Pulmonary Rehabilitation in Asthmatic Patient

August 5, 2019 updated by: Fernanda de Cordoba Lanza

Pulmonary Rehabilitation in Asthmatic Pediatric Patients: Randomized Clinical Trial

Asthma is one of the main chronic diseases in childhood and it is characterized by the inflammation of airways. Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance due to pulmonary limitations. The pulmonary rehabilitation may improve the physical capacity in asthmatic patients, as observed in other chronic lung diseases.

Study Overview

Status

Completed

Conditions

Detailed Description

The asthmatic patient's clinical changes may impair their functional capacity and exercise tolerance. Thus, the treatment of these individuals should be extended to pulmonary rehabilitation. Randomized clinical trials have shown interesting results, whether in cardiopulmonary conditions, quality of life or in the number of crises, after applying pulmonary rehabilitation program in asthmatic children and adolescents. In a systematic review on physical training with asthmatic children and adolescents the authors concluded that physical activity should be recommended to this population, although some issues have not yet been clarified due to limitations in the clinical trial. The control of the disease has not been evaluated by specific questionnaires in any study. The assessment of inflammatory markers was rarely addressed and the same occurred in the quality of life after physical training. In addition, it is possible to question the intensity and frequency of training, factors that can significantly contribute to the intervention results. All these information let us know that is necessary a randomized control trial to answer questions about physical characteristics, quality of life, inflammatory markers, and muscles strength.

Study Type

Interventional

Enrollment (Actual)

66

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Sao Paulo, Brazil, 01504001
        • Fernanda C Lanza

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

6 years to 18 years (Child, Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • between six and 18 years old
  • asthma-diagnosed patients
  • under medical treatment and disease control

Exclusion Criteria:

  • fail to carry out the protocol evaluations
  • interrupt the medical care and/or drug-based treatment
  • acute lung infection or other chronic lung diseases
  • other comorbidities (neuropathies, heart disease)
  • missing in more than 20% the rehabilitation protocol

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Group
The intervention group will have supervised rehabilitation program held twice a week, each session will have 60 minutes duration, with minimum interval of 24 hours, for a period of 8 weeks. Each session will consist of three parts: aerobic training, strength training and respiratory physiotherapy. The aerobic training will be held for 35 minutes (10 min of warm up, 20 min on target load and 5 min of slowdown) with initial intensity of 60% of the maximum load obtained in the maximal cardiopulmonary exercise testing or in incremental shuttle walk test (ISWT). The intensity will be gradually increased up to 80%, so that fatigue or dyspnea values are kept between 4 and 6, according to the modified Borg scale.
Aerobic training
Other Names:
  • Pulmonary Rehabilitation
Active Comparator: Control Group
The control group will be subjected to supervised respiratory physiotherapy and stretching exercises twice a week, each session with duration of 60 minutes, with minimum interval of 24 hours, for a period of 8 weeks. The oral high-frequency oscillation device (Flutter®) will be used for 10 minutes, 5 minutes in each lateral decubitus, followed by the stretching of upper and lower limbs for 40 minutes. All exercises will be active, performed in sitting and lying positions without increasing the heart rate. The remaining 10 minutes will be used to discuss doubts about the disease and the use of the booklet.
Chest physiotherapy: Flutter and muscle stretching
Other Names:
  • Chest Physiotherapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Physical capacity as measure by distance walked of shuttle walk test and oxygen consumption (VO2)
Time Frame: Physiscal capacity will be measured at the beginning and at the end of the protocol (after 8 weeks)
Modified shuttle test was conducted
Physiscal capacity will be measured at the beginning and at the end of the protocol (after 8 weeks)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Muscle strength as measure by electromyography (EMG)
Time Frame: Muscles strenght will be measured at the begening and at the end of the protocol (after 8 weeks).
1 maximal repetition was performed
Muscles strenght will be measured at the begening and at the end of the protocol (after 8 weeks).
Muscle endurance as measure by electromyography (EMG)
Time Frame: Muscles endurance will be measured at the begening and at the end of the protocol (after 8 weeks).
Muscles endurance will be measured at the begening and at the end of the protocol (after 8 weeks).
Quality of life measured by Pediatric questionnaire
Time Frame: Quesitionnaire will be measured at the begening and at the end of the protocol (after 8 weeks).
Quesitionnaire will be measured at the begening and at the end of the protocol (after 8 weeks).
Inflammatory markers as measure by interleukines
Time Frame: Inflamatory markers will be measured at the begening and at the end of the protocol (after 8 weeks).
Inflamatory markers will be measured at the begening and at the end of the protocol (after 8 weeks).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Study Chair: Dirceu Solé, PhD, Unifesp, Federal University of Sao Paulo

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

February 1, 2015

Primary Completion (Actual)

July 1, 2016

Study Completion (Actual)

August 1, 2018

Study Registration Dates

First Submitted

February 10, 2015

First Submitted That Met QC Criteria

March 3, 2015

First Posted (Estimate)

March 9, 2015

Study Record Updates

Last Update Posted (Actual)

August 7, 2019

Last Update Submitted That Met QC Criteria

August 5, 2019

Last Verified

August 1, 2019

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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