Faculty of Medicine
Faculty of Medicine
UNIverse - Public Research Portal

[FG] Schmidt-Trucksäss Arno

Projects & Collaborations

15 found
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Increasing habitual walking by promoting purposeful activities in the neighbourhood: effects of a personalized, GIS-based intervention for mobility-limited and chronically ill older adults (MOBITEC-Routes)

Research Project  | 7 Project Members

Background

There is growing evidence that even low-intensity physical activity (e.g., walking at a “normal” pace) produces substantial health benefits. Walking is “universally accessible”, even for mobility-limited and chronically ill older people. To date, little consideration has been given to the environment and individual preferences of older people when promoting walking. A personalized approach based on geographic information systems (GIS) could help address the problem of low long-term adherence to walking programs.

Objective

MOBITEC-Routes aims to investigate the effects of an individualized GIS-based intervention on walking, physical activity, physical function, life space, participation in social activities, and quality of life.

Methods

In the target group of chronically ill, mobility limited older people (aged 65 years and older), the experimental intervention will be compared with a control intervention in a randomized controlled trial.

Outlook

If successful, the personalized GIS-based approach can be easily implemented in preventive health promotion.

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Fitness Testing in Patients with Depression (FITPAD)

Research Project  | 7 Project Members

The goal of this project is to examine the usefulness and validity of four standardized fitness tests in 48 patients with MDD. The four tests are: (a) Incremental bicycle ergometer test, (b) Åstrand-Rhyming bicycle ergometer test, (c) PWC-150/130 test (PWC150/130), (d) 6-minute walking test (6MWT) Primary objective: To compare estimated maximal oxygen uptake (VO 2 max/peak) of patients with MDD based on standardized fitness tests and examine correlations between the estimated VO 2 max/peak scores of the different fitness tests. Secondary objective A: To examine how the VO 2 max/peak scores of the four standardized fitness tests are associated with participants' perceived fitness. Secondary objective B: To examine the practicability of the four standardized fitness tests in a patient population suffering from MDD. Different parameters will be used to obtain a comprehensive picture of the practicability of each single test.

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Recovery of mobility function and life-space mobility after ischemic stroke: the patient perspective (MOBITEC-PatientPerspective)

Research Project  | 5 Project Members

Background: If survived, stroke often results in permanent mobility limitations. From the patient's perspective, one of the most important measures is the life-space mobility, defined by the places a patient can or cannot go. The overall aim of this study is to evaluate actual and desired life-space, and what factors contribute or inhibit reaching the patient's desired life-space mobility in the rehabilitation process. Objectives: The study has three objectives: (1) to characterize the actual and desired life-space - of patients who went through the rehabilitation process as well as its association with quality of life, (2) to identify barriers and motivators during rehabilitation focusing on regaining the desired life-space mobility, and (3) to derive the needs, barriers and facilitators for optimal recovery, as well as the opportunities and threats for individualized rehabilitation. Methods: The first objective will be targeted by a cross-sectional study in which we will measure actual and desired life-space mobility as well as quality of life in 67 patients who are one to three years after stroke. We will use the validated University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA) tool to assess life-space, as well as a novel digital map-based assessment tool. Quality of life will be assessed with the validated short version of the Stroke-Specific Quality of Life scale. We will compare patient characteristics between groups of (1) patients who reach their desired life-space mobility, (2) patients with a reduced life-space, and (3) patients with a clearly restricted life-space mobility. Objective two and three will be targeted using focus group discussions with patients and clinicians (physiotherapists, occupational therapists, and physicians). We will obtain the patient's and clinician's perspective on recovery trajectories, facilitators and barriers in this process as well as opportunities and threats for the implementation of individualized treatment. Relevance: The patient's perspective plays the key role in this project. The findings of this project will enable us to develop rehabilitation guidelines that meet the expectations and constraints of patients and clinicians working with this population. This study can make a big difference regarding the life-space mobility and quality of life of stoke survivors.

