- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03347045
Trimodal Prehabilitation for Cystectomy Patients to Enhance Post-operative Care (TPC-RCT)
Trimodal Prehabilitation for Cystectomy Patients to Enhance Post-operative Care: A Randomized Control Trial
Trimodal prehabilitation is a preoperative three-tiered (trimodal) approach to optimizing physical and mental health. It has been found to successfully improve functional recovery in patients undergoing colorectal surgery following an evidence-based enhanced-recovery pathway (ERP). It is unknown whether the same program is effective in patients undergoing a similar surgery for bladder cancer (radical cystectomy).
Objective: To evaluate the appropriateness of a standardized prehabilitation program for implementation into an enhanced recovery pathway for cystectomy patients and determine whether prehabilitation facilitates earlier recovery of functional capacity.
Hypothesis: Prehabilitation will ultimately improve recovery of functional capacity, clinical and patient-centered outcomes in patients undergoing radical cystectomy for bladder cancer.
Design: Participants will follow an 8-week trimodal prehabilitation program consisting of exercise therapy combined with nutritional counseling, protein supplementation, and psychological care; they will be compared to a cohort of participants following ERP care alone.
Conclusion: The proposal will provide insight into the feasibility and effectiveness of trimodal prehabilitation for radical cystectomy patients and may ultimately lead to improved clinical outcomes and reduced morbidity.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Jason Martyn, MScPT
- Phone Number: 403-943-3575
- Email: jason.martyn@ahs.ca
Study Contact Backup
- Name: Chelsia Gillis, PhD
- Email: chelsia.gillis@ucalgary.ca
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male or female ≥ 18 years of age at time of consent for surgery.
- Documentation of bladder cancer diagnosis as evidenced by diagnostic imaging and biopsy.
- May or may not receive adjuvant therapy.
- Written informed consent obtained from subject
Exclusion Criteria:
Presence of a condition or abnormality that in the opinion of the investigator would compromise the safety of the patient or adherence to the program. This includes:
- American Society of Anesthesiologists (ASA) health class status 4-5;
- Co-morbid medical, physical, and/or mental conditions including dementia, disabling orthopedic and neuromuscular disease, psychosis;
- Severe cardiac abnormalities, end-stage organ disease, sepsis, or morbid obesity (BMI greater than 35);
- Undergoing radical cystectomy for a reason other than bladder cancer.
- Poor comprehension of English or French
- Screened by Total Cardiology staff and determined to be inappropriate for prehabilitation at their facility.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Trimodal Prehab & ERP
Trimodal prehab includes:
|
1-hr daily exercise will be completed a total of 5d/week, of which 2 of these sessions are completed through a community fitness center. Following these sessions, the participant will consume a high-protein oral supplement. Additionally, during the program, participants will be given the option of attending a stress-reduction group and will receive a take-home anxiety-reduction program. They will have access to a physiotherapist, kinesiologist, registered dietitian, and physician throughout the program. The total length of this program is 8-weeks and is timed to occur in the waiting period between the consent for surgery and operation date.
Other Names:
|
ACTIVE_COMPARATOR: No Prehab; ERP Alone
The active comparator group will be given a home exercise program, nutrition education, and a take-home anxiety reduction program.
|
1-hr daily exercise with a self-completed home-exercise program.
The participant will be given nutritional education material and a take-home anxiety-reduction program.
They will be responsible for maintaining a journal of their activity.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
6-minute walk test (6MWT)
Time Frame: Multiple time-points over 20-weeks
|
The 6MWT is a sub-maximal exercise test used to assess aerobic capacity and endurance.
The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.
|
Multiple time-points over 20-weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
10-meter walk test (10mWT)
Time Frame: Multiple time-points over 20-weeks
|
The 10 Metre Walk Test is a performance measure used to assess walking speed in metres per second over a short distance.
It can be employed to determine functional mobility, gait, and vestibular function.
|
Multiple time-points over 20-weeks
|
30s sit-to-stand test (30CST)
Time Frame: Multiple time-points over 20-weeks
|
The 30CST is a measurement that assesses functional lower extremity strength in older adults.
It is part of the Fullerton Functional Fitness Test Battery.
This test was developed to overcome the floor effect of the 5 or 10 repetition sit to stand test in older adults.
|
Multiple time-points over 20-weeks
|
Hand-grip dynamometry
Time Frame: Multiple time-points over 20-weeks
|
A quantitative and objective measure of isometric muscular strength of the hand and forearm, predictive of overall upper-extremity function.
|
Multiple time-points over 20-weeks
|
Functional Assessment of Cancer Therapy for Bladder Cancer (FACT-Bl)Questionnaire
Time Frame: Collected at beginning and end of 20-week participant involvement period
|
A reliable and valid questionnaire that comprehensively assesses quality of life concerns pertinent to bladder cancer patients.
|
Collected at beginning and end of 20-week participant involvement period
|
EuroQOL five dimensions (EQ-5D) Questionnaire
Time Frame: Collected at beginning and end of 20-week participant involvement period
|
A short, generic quality of life questionnaire
|
Collected at beginning and end of 20-week participant involvement period
|
Godin Leisure Time Exercise Questionnaire
Time Frame: Collected at beginning and end of 20-week participant involvement period
|
A short questionnaire on self-reported physical activity.
|
Collected at beginning and end of 20-week participant involvement period
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Length of hospital stay (LOS)
Time Frame: Collected at the finale of participant-involvement (20-weeks)
|
Length of stay in the hospital starting from post-operative day #0 and terminating when the participant is discharged from the hospital.
|
Collected at the finale of participant-involvement (20-weeks)
|
30 day readmission rate
Time Frame: Collected at the finale of participant-involvement (20-weeks)
|
Number of participants re-admitted to hospital within 30 days of discharge as a percentage of the total number of participants involved in the study.
|
Collected at the finale of participant-involvement (20-weeks)
|
Clavien-Dindo classification of Surgical Complications
Time Frame: Collected at the finale of participant-involvement (20-weeks)
|
A classification scheme that objectively grades surgical complications using a descriptive grading system.
|
Collected at the finale of participant-involvement (20-weeks)
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Jason Martyn, MScPT, Alberta Health Services
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 (ACTUAL)
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
- 2017CRIF-JMARTYN
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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