- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02997618
The AAA Get Fit Trial: A Pilot Randomised Controlled Trial of Community Based Exercise in Patients With Abdominal Aortic Aneurysms
The AAA Get Fit Trial: A Pilot Randomised Controlled Trial of Community Based Exercise to Improve Fitness and Reduce Morbidity and Mortality of Patients With Abdominal Aortic Aneurysms
Rupture of abdominal aortic aneurysms(AAA) causes 12,000 deaths/year in the UK.1 Elective repair to prevent this carries a perioperative mortality of 4.5% for open surgery and 1% for endovascular repair. This risk is associated with poor cardiorespiratory fitness which can be measured using Cardiopulmonary Exercise Testing(CPET) with the CPET variables, peak oxygen uptake(peakVO2)<15ml/kg/min and anaerobic threshold(AT)<10.2ml/kg/min identifying patients at increased risk of early death after AAA repair.3 These variables can therefore be used as surrogate markers for cardiovascular fitness and risk of mortality and morbidity in AAA surgery; optimising these markers should improve fitness and decrease this risk. The optimal duration and type of exercise training for improving peak VO2 and AT in AAA patients is not known. AAA patients are unique as they are motivated to reduce the risk of impending surgery but are afforded the time to improve their fitness as repair may not be needed for months or even years.
The investigators propose a pilot randomised controlled trial to explore the effectiveness of a 20-week community (either home or gym-based) exercise programme to achieve sustained improvements in peak VO2 and AT, as measured by CPET, in AAA patients. Changes in QoL, habitual activity levels and cardiovascular risk will also be assessed. The results will inform a definitive multicentre clinical trial on exercise to improve outcomes in elderly patients with cardiovascular disease and AAA.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Adam Haque, MBChB, MRCS
- Phone Number: 01612915848
- Email: adam.haque@manchester.ac.uk
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Men with an AAA ≥ 3.0 and < 5.0 cm and women with a AAA ≥ 3.0 and < 4.5 cm
- Aged 60 - 85 years inclusive
- Willing and able to engage in gym- and/or home-based exercise training and undertake CPET
Exclusion Criteria:
- Unable or unwilling to undertake CPET or exercise training Patients unwilling will not be able to give informed consent and those who are unable would not be able to be randomised to the intervention study group nor undergo satisfactory testing to obtain our outcome measures.
High levels of habitual physical activity (those scoring "high" on the PASE questionnaire) These patients already have a high level of physical activity and therefore it may not be possible to improve their fitness any further which is the primary objective of the study.
Exclusion criteria 3-10 are all based on medical conditions which would mean either exercise training may be unsafe, they would require further investigation and treatment of that medical condition or are likely to need upcoming intervention for their medical condition which would take priority over any participation in a research study. If any medical conditions are discovered during the study, these patients will be withdrawn from the study and referred to the necessary health professional.
- Severe liver disease (INR > 2, serum albumin < 3.0g/dL, bilirubin > 50µmol/L)
- Unstable angina, angina of < 2 month's duration, occurring more than twice daily, angina that is increasing in frequency or precipitated by less exertion, angina at rest
- Uncontrolled atrial fibrillation (AF) or other arrhythmia: untreated paroxysmal AF
- Moderate or severe aortic valve stenosis (peak systolic pressure gradient >40mmHg or with an aortic valve area < 1cm2)
- Class II/III/IV heart failure and/or left ventricular ejection fraction < 25%
- Pericarditis or myocarditis within last six months
- Patients with > 2mm ST depression on exercise ECG will not be eligible to take part and will be referred to a cardiologist for further assessment.
- Diagnosis or treatment for a malignancy over the previous 12 months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Control
1. Usual care (control) Usual care given to patients on AAA surveillance. This includes six-monthly or annual ultrasound measurements of AAA, attendance to surveillance clinic and written (APPENDIX A) and verbal advice on managing cardiovascular risk. This advice will be based on current widely available NHS patient information15 and consists of the following information with regard to: Smoking Exercise Weight Diet |
Usual care consisting of advice.
|
EXPERIMENTAL: Community Based Exercise Programme
Community based-exercise (in addition to usual care) with the choice of either:
Duration and Frequency At least 50 minutes of exercise per day on three non-consecutive days of the week for 20 weeks. |
20 week community (home or gym based) exercise programme
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Peak VO2 as measured by CPET
Time Frame: at 20 weeks
|
at 20 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Anaerobic Threshold as measured by CPET
Time Frame: at 20 weeks
|
at 20 weeks
|
|
Biomarkers of Cardiovascular disease risk
Time Frame: at 20 weeks
|
at 20 weeks
|
|
Other risk factors of Cardiovascular disease risk
Time Frame: at 20 weeks
|
Weight, BMI, Waist Circumference and Blood Pressure
|
at 20 weeks
|
Subjective measure of habitual activity levels (PASE questionnaire)
Time Frame: at 20 weeks
|
at 20 weeks
|
|
Objective measure of habitual activity levels (via Accelerometry)
Time Frame: at 20 weeks
|
at 20 weeks
|
|
Health-related quality of life
Time Frame: at 20 weeks
|
at 20 weeks
|
|
Early changes in outcome measures
Time Frame: at 10 weeks
|
All outcome measures will also be measured at 10 weeks and compared with other time intervals.
|
at 10 weeks
|
Sustainability of changes in outcome measures
Time Frame: at 30 weeks
|
All outcome measures recorded 10 weeks post cessation of exercise at 30 weeks and compared with the other time intervals.
|
at 30 weeks
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Charles McCollum, MD, FRCS, University of Manchester
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 162347
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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