Telerehabilitation Program Via Videoconference PAH - Randomized Clinical Trial

December 16, 2022 updated by: LUCIANA MARIA MALOSA SAMPAIO, University of Nove de Julho

Effects of a Home Telerehabilitation Program Via Videoconference in Patients With Pulmonary Arterial Hypertension- Randomized Clinical Trial

Pulmonary arterial hypertension (PAH) is a serious, progressive disease that causes pulmonary arterial pressure, significantly affecting functional capacity and quality of life.

Over the last few years, knowledge in pulmonary hypertension has evolved consistently and significantly. New diagnostic and treatment algorithms were combined based on the results of several clinical studies that showed the usefulness of new tools, as well as the effectiveness of new drugs as well as non-pharmacological treatment. The new guidelines felt the benefits of physical exercise in individuals with PAH, with promising results in improving symptoms, exercise capacity, peripheral muscle function and quality of life.

With the COVID 19 pandemic, the complex scenario was for world health, and social distancing made it impossible to carry out individual outpatient rehabilitation, in groups and in person, indicating the need for rehabilitation programs, including physical training, to be adapted to the domicile.

New alternative modes of pulmonary rehabilitation include home-based models and the use of telehealth. Telerehabilitation is the provision of rehabilitation services at a distance, using information and communication technologies. To date, there has been no evaluation of the clinical efficacy or safety of telerehabilitation in the population affected by PAH.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Pulmonary arterial hypertension is a type of high blood pressure that affects the arteries in the lungs and the right side of the heart.

In one form of pulmonary hypertension, called PAH, blood vessels in the lungs are narrowed, blocked or destroyed. The damage slows blood flow through the lungs, and blood pressure in the lung arteries rises. The heart must work harder to pump blood through the lungs. The extra effort eventually causes the heart muscle to become weak and fail. In some people, pulmonary hypertension slowly gets worse and can be life-threatening. Although there's no cure for some types of pulmonary hypertension, treatment can help reduce symptoms and improve quality of life.

Several studies show the importance of physical training in patients with PAH. In the study by Meirelles et al. individuals with severe chronic PAH achieved positive results when manifested to physical training, improved the distance walked in the 6-minute walk test (6MWD) by 96±61m after 15 weeks compared to the control group (p<0.001) and several other studies point out the importance of aerobic training for this pulmonary hypertension (PH) population.

However, it is known that exercise limitation in PAH is multifactorial, having right ventricular dysfunction, chronotropic incompetence, ventilatory abnormalities and skeletal muscle dysfunction as causes. mechanical restrictions, poor oxygenation of the skeletal and cerebral muscle, hyperventilation with variations/or increase in the sympathetic impulse.

Study Type

Interventional

Enrollment (Anticipated)

50

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 Contact

Study Contact Backup

Study Locations

  • Brazil
    • Sao Paulo
      • São Paulo, Sao Paulo, Brazil, 03332010
        • Luciana Maria Malosa Sampaio
        • Contact:
          • Luciana Malosa Sampaio, PhD

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

14 years to 66 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Participants with PAH from group 1 of the HP leaderboard
  • Confirmed diagnosis of PAH by cardiac catheterization measurements as defined in group 1, with NHNY functional class I to IV (receiving specific pharmacological therapy for PAH), aged 18 to 70 years
  • They are clinically stable without having been hospitalized in the last few weeks.
  • Having internet with a data package and knowing how to use WhatsApp to manage telerehabilitation

Exclusion Criteria:

  • Requiring continuous oxygen therapy
  • Clinical groups 3, 4 and 5
  • Significant musculoskeletal disease or limb claudication pain; Psychological or cognitive impairment, psychiatric psychological or mood disorders that may affect your ability to perform the clinical field test
  • History of moderate or severe chronic lung disease
  • Left heart disease, angina and/or fast heart rate.

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: Treatment
  • Allocation: Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Telerehabilitation

AEROBIC TRAINING

2 training sessions per week for a period of 8 weeks

Connection platform: WhatsApp

The research participant will use a 20 cm step on which he will have to go up and down until he reaches the predicted training heart rate.

Intensity: 60-80% of the maximum heart rate reached at the peak of the incremental step test

5 minutes warm-up: 60% of maximum heart rate

20 minutes of Training: 60 to 80% of the maximum heart rate reached at the peak of the incremental step test

5 minute cool down: 60% of maximum heart rate

Duration 30 minutes

RESISTANCE TRAINING

Devices: Anklet (variable load), these devices will be made available to the research participant

Exercises for upper limbs, shoulder flexion, elbow flexion and shoulder abduction, and for lower limbs hip flexion and extension.

Intensity: 70% of the maximum starting load of a 1RM repetition

3 sets of 8 repetitions

Duration: 30 minutes
Other: Aerobic and Resistance training with rehabilitation
Effects of home telerehabilitation program improve functional capacity variables
Experimental: Telehealth

Guidelines leaflet with health education proposals Explanations about your disease, what it is, psychopathological diagnoses and pharmacological and non-pharmacological treatment), information about the importance of physical activity in your daily life, such as walking, stretching or some daily physical activity according to your preference .

This group will not receive aerobic or resistance training.

You will receive telemonitoring twice a week over a period of 8 weeks as a form of teleconsultation in health with the physiotherapist for monitoring throughout the research.

After this period it will be reassessed.
Other: Health education
Telehealth and guidelines for the practice of physical activity and health education

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Functional exercise capacity
Time Frame: Change from baseline to 8 weeks
Oxygen consumption measured during cardiopulmonary testing
Change from baseline to 8 weeks
6 Minute Walking Test
Time Frame: Change from baseline to 8 weeks
Distance in meters
Change from baseline to 8 weeks
Maximum heart rate
Time Frame: Change from baseline to 8 weeks
Correlate the maximum heart rate of both functional capacity tests
Change from baseline to 8 weeks
Interchangeable tests
Time Frame: Change from baseline to 8 weeks
Correlate the distance covered in the six-minute walk test with the number of climbs in the incremental step test
Change from baseline to 8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
FVC
Time Frame: Change from baseline to 8 weeks
Lung function - forced vital capacity
Change from baseline to 8 weeks
FEV1
Time Frame: Change from baseline to 8 weeks
Lung function - expiratory volume in 1 second
Change from baseline to 8 weeks
Health-related quality of life score
Time Frame: Change from baseline to 8 weeks
scores by EmPHasis-10- health-related quality of life Pulmonary hypertension. Score 0-50
Change from baseline to 8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Nove de Julho

Investigators

  • Principal Investigator: Luciana Malosa Sampaio, Ph.D, University of Nove de Julho

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

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 (Anticipated)

January 15, 2023

Primary Completion (Anticipated)

April 25, 2023

Study Completion (Anticipated)

May 10, 2025

Study Registration Dates

First Submitted

December 8, 2022

First Submitted That Met QC Criteria

December 16, 2022

First Posted (Actual)

December 19, 2022

Study Record Updates

Last Update Posted (Actual)

December 21, 2022

Last Update Submitted That Met QC Criteria

December 16, 2022

Last Verified

December 1, 2022

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PAH - Telerehabilitation

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

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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