Physical Activity Behavior Change for Older Veterans after Dysvascular Amputation

 描述(由申请人提供)： 项目摘要/摘要目前有100多万美国人接受截肢，预计到2050年，这一数字将增加一倍以上。超过80%的下肢截肢是由严重糖尿病和/或严重外周动脉疾病引起的血管并发症引起的，这些疾病被称为血管功能障碍截肢。患有血管障碍的下肢截肢的退伍军人人数正在增长，高水平的死亡率和残疾突出了确定优化身体康复的方法的重要性。血管功能障碍截肢人群的特点是：1)体力活动水平低，2)伤残率高。这种糟糕的体力活动和残疾结果可能与退伍军人在血管障碍下肢截肢前和截肢后采取的慢性体力活动行为有关。因此，这项初步研究的主要目的是确定使用体力活动行为改变(PABC)干预措施的可行性，以增加退伍军人的体力活动，减少血管功能障碍下肢截肢后1-5年的残疾。这项先导性研究将首次评估对患有血管功能障碍截肢的老年退伍军人使用PABC干预的可行性。PABC的干预为期三个月。测试将在基线(干预前)、三个月(干预结束)和六个月进行。可行性将通过1)参与者保持、2)剂量目标实现、3)参与者可接受性、4)安全性和5)初始效果大小来确定。效果大小将基于基于加速计的体力活动和使用晚年功能和残疾指数的自我报告残疾的结果衡量标准。这项试点研究针对的是研究不足且不断增长的老年退伍军人群体，他们的特点是健康状况复杂。这一成果将通过提供与改善这一老年退伍军人群体所经历的长期低体力活动和高残疾水平有关的关键可行性数据，大大推进当前的研究。

 DESCRIPTION (provided by applicant): Project Summary/Abstract Over 1 million Americans currently live with lower limb amputations and the number is expected to more than double by 2050. More than 80% of all lower limb amputations result from vascular complications due to diseases such as severe diabetes mellitus and/or severe peripheral artery disease, known as dysvascular amputation. The population of Veterans with dysvascular lower limb amputation is growing, and high levels of mortality and disability highlight the significance of identifying ways to optimize physical rehabilitation. The dysvascular amputation population is characterized by: 1) low levels of physical activity and 2) high rates of disability. Such poor physical activity and disability outcomes are likely linked to chronic physical activity behaviors that Veterans adopt before dysvascular lower limb amputation and carry over after amputation. Therefore, the primary aim of this pilot study is to determine the feasibility of using a physical-activity behavior-change (PABC) intervention for increasing physical activity and reducing disability in Veterans 1-5 years following dysvascular lower-limb amputation. This pilot study will be the first to assess the feasibility of using a PABC intervention for older adult Veterans with dysvascular amputation. The PABC intervention is three months in duration. Testing will occur at baseline (pre-intervention), three months (end of intervention), and six months. Feasibility will be determined using measures of 1) participant retention, 2) dose goal attainment, 3) participant acceptability, 4) safety, and 5) initial effect size. Effect size will be based on the outcome measures of accelerometer-based physical activity and self-report disability using the Late-Life Function and Disability Index. This pilot study addresses an understudied and growing population of older Veterans characterized by complex health conditions. The outcome will significantly advance current research by providing critical feasibility data related to improving the chronic low physical activity and high levels of disability experienced by this population of older Veterans.