- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04575220
Adaptive Home Based Pulmonary Tele-exercise (AHTE)
Pilot Study of Adaptive Home Based Pulmonary Tele-exercise (AHTE)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Studies have shown that pulmonary rehabilitation, which includes exercise and patient education, is a valuable therapy for patients with pulmonary diseases. In fact, pulmonary rehabilitation delivered soon after patient discharge is known to produce a major improvement in patient outcomes. Specifically, studies have shown this intervention reduces readmission rates by 30-70% over the next year. In addition, this therapy improves exercise tolerance, performance of tasks of daily living and sense of patient well being. One study even shows this therapy is 30 times as effective as bronchodilator therapy in improving patient outcomes.
Surprisingly, however, very few pulmonary patients receive pulmonary rehabilitation. Recent studies have shown that 94-98% of discharged pulmonary patients fail to receive this therapy. This pattern has been shown to exist across the United States, with no state demonstrating a much larger use of this therapy. Moreover, use of this therapy is even worse for minorities (only 1% receive pulmonary rehabilitation) and rural populations, such as patients in southern and eastern Kentucky. Several factors are responsible for this failure to employ pulmonary rehabilitation including: (a) very few centers are available and patients cannot realistically travel to the existing centers because of distance, (b) this form of rehabilitation is expensive and patients must pay a large copay (30-50 dollars per session, adding up to a total of 1800 dollars for a typical 12 week program) which many patients cannot afford, (c) centers are only open for restricted hours and working patients cannot miss work to go for rehabilitation, and (d) patients are only eligible for 36 treatment sessions for life.
The purpose of the present project is to define a new home based exercise program that should provide exercise training as good or better than conventional brick and mortar rehabilitation programs. The investigators will use technological advances in home based exercise equipment to both precisely measure participant exercise and to assess physiological improvements over time. This technology will also reduce the expense required to supervise participant training, dramatically reducing costs compared to conventional center based programs. In addition, because programs are home based, the investigators can provide access to participants in rural locations, reduce travel, and easily extend the convenience and schedule of training sessions to accommodate participant lifestyles. While recently there have been a few attempts to provide home based pulmonary rehabilitation programs (e.g. by VA rural health, the Southern Alabama consortium) these other programs do not provide the intensity of training possible with the new paradigm in the current project, are not proven to have the same beneficial effects as conventional center based rehabilitation, and have higher personnel costs making long term financial viability uncertain.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Gerald S Supinski, MD
- Phone Number: 859 494 3480
- Email: gsupi2@email.uky.edu
Study Locations
-
-
Kentucky
-
Lexington, Kentucky, United States, 40536
- Chandler Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria
- age from 18-80 years
- previous diagnosis of pulmonary disease, including known chronic pulmonary diseases (COPD, ILD), recent admission for pulmonary disease (pneumonia, asthma, obstructive lung disease), recent ICU discharge for a diagnosis of respiratory failure, and/or previous COVID-19 disease with demonstration of recovery (two negative antigen tests)
- the capacity to perform cycling exercise
Exclusion Criteria
- if the physician caring for the patient determines that the patient should not participate in a home based exercise program
- if the patient has active ischemic cardiac disease
- if the patient's home does not have sufficient space or internet connectivity for the computer and bicycle to be operative
- if the patient is a pregnant female
- if the patient is a prisoner
- if the patient is institutionalized
- if the patient has a terminal clinical condition.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: tele-exercise
Subjects will perform three sessions/week of home exercise using bicycles for 12 weeks
|
Subjects will conduct monitored exercise, three sessions per week for 12 weeks.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
80% work rate test
Time Frame: This will be measured at baseline, at 6 weeks, and at 12 weeks. The primary outcome measure to be assessed is the change in the 80% work rate test time between the initial and 12 week assessment.
|
This will measure changes in the time the subject can exercise at 80% of the maximum work rate.
|
This will be measured at baseline, at 6 weeks, and at 12 weeks. The primary outcome measure to be assessed is the change in the 80% work rate test time between the initial and 12 week assessment.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
CRQ score: Chronic Respiratory Questionnaire
Time Frame: baseline and at 6 weeks and 12 weeks
|
this will ask how short of breath the subject is: Scores will range from 20 to 140, the higher the score, the better the patient's condition
|
baseline and at 6 weeks and 12 weeks
|
SF36: Short Form Survey; 36 Questions
Time Frame: baseline and at 6 weeks and 12 weeks
|
this questionnaire will ask about quality of life; each question scores from 1 to 6; the higher the score, the worse the patients' condition
|
baseline and at 6 weeks and 12 weeks
|
SPPB: Short Physical Performance Battery
Time Frame: baseline and at 6 weeks and 12 weeks
|
this will test the ability to perform simple movements; balance will be scores 0 to 4, gait speed 2 to 8, and chair standing 0 to 4; the higher the score, the better the patient's condition
|
baseline and at 6 weeks and 12 weeks
|
Collaborators and Investigators
Sponsor
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
Other Study ID Numbers
- 58756
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
- Informed Consent Form (ICF)
- Clinical Study Report (CSR)
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.
Clinical Trials on Rehabilitation
-
Westfälische Wilhelms-Universität MünsterNational Paralympic Committee Germany (NPCG)CompletedCardiac Rehabilitation | Feasibility Studies | Organization and Administration | Rehabilitation ExerciseGermany
-
Asan Medical CenterRecruitingPulmonary Rehabilitation | Cardiac RehabilitationKorea, Republic of
-
University Hospital, ToursCompletedPulmonary Rehabilitation | Respiratory RehabilitationFrance
-
Suleyman Demirel UniversityCompleted
-
Orton Orthopaedic HospitalCompleted
-
Richard Watson, PTCompletedMedial Patellar Femoral Ligament Reconstruction Rehabilitation | Anterior Cruciate Ligament Reconstruction RehabilitationUnited States
-
Cairo UniversityRecruiting
-
Bruyere Research InstituteBruyere Academic Medical OrganizationRecruiting
-
National Cheng Kung UniversityRecruiting
-
University College AbsalonUniversity of Southern Denmark; Arla Foods; Danish Council for Independent Research and other collaboratorsCompleted
Clinical Trials on 12 weeks of bicycle exercise
-
Nottingham Trent UniversityUniversity of ReadingRecruitingPhysical InactivityUnited Kingdom
-
University of Southern CaliforniaCompleted
-
Hitit UniversityHacettepe UniversityRecruitingHeart Failure With Reduced Ejection FractionTurkey
-
Universidad Pablo de OlavideUnknownExercise Therapy | Severe Mental IllnessSpain
-
Cairo UniversityCompletedMetabolic Syndrome in WomenEgypt
-
Aarhus University HospitalUnknown
-
VA Office of Research and DevelopmentBaltimore VA Medical Center; South Texas Veterans Health Care SystemNot yet recruitingObesity | Post-COVID ConditionsUnited States
-
Aarhus University Hospital SkejbyInstitute for Clinical and Experimental MedicineCompletedHeart Failure | Coronary Heart Disease | Ischemic Heart DiseasesDenmark
-
Norwegian University of Science and TechnologySt. Olavs HospitalCompletedHealthy VolunteersNorway
-
Taichung Veterans General HospitalCompletedMetabolic Cardiovascular Syndrome