Physical Activity Program for Older Renal Transplant Candidates (PART)
Impact of a Physical Activity Intervention on Physical Function and Quality of Life in Aging Candidates for Renal Transplantation: The PART Study
The physical function of older candidates for renal transplantation and their ability to sustain physical activity programs are currently unknown. The primary goal of this study is to determine the feasibility of a physical activity intervention in older dialysis-dependent patients, assessing its effect on maintaining transplant candidacy and outcome after transplantation. Clinical practice guidelines do not set an absolute age limit for evaluating potential renal transplant candidates. While cardiovascular risk assessment and malignancy screening are emphasized in the older age group, physical performance and the risk for disability are often overlooked. Although healthy older patients experience increased life expectancy after renal transplantation versus remaining on dialysis, outcomes such as the capacity to live independently and function well have not been studied. Given the poorer baseline health status in aging end-stage renal disease patients, rapid changes in health on dialysis, and the national organ shortage, it is increasingly important to identify factors that predict better outcomes and devise strategies that will maximize the benefit of transplantation in older individuals.
The investigators hypothesize that muscle is the principal organ system underlying impaired physical function among older transplant candidates, and that decreased muscle mass and physical functioning lead to poorer outcomes in older renal transplant candidates. The investigators propose that a simple bedside performance measurement of lower extremity functional limitations, the Short Physical Performance Battery, will be a strong predictor of outcomes in this patient cohort. The investigators also propose that outcomes can be improved with exercise training, potentially leading to longer durations of active transplant candidacy and greater independence after successful transplantation. The Specific Aims of this research are:
- Determine the feasibility of an exercise intervention in dialysis-dependent wait-listed patients age 60 years and over who will be randomized to one of two groups: usual care versus a structured physical activity program.
- Define the natural history of physical function in patients age 60 years and greater who remain on dialysis or undergo renal transplantation attempting to identify a subgroup of older wait listed patients who are at high risk for developing disability.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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North Carolina
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Winston-Salem, North Carolina, United States, 27157
- Wake Forest University
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥ 60 years
- Listed on the renal transplant waiting list (either active or inactive status)
- Able to give consent
- Able to maintain sitting or standing balance and ambulate without assistance from another person
Exclusion Criteria:
- MMSE score less than 21
- Unstable coronary artery disease
- Less than three months since the patient had a myocardial infarction
- Congestive heart failure NY class III or IV
- Lower extremity amputation without prosthesis
- Severe and active lower extremity musculoskeletal problem which prevents participation in the intervention
- Individuals who are more active than the intervention and thus would not be likely to benefit
- SPPB score of 12 (the maximum score) at screening
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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No Intervention: Usual Care
No physical activity intervention will be prescribed for the Usual Care Arm.
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Active Comparator: Physical Activity
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The intervention is an individualized, structured, moderate intensity home-based physical activity program.
During the first 12 weeks the program will focus on lower extremity strengthening, and thereafter incorporate cardiovascular activity.
The target duration of activity is 150 minutes per week, i.e., 20-30 min on most days of the week.
However, the program is adjusted based on each participant's progression, initial level of physical fitness and will be modified in response to illness, injury, or physical symptoms.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
The Short Physical Performance Battery SPPB) score, a brief and simple bedside performance-based instrument.
Time Frame: One year
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One year
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Health-related quality-of-life scores
Time Frame: One year
|
One year
|
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Self-reported disability scores
Time Frame: One year
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One year
|
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Re-hospitalization
Time Frame: One year
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One year
|
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Inter-current illness including cardiovascular events or falls
Time Frame: One year
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One year
|
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Endurance
Time Frame: One year
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One year
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Body composition by both DEXA and thigh CT
Time Frame: One year
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One year
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Grip strength
Time Frame: One year
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One year
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Leg strength
Time Frame: One year
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One year
|
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ADL disability
Time Frame: One year
|
One year
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Stephen Kritchevsky, Ph.D., Wake Forest University Health Sciences
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- IRB00001451
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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