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High-intensity interval training as treatment strategy for heart failure patients with preserved ejection fraction: A prospective, single-blind, randomized controlled trial (The HIT-HF Trial)

Research Project  | 6 Project Members

Background: Heart failure with preserved ejection fraction (HFpEF) occurs in about 50% of all HF patients. Remodeling and fibrosis stimulated by inflammation appear to be main factors for the progression of HFpEF. The lack of treatment options in HFpEF urgently calls for new therapeutic approaches. While beneficial effects of exercise training have been demonstrated in heart failure with reduced ejection fraction, they have not yet been sufficiently evaluated in HFpEF. The aim of this study is to investigate the effects of high-intensity interval training on the exercise tolerance of HFpEF patients. The primary outcome exercise tolerance will be measured as peak oxygen uptake (VO 2peak ). Methods: The proposed study will be a prospective, single-blind, randomized controlled trial in a primary care setting, including 86 patients with stable HFpEF. Patients will undergo two study visits including measurements of disease-specific biomarkers, cardiac and arterial vessel structure and function, exercise tolerance, habitual physical activity, and quality of life. After the first visit, patients will be randomized into the intervention or control group. The intervention group (n=43) will attend a supervised 12-week high-intensity interval training on a bicycle ergometer. The control group (n=43) will participate in a 12-week moderate-intensity continuous training. After 12 weeks, the study measurements will be repeated in all patients to monitor the effects of the intervention. At 6 months, 1, 2 and 3 years after the intervention, telephone interviews will be performed to assess medical outcomes and quality of life. Discussion: This study is expected to add important knowledge about the potential utility of a novel treatment strategy in HFpEF patients, which may help to improve quality of life, functional status, and prognosis.

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Recovery of mobility function and life-space mobility after ischemic stroke (MOBITEC-Stroke)

Research Project  | 9 Project Members

Schlaganfälle zählen zu den häufigsten Todesursachen und mit dem Alter steigt die Wahrscheinlichkeit, einen Schlaganfall zu erleiden. Wird ein Schlaganfall überlebt, so bleiben oft Behinderungen zurück. Häufig ist die Mobilität betroffen. Diese umfasst sowohl die Fähigkeit sich zu bewegen, als auch die Fähigkeit, den Lebensraum optimal zu nutzen. Hauptziel des Projektes ist es, Veränderungen der Mobilität von Patienten im ersten Jahr nach Schlaganfall zu charakterisieren. Hierbei stellt sich insbesondere die Frage, welche Erholungsverläufe von welchen Patientenmerkmalen begünstigt werden. Zudem sollen motivationale Aspekte sowie Umgebungsfaktoren untersucht werden, welche die Mobilität erleichtern oder erschweren können. Hierzu werden etwa 60 Patienten, die erstmalig einen Schlaganfall erlitten haben, in die Studie eingeschlossen. Ein Jahr lang werden sich diese Patienten regelmässig Analysen der funktionellen und der räumlichen Mobilität unterziehen. Hierzu kommen laborbasierte Testverfahren (z. B. Kraft-, Balance- und Ganganalysen) und Messungen im täglichen Leben der Patienten (z. B. mittels GPS) zum Einsatz. Zudem werden die Patienten mittels digitaler Karten zu motivationalen Aspekten und Umgebungsfaktoren befragt. Die detaillierte Kenntnis unterschiedlicher Erholungsverläufe wird es ermöglichen, Rehabilitationsmassnahmen gezielt und zum idealen Zeitpunkt einzusetzen. Zudem wird das gewonnene Wissen die Festlegung individualisierter und motivierender Rehabilitationsziele ermöglichen.

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Functional Aging in Health and Disease - the COmPLETE Project

