- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04037436
Functional Exercise and Nutrition Education Program for Older Adults (MoveStrong)
A Model for Delivering Strength Training and Nutrition Education for Older Adults (MoveStrong): A Pilot Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Ontario
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Cambridge, Ontario, Canada
- Chaplin Family YMCA
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Guelph, Ontario, Canada, N1G 0C9
- The Village of Arbour Trails
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Kitchener, Ontario, Canada, N2G 3C5
- A.R. Kaufman Family YMCA
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Kitchener, Ontario, Canada, N2E 3K1
- Village of Winston Park
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Sudbury, Ontario, Canada, P3A 2T4
- Your Family Health Team
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Speak English or attend with a translator;
- ≥ 60 years;
- FRAIL scale score ≥1;
- Have ≥1 diagnosed chronic condition (i.e., diabetes, obesity, cancer (other than minor skin cancer), chronic lung disease, cardiovascular disease, congestive heart failure, hypertension, osteoporosis, arthritis, stroke, or kidney disease).
Exclusion Criteria:
- Currently doing similar resistance exercise ≥2x/week;
- In palliative care;
- Not able to perform basic activities of daily living;
- Cognitive impairment (e.g., unable to follow two-step commands);
- Travelling >1 week during exposure;
- Absolute exercise contraindications (i.e., if they select "no" to any question in the Get Active Questionnaire they must seek physician approval before exercising)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intervention
At regular intervals (the "steps") one cluster (i.e., one site) is randomised to cross from the control to the intervention under evaluation.
This process continues until all clusters have crossed over to be exposed to the intervention.
At the end of the study there will be a period when all clusters are exposed.
Four sites are cluster-randomized to implement MoveSTroNg at one of four start times, each three weeks apart.
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Exercise:A kinesiologist-led twice-weekly program.
Prior to attending the program, each attendee gets a 1:1 session with the kinesiologist to decide exercise starting levels.
Group exercises start with a warm-up stepping game.
Participants then perform 2 sets of 8 repetitions of each exercise, gradually progressing to an intensity of 3-8 repetitions maximum.
Exercises include one each of a push, pull, squat, reach/press, lunge/step-up, lift and carry movement.
After, there is a 10-minute group discussion to prompt making exercise routine at home.
Nutrition:Two dietitian-led interactive group seminars to promote strategies to increase protein intake and sampling of protein-rich snacks and protein supplements.
Seminar topics consider the cost to prepare high protein foods, the ability of retirement home residents to alter diet, how and why to spread protein intake through the day, how much protein is in their usual choices, and easy-to-consume protein-rich snacks.
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Other: Control
Each cluster contributes observations under both control and intervention observation periods.
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During periods when a site is not involved in the MoveSTroNg program, participants will continue with their usual care routine.
Usual care routines should not involve strength and balance exercises.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility - Recruitment
Time Frame: 1 month (August 1 to 31st, 2019)
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Definition: Number recruited at end of rollout.
The criterion for success is to recruit 10 participants at each of 4 sites.
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1 month (August 1 to 31st, 2019)
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Feasibility - Retention
Time Frame: Start of the program to 9 weeks
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Definition: Number retrained at post-rollout end.
The criterion for success is 90% at rollout end.
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Start of the program to 9 weeks
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Feasibility - Adherence
Time Frame: 18 weeks after the start of the program
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Definition: Percentage of individuals that attended exercise and nutrition sessions. The criterion for success is 70% or higher. |
18 weeks after the start of the program
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Body weight
Time Frame: Start of the program and 18 weeks after the start
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Fried Frailty Index Components: We will measure the change in body weight with a calibrated scale.
A change of 5% (greater or lower) in 1 year is considered worse.
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Start of the program and 18 weeks after the start
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10 Meter Walk Test
Time Frame: Start of the program and every 6 weeks until the 18th week
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Fried Frailty Index Components: walking speed via the 10-meter walk test protocol.
A change of 0.05 m/s is considered as a small meaningful change, while 0.13m/s is considered a substantial change.
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Start of the program and every 6 weeks until the 18th week
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Center for Epidemiological Study Depression Scale
Time Frame: Start of the program and every 6 weeks until the 18th week
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Fried Frailty Index Components: fatigue/exhaustion via the Center for Epidemiologic Study Depression Scale-Fatigue Questions.
