training, involves performing low-intensity exercise while externally-applied compression mildly restricts blood flow to the active skeletal muscle. The overarching objective of the present application is to evaluate the efficacy and feasibility of chronic KAATSU training for the improvement of skeletal muscle strength and physical function among persons aged > 60 years with symptomatic knee OA and mild to moderate physical limitations. A total of 60 participants will be recruited to participate in this three month intervention study. Participants will be randomly assigned to one of two intervention conditions: (1) a standard exercise intervention consisting of center-based, moderate- intensity resistance training, or (2) a KAATSU training program matched for overall workload. This study will provide novel information regarding the therapeutic potential of KAATSU training for improving strength and function as well as attenuating pain among these individuals. The study will also provide critical information regarding the long-term, clinical viability of the paradigm by evaluating participant safety, discomfort, and willingness to continually engage in the KAATSU training program.