Research Project  | 1 Project Members

The increasing prevalence of chronic non-communicable diseases and associated risk factors contribute to earlier disability and frailty onset over the course of life in industrialized western countries. This process applies also to diseases of the cardiovascular system, including heart failure, which is a widespread syndrome in middle-aged and older people. Although life expectancy has steadily increased in past decades, the traditional curative way of thinking in medicine is unlikely to compress the disease phase to the final stage of life and thus increase the health span, which is defined as a period of relatively disease-free aging followed by a period of age-related diseases and disabilities. In the period of healthy aging, the function of the organs, including the cardiovascular system, is already deteriorating. To counteract this process and to increase the health span, the preservation or improvement of components of physical fitness (endurance capacity, muscle strength, and neuromuscular function) is thought to be an essential element. The proven, independently predictive value of the single physical fitness components for total and cardiovascular mortality confirms this assumption. However, comprehensive data regarding individual physical fitness characteristics over the course of life are not yet available. Such data is necessary for any targeted prevention program with physical activity and exercise training as crucial pillars. Furthermore, healthy reference values could be used to estimate the adaptive capacity in healthy individuals compared to patients. Therefore, the aims of the COmPLETE project are:1.To determine the trajectories of physical fitness components of healthy aging by measurement of endurance capacity, muscular strength and neuromuscular coordination in a healthy population sample between 20 and 100 years (COmPLETE-Health) and 2.To determine the health distance between healthy individuals (COmPLETE-Health) and heart failure patients (COmPLETE-Heart) on the basis of different physical fitness components (endurance capacity, muscular strength and neuromuscular coordination). After an extensive preparatory phase and obtaining approval from the Ethics Committee North-West Switzerland (EKNZ), we have started the recruitment and investigation. Ninety-nine (as of March 22, 2018) out of 490 planned participants of COmPLETE-Health have already been examined. The aim is to cover every decade up to 100 years of age, with 70 participants per age category (20-30, 30-40, 40-50, 50-60, 60-70, 70-80, and 80+ years of age), 50% women and 50% from the rural area of Basel region. Eighty well-characterized patients with heart failure (COmPLETE-Heart) will be examined as an example of chronic condition. The following core examinations will be carried out to characterize the components of physical fitness: cardio-pulmonary exercise test (maximal and submaximal aerobic capacity), leg and grip strength (isometric muscular strength and peak power), balance and coordination (balance plate and gait analysis). To accurately characterize cardiovascular health and to exclude vascular abnormalities, which potentially reduces physical fitness, additional non-invasive measurements of established cardiovascular parameters will be performed. This encompasses measurements such as echocardiography (in participants over 50 years), exercise ECG, pulse wave velocity, brachial artery flow-mediated dilation, and retinal vessel analysis. Several questionnaires, blood analyses, and body composition analyses will supplement the characterization of the participants of both cohorts. We anticipate that, for the first time, a basis for targeted prevention programs will be created through better and comprehensive knowledge of the individual physical fitness to improve the health span. In addition, we are convinced that by calculating the health distance between healthy and heart failure patients, we are laying the foundation for more individual exercise therapy. The COmPLETE project could be the starting point for strengthening the in-depth diagnostics of physical fitness as a component of preventative health care.

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Functional Aging in Health and Disease - the COmPLETE Project

Research Project  | 5 Project Members

The increasing prevalence of chronic non-communicable diseases and associated risk factors contribute to earlier disability and frailty onset over the course of life in industrialized western countries. This process applies also to diseases of the cardiovascular system, including heart failure, which is a widespread syndrome in middle-aged and older people. Although life expectancy has steadily increased in past decades, the traditional curative way of thinking in medicine is unlikely to compress the disease phase to the final stage of life and thus increase the health span, which is defined as a period of relatively disease-free aging followed by a period of age-related diseases and disabilities. In the period of healthy aging, the function of the organs, including the cardiovascular system, is already deteriorating. To counteract this process and to increase the health span, the preservation or improvement of components of physical fitness (endurance capacity, muscle strength, and neuromuscular function) is thought to be an essential element. The proven, independently predictive value of the single physical fitness components for total and cardiovascular mortality confirms this assumption. However, comprehensive data regarding individual physical fitness characteristics over the course of life are not yet available. Such data is necessary for any targeted prevention program with physical activity and exercise training as crucial pillars. Furthermore, healthy reference values could be used to estimate the adaptive capacity in healthy individuals compared to patients. Therefore, the aims of the COmPLETE project are:1.To determine the trajectories of physical fitness components of healthy aging by measurement of endurance capacity, muscular strength and neuromuscular coordination in a healthy population sample between 20 and 100 years (COmPLETE-Health) and 2.To determine the health distance between healthy individuals (COmPLETE-Health) and heart failure patients (COmPLETE-Heart) on the basis of different physical fitness components (endurance capacity, muscular strength and neuromuscular coordination). We anticipate that, for the first time, a basis for targeted prevention programs will be created through better and comprehensive knowledge of the individual physical fitness to improve the health span. In addition, we are convinced that by calculating the health distance between healthy and heart failure patients, we are laying the foundation for more individual exercise therapy. The COmPLETE project could be the starting point for strengthening the in-depth diagnostics of physical fitness as a component of preventative health care.