The score ranges from 0-60 (higher scores reflect increased symptom severity)
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Start of the program and every 6 weeks until the 18th week
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Physical Activity Scale
Time Frame: Start of the program and every 6 weeks until the 18th week
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Fried Frailty Index Components: lower physical activity via the CHAMPS Physical Activity Questionnaire for older adults.
No score, but the recommended physical activity levels are 150 minutes of moderate to vigorous activity and 2 days of strength training of major muscle groups.
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Start of the program and every 6 weeks until the 18th week
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Grip Strength
Time Frame: Start of the program and every 6 weeks until the 18th week
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Fried Frailty Index Components: weakness via the Jamar hand-held dynamometer
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Start of the program and every 6 weeks until the 18th week
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30 Second Chair Stand Test
Time Frame: Start of the program and every 6 weeks until the 18th week
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We will use a chair with a straight back without arm rests (seat 17" high), and a stopwatch.
This will assess leg strength and endurance.
Scores range depending on age and sex (e.g., male 60 to 64, < 14 chair stands is considered below average, while a male 65 to 69, < 12 is below average).
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Start of the program and every 6 weeks until the 18th week
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4 Square Step Test
Time Frame: Start of the program and every 6 weeks until the 18th week
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The Four Square Step Test is used to assess dynamic stability and the ability of the subject to step over low objects forward, sideways, and backward.
For older adults > 15 seconds indicates increased risk of falls
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Start of the program and every 6 weeks until the 18th week
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EuroQol 5 dimension version 5-level (EQ-5D-5L)
Time Frame: Start of the program and every 6 weeks until the 18th week
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The EuroQol 5 dimension version 5-level (EQ-5D-5L) measures quality of life using 5 dimensions, on a 5 point scale, where a higher point is considered better. The EuroQol 5 dimension version 5-level (EQ-5D-5L) also records the respondent's self-rated health on a 20 cm vertical, visual analogue scale with endpoints labelled 'the best health you can imagine' (100) and 'the worst health you can imagine' (0). This information can be used as a quantitative measure of health as judged by the individual respondents. A higher score indicates better quality of life |
Start of the program and every 6 weeks until the 18th week
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Automated Self-Administered 24-Hour (ASA24®) Dietary Assessment Tool
Time Frame: Start of the program and every 6 weeks until the 18th week
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We will use the Automated Self-Administered 24-Hour (ASA24®) Dietary Assessment Tool to conduct interviewer administered diet recalls for 2 weekdays and 1 weekend day.
Nutrient analysis is automated and will be used to quantify and compare protein and energy intakes at baseline and follow-up only.
There is no scale to this section
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Start of the program and every 6 weeks until the 18th week
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Participant and provider experience
Time Frame: 18 weeks after the start of the program
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We will use a semi-structured interview guide to conduct exit interviews with each participant and kinesiologist.
Interviews and training sessions will be audio-recorded and transcribed verbatim.
Two researchers will perform thematic analyses to describe participant and provider experience and satisfaction, adaptations, and learning needs.
There is no scale to this section
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18 weeks after the start of the program
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Adverse events
Time Frame: every 6 weeks until the 18th week after the start of the program
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We will ask participants to report adverse events and falls, using Health Canada definitions.
We will report serious and non-serious adverse events (total and attributable to intervention).
There is no scale to this section
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every 6 weeks until the 18th week after the start of the program
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Resource use
Time Frame: Start of the program and every 6 weeks until the 18th week
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We will use the Productivity and Activity Index questionnaire to assess indirect resource use over the last 6 weeks of the program.There is no scale to this section
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Start of the program and every 6 weeks until the 18th week
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Resource use
Time Frame: Start of the program and every 6 weeks until the 18th week
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We will use the Health Utility Form to assess direct medical resource use over the last 6 weeks of the program.
Direct medical costs will be measured using a closed and open-ended survey about their personnel, hospitalization, medications, rehabilitation, and test costs.
This questionnaire also evaluates out of pocket expenses and transportation.There is no scale to this section
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Start of the program and every 6 weeks until the 18th week
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Collaborators and Investigators
Publications and helpful links
General Publications
- Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999 Sep;89(9):1322-7. doi: 10.2105/ajph.89.9.1322.
- Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA; Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. doi: 10.1093/gerona/56.3.m146.
- Beaudart C, Rizzoli R, Bruyere O, Reginster JY, Biver E. Sarcopenia: burden and challenges for public health. Arch Public Health. 2014 Dec 18;72(1):45. doi: 10.1186/2049-3258-72-45. eCollection 2014.
- Cruz-Jentoft AJ, Landi F, Schneider SM, Zuniga C, Arai H, Boirie Y, Chen LK, Fielding RA, Martin FC, Michel JP, Sieber C, Stout JR, Studenski SA, Vellas B, Woo J, Zamboni M, Cederholm T. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014 Nov;43(6):748-59. doi: 10.1093/ageing/afu115. Epub 2014 Sep 21.
- Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JCT, Lord SR. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2017 Dec;51(24):1750-1758. doi: 10.1136/bjsports-2016-096547. Epub 2016 Oct 4.
- Pahor M, Guralnik JM, Ambrosius WT, Blair S, Bonds DE, Church TS, Espeland MA, Fielding RA, Gill TM, Groessl EJ, King AC, Kritchevsky SB, Manini TM, McDermott MM, Miller ME, Newman AB, Rejeski WJ, Sink KM, Williamson JD; LIFE study investigators. Effect of structured physical activity on prevention of major mobility disability in older adults: the LIFE study randomized clinical trial. JAMA. 2014 Jun 18;311(23):2387-96. doi: 10.1001/jama.2014.5616.
- Brosseau L, Wells GA, Poitras S, Tugwell P, Casimiro L, Novikov M, Loew L, Sredic D, Clement S, Gravelle A, Kresic D, Hua K, Lakic A, Menard G, Sabourin S, Bolduc MA, Ratte I, McEwan J, Furlan AD, Gross A, Dagenais S, Dryden T, Muckenheim R, Cote R, Pare V, Rouhani A, Leonard G, Finestone HM, Laferriere L, Haines-Wangda A, Russell-Doreleyers M, De Angelis G, Cohoon C. Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for low back pain. J Bodyw Mov Ther. 2012 Oct;16(4):424-55. doi: 10.1016/j.jbmt.2012.04.002. Epub 2012 Jun 23.
- Giangregorio LM, Papaioannou A, Macintyre NJ, Ashe MC, Heinonen A, Shipp K, Wark J, McGill S, Keller H, Jain R, Laprade J, Cheung AM. Too Fit To Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int. 2014 Mar;25(3):821-35. doi: 10.1007/s00198-013-2523-2. Epub 2013 Nov 27.
- Ravindran AV, Balneaves LG, Faulkner G, Ortiz A, McIntosh D, Morehouse RL, Ravindran L, Yatham LN, Kennedy SH, Lam RW, MacQueen GM, Milev RV, Parikh SV; CANMAT Depression Work Group. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments. Can J Psychiatry. 2016 Sep;61(9):576-87. doi: 10.1177/0706743716660290. Epub 2016 Aug 2.
- Peterson MD, Sen A, Gordon PM. Influence of resistance exercise on lean body mass in aging adults: a meta-analysis. Med Sci Sports Exerc. 2011 Feb;43(2):249-58. doi: 10.1249/MSS.0b013e3181eb6265.
- Borde R, Hortobagyi T, Granacher U. Dose-Response Relationships of Resistance Training in Healthy Old Adults: A Systematic Review and Meta-Analysis. Sports Med. 2015 Dec;45(12):1693-720. doi: 10.1007/s40279-015-0385-9.
- Liu CJ, Latham NK. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev. 2009 Jul 8;2009(3):CD002759. doi: 10.1002/14651858.CD002759.pub2.
- Trombetti A, Hars M, Hsu FC, Reid KF, Church TS, Gill TM, King AC, Liu CK, Manini TM, McDermott MM, Newman AB, Rejeski WJ, Guralnik JM, Pahor M, Fielding RA; LIFE Study Investigators. Effect of Physical Activity on Frailty: Secondary Analysis of a Randomized Controlled Trial. Ann Intern Med. 2018 Mar 6;168(5):309-316. doi: 10.7326/M16-2011. Epub 2018 Jan 9.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
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
- 20190401
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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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