- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03311763
Exercise is Medicine for Patients With CKD (EIM-CKD)
January 24, 2022 updated by: Shuchi Anand, Stanford University
A Multi-center Exercise Intervention for Persons Transitioning to Dialysis Using the "Exercise is Medicine" Framework
The investigators plan to integrate and tailor the existing Exercise is Medicine framework, an evidence-based multi-level intervention program developed by the American Society of Sports Medicine, for the care of patients with advanced chronic kidney disease.
In this pilot randomized control trial, investigators will compare the effects and feasibility of two intervention arms designed to start and maintain physical activity in this high-risk population (Group 1: physical activity assessment, brief counseling session + physical activity wearable versus Group 2: Group 1 intervention components + referral to a free, community-based, EIM practitioner led group exercise program).
Study Overview
Status
Completed
Intervention / Treatment
Detailed Description
Persons on dialysis are physically inactive, with most reporting activity levels below the fifth percentile of healthy age-matched groups.
Physical inactivity in turn increases the risk for functional decline and mortality in this vulnerable population.
The investigators propose a pragmatic clinical trial for an exercise intervention among persons transitioning to dialysis.
The investigators will use an existing framework - Exercise is Medicine (EIM) - developed by the American College of Sports Medicine.
The investigators will randomize 98 persons from two regions-Atlanta and Bay Area-in two intervention arms with incremental levels of clinical-community integration: physical activity assessment during Nephrology clinical visit, brief counseling at pre-dialysis education and physical activity wearable (group 1) versus group 1 intervention components plus a referral to a free, EIM practitioner-led group exercise program over 16 weeks (group 2; 8 week core intervention; 8 week follow up).
The investigators will assess efficacy by comparing between group differences in minutes/week of (measured) moderate intensity physical activity.
To evaluate implementation, investigators will use questionnaires and exit interviews for assessing barriers to referral, participation and retention along the path of the intervention; investigators will use cost-utility analyses to assess scalability.
Further the investigators will have a plan for dissemination of the intervention by partnering with insurance providers and both for-profit and non-profit dialysis organizations.
The overall goal is to inform the development of a practical, cost-conscious intervention that addresses barriers to physical activity commonly faced by persons on dialysis, and can be delivered as a "package" to interested practices.
Study Type
Interventional
Enrollment (Actual)
56
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
-
-
California
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San Jose, California, United States, 95128
- Santa Clara Valley Nephrology
-
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Georgia
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Atlanta, Georgia, United States, 30322
- Emory University
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-
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
30 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- - eGFR < 30 ml/min/1.73m2
- Age ≥30 and ≤80 years
- Noncompliance with physical activity guidelines
- Not in precontemplation stage
- Non-wheelchair bound
- Able to provide informed consent in English or Spanish
- Anticipated to be living in the area over the next 36 weeks
Exclusion Criteria:
- - Inability to provide consent in English
- Diagnosed mental health disorder
- Alcohol or drug abuse
- No fixed address or contact details
- Unstable angina or unstable arrhythmias
- Lack of access to internet
- Any concern not otherwise stated by patient's nephrologist
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: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Counseling alone
Group 1: physical activity assessment, brief counseling session + physical activity wearable
|
Brief exercise counseling session and provision of a wearable fitness tracking device to promote physical activity.
|
Experimental: Group exercise
Group 2: Group 1 intervention components + referral to a free, community-based, EIM practitioner led group exercise program (two, 1 hour classes/week for 8 weeks).
|
Brief exercise counseling session and provision of a wearable fitness tracking device to promote physical activity.
Exercise is Medicine Practitioners will facilitate peer groups that attend twice-weekly exercise classes for 8 weeks, with clinical monitoring and advise regarding increasing physical activity.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Differences in minutes of physical activity per week as measured by wearable device
Time Frame: measured at baseline, 8 weeks and 16 weeks post start of intervention.
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The Garmin wearable device will be used to track physical activity minutes during the week, with differences in total minutes per week in baseline versus 8 weeks (and 16 weeks) post intervention compared between exercise classes versus counseling alone groups
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measured at baseline, 8 weeks and 16 weeks post start of intervention.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Six minute walk test (6MWT)
Time Frame: measured at baseline, 8 weeks and 16 weeks post start of intervention.
|
6 minute walk test will be administered by research personnel in 100 feet walkway, with differences in distance walked between baseline and 8 weeks (and 16 weeks), compared between group exercise and counseling alone groups
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measured at baseline, 8 weeks and 16 weeks post start of intervention.
|
Handgrip
Time Frame: measured at baseline, 8 weeks and 16 weeks post start of intervention.
|
Dynamometers will be used to measure handgrip strength, with differences in distance walked between baseline and 8 weeks (and 16 weeks), compared between group exercise and counseling alone groups
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measured at baseline, 8 weeks and 16 weeks post start of intervention.
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Health-related Quality of life using Medical Outcomes Short form 12
Time Frame: measured at baseline, 8 weeks and 16 weeks post start of intervention.
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Questionnaire based Sf12 will be used to measure health related quality of life, with differences in distance walked between baseline and 8 weeks (and 16 weeks), compared between group exercise and counseling alone groups
|
measured at baseline, 8 weeks and 16 weeks post start of intervention.
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Symptoms of Depression as measured by Center for Epidemiologic Studies Depression Scale (CESD20)
Time Frame: measured at baseline, 8 weeks and 16 weeks post start of intervention.
|
Questionnaire based CESD-2 scale will be used to measure depression
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measured at baseline, 8 weeks and 16 weeks post start of intervention.
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Physical activity self-efficacy questionnaire
Time Frame: measured at baseline, 8 weeks and 16 weeks post start of intervention.
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measured at baseline, 8 weeks and 16 weeks post start of intervention.
|
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Waist circumference
Time Frame: measured at baseline, 8 weeks and 16 weeks post start of intervention.
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measured at baseline, 8 weeks and 16 weeks post start of intervention.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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.
General Publications
- Anand S, Ziolkowski SL, Bootwala A, Li J, Pham N, Cobb J, Lobelo F. Group-Based Exercise in CKD Stage 3b to 4: A Randomized Clinical Trial. Kidney Med. 2021 Jul 8;3(6):951-961.e1. doi: 10.1016/j.xkme.2021.04.022. eCollection 2021 Nov-Dec.
- Jagannathan R, Ziolkowski SL, Weber MB, Cobb J, Pham N, Long J, Anand S, Lobelo F. Physical activity promotion for patients transitioning to dialysis using the "Exercise is Medicine" framework: a multi-center randomized pragmatic trial (EIM-CKD trial) protocol. BMC Nephrol. 2018 Sep 12;19(1):230. doi: 10.1186/s12882-018-1032-0.
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)
April 16, 2018
Primary Completion (Actual)
December 31, 2020
Study Completion (Actual)
November 30, 2021
Study Registration Dates
First Submitted
October 9, 2017
First Submitted That Met QC Criteria
October 14, 2017
First Posted (Actual)
October 17, 2017
Study Record Updates
Last Update Posted (Actual)
February 8, 2022
Last Update Submitted That Met QC Criteria
January 24, 2022
Last Verified
January 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB-43198
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
product manufactured in and exported from the U.S.
Yes
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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