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MOBIlity assessment with modern TEChnology in older patients' real-life by the General Practitioner (MOBITEC-GP)

Research Project  | 7 Project Members

Mobility - often referred to as the "sixth vital sign" - is a basic integrator of older adults' health and an important predictor of health-related outcomes such as loss of independence. MOBITEC-GP aims to improve the health of older patients by providing general practitioners with a novel smartphone application that allows them to easily quantify and appraise their patients' real life mobility. By following their older patients' mobility over time, general practitioners will be able to recognize impending needs within pre-clinical stages of decline and to initiate targeted interventions such as exercise programs or management of joint problems. This project is funded by the Velux Stiftung (project no. 1155).

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Physical activity as a life style component of aggressive decrease of atherosclerotic modifiers (ADAM) in elderly subjects: the SAPALIDA Cohort Study

Research Project  | 3 Project Members

This proposal outlines a research program of a large nested study of the third part of the S wiss Cohort Study on A ir P ollution a nd L ung and Heart D iseases i n A dults (SAPALDIA 3) including 3026 subjects. The research program seeks (i) to evaluate the measuring characteristics of the new cardio-ankle vascular index (CAVI) as a measurement tool of arterial stiffness for the first time in a Caucasian cohort and (ii) to analyse the association between PA as a preventive life style component of aggressive decrease of atherosclerotic modifiers (ADAM) and cardiovascular disease (CVD) in this Caucasian clientele. Cardiovascular diseases constitute a major worldwide health problem, upon which the bigger part of death causes are attributed to. Cardiovascular health issues are closely related to long-term asymptomatic changes of the vasculature in terms of arteriosclerosis and, especially, atherosclerosis as its major condition. Starting point of these alterations are vessel stiffening processes, for which reason arterial stiffness is an early, subclinical marker of potentially grave cardiovascular modifications. CAVI's beneficial characteristic is the lower correlation with blood pressure (BP) fluctuations during investigations compared to other arterial stiffness measurements. Therefore, CAVI as a non-invasive, easy-to-apply technique may present a highly useful clinical tool for cardiovascular risk stratification and evidence-based treatment procedures at an early stage. In order to evaluate the potential usefulness of CAVI in Caucasians this research project targets three specific aims. At first this study aims at determining CAVI's measuring characteristics so as to lay the basis for serial clinical application of CAVI in Caucasian populations. This will be performed by scrutinizing CAVI's reproducibility, its dependency on blood pressure (BP) and the correlation with carotid intima-media thickness (CIMT), a traditional ultrasonographic marker of atherosclerosis reliability and validity in the SAPALDIA 3 cohort. All the named has not been shown for Caucasian people before, which is a prerequisite for the clinical application in these subjects. Within the second and third aim of the research project CAVI will be implemented for stratifying the cardiovascular risk based on physical inactivity. During the data collection of SAPALDIA 3 the International Physical Activity Questionnaire (IPAQ) has been consulted to classify the subjects' physical activity (PA), which is regarded as an important health promotion measure with protective impact on the cardiovascular system and, thus, as one component of ADAM. Therefore, CAVI will be analysed across groups of different physical activity patterns in the SAPALDIA 3 cohort. In this context the question, whether a sedentary lifestyle is associated with increased CAVI values is of particular relevance. Up-to-date there exists no comparable cohort in which a measure of arterial stiffness may be analysed in association with a detailed questionnaire of PA like the IPAQ. Furthermore, this project implies the unique and worldwide first chance to study changes of PA in association with CAVI measurement over a time period of several years like between SAPALDIA 2 and SAPALDIA 3. Differences of arterial stiffness in association with changes in PA ranking from SAPALDIA 2 to SAPALDIA 3 over a reasonable time span of nine years may strengthen PA recommendations in middle-aged and elderly with respect to the prevention of manifest cardiovascular disease. Consequently, a systematic study is proposed, which tends to establish CAVI for cardiovascular risk group evaluations like physically inactive people. Because of CAVI having specific significance for examinations of asymptomatic subjects the herewith obtained cohort study results may lead to improvements of early stage diagnosis and treatment of cardiovascular disease including guidelines for appropriate PA.