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Larry W Forrester

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Claude D. Pepper Older Americans Independence Center (O*

Andrew P Goldberg

15 July 1994 - 31 August 2006
NATIONAL INSTITUTE ON AGING

Abstract

The mission of the University of Maryland, Baltimore (UM)-OAIC is to conduct mechanistic and outcome-based research in exercise rehabilitation and provide research training in gerontology and geriatrics that will improve lifestyle and functionality for millions of older disabled Americans. The research focus is on older patients who are chronically disabled by hemiparetic stroke, a major complication of arteriosclerotic cardiovascular disease (CVD) which affects greater than 750,000 Americans annually. These patients have reduced ambulatory capacity and functionality, impaired IADL performance, gait dysfunction and a multitude of comorbidities, which worsen their quality of life and increase their utilization of the healthcare system. While our focus is on hemiparetic stroke, the UM-OAIC also collaborates with and provides infrastructure support for research on peripheral arterial occlusive disease, hip fracture and other disabling conditions where there are institutional strengths. Exercise rehabilitation is the consistent theme in the UM-OAIC that provides cohesiveness for the research training, the research resources cores, education, dissemination, and clinical care. The intervention development studies (IDS) examine the effects of task-oriented treadmill exercise in patients with lower extremity hemiparesis (IDS-1) and upper extremity training with auditory cueing in patients with upper extremity paresis (IDS-2) on: 1) functional mobility and ambulation, motor control and strength, V02 peak, and free living daily activity; 2) central (neural) and peripheral (muscle) mechanisms underlying these functional responses using functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) to assess neural plasticity; 3) muscle biopsies with histochemical and biochemical analyses to determine conditioning; and 4) long-term functionality and psychosocial status in hemiparetic stroke patients. These and other studies of disabling conditions utilize RRCs in 1) epidemiology research and recruitment; 2) neuromuscular mechanisms and function performance; and 3) physiology that are blinded to patient randomization for measuring outcomes. The biostatistics RRC provides data management and analysis, and maintains confidentiality and records for the safety monitoring board. OAIC leadership and advisory committees 1) guide and review accomplishments of the RCT?s on hemiparetic stroke, 2) train young investigators in mechanistic, functional, and psychosocial research examining physiologic as well as cellular adaptations to exercise and outcomes research, 3) promote collaboration of UMB and Johns Hopkins faculty in interdisciplinary aging research and research training, and 4) disseminate OAIC findings to the public and health professionals. OAIC leaders have institutional support for interdisciplinary aging research that supports a cadre of gerontologists to achieve the interdisciplinary research goals of the OAIC.

149 Resulting Publications

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