Hodnocení bezpečnosti a účinnosti digitálního terapeutického zařízení ke zlepšení síly u sarkopenie (Sarc-DTx)
Multicentrická, prospektivní, randomizovaná, paralelně uspořádaná, hodnotitelsky zaslepená, potvrzovací klinická studie k vyhodnocení bezpečnosti a účinnosti digitálního terapeutického zařízení pro zlepšení svalové síly u pacientů se sarkopenií
This clinical trial aims to demonstrate that the use of a digital therapeutic device (exoDTx) in patients with sarcopenia is superior to self-exercise in terms of muscle strength improvement and safety.
Přehled studie
Postavení
Postavení
Podmínky
Podmínky
Intervence / Léčba
Intervence / Léčba
Detailní popis
Background Sarcopenia is a condition characterized by progressive loss of skeletal muscle mass and strength, which is closely associated with functional decline, falls, and increased mortality.Conventional first-line treatment involves resistance training; however, in older adults, low adherence and practical challenges often limit its effectiveness.Recently, digital therapeutics (DTx) have emerged as promising tools by providing personalized exercise programs, automatic adjustment of intensity, and integrated recording and monitoring functions. These features are expected to overcome the limitations of selfdirected exercise.Therefore, this study seeks to validate the effectiveness and safety of DTx in improving muscle strength and physical function through a randomized controlled trial (RCT). Research Hypothesis In patients with sarcopenia, the group using digital therapeutics (DTx) will demonstrate superior outcomes in muscle strength improvement and safety compared to the self-exercise group.
Typ studie
Typ studie
Zápis (Odhadovaný)
Zápis
Fáze
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
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Bucheon-si, Jižní Korea
- Bucheon St. Mary's Hospital
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Suwon, Jižní Korea
- St.Vincent's hospital
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Kritéria účasti
Kritéria způsobilosti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria
- Individuals diagnosed with sarcopenia according to both the European Working Group on Sarcopenia in Older People (EWGSOP) criteria and the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria
- Individuals with reduced muscle strength, defined as at least one of the following:
- Handgrip strength < 28 kg for men or < 18 kg for women
- Five-times Sit-to-Stand Test time > 12 seconds without arm support
- Individuals with reduced muscle mass, defined as at least one of the following:
- Skeletal Muscle Mass Index (SMI) < 7.0 kg/m² for men or < 5.4 kg/m² for women measured by DXA
- Skeletal Muscle Mass Index (SMI) < 7.0 kg/m² for men or < 5.7 kg/m² for women measured by BIA
- Individuals able to independently perform sit-to-stand movements
- Individuals with sufficient physical and cognitive capacity to participate in the exercise program
- Individuals able and willing to provide written informed consent
- Individuals able to operate a mobile phone independently or with assistance from a caregiver
Exclusion Criteria
- Individuals with cognitive impairment, defined as a Mini-Mental State Examination (MMSE) score < 20, or those unable to participate due to cognitive decline
- Individuals with an implanted cardiac pacemaker or other implanted electronic medical device
- Individuals with uncontrolled cardiovascular disease despite appropriate medical management
- Individuals who have undergone lower-limb surgery within the past 6 months and are unable to ambulate independently
- Individuals with moderate-to-severe musculoskeletal pain or functional limitations that interfere with objective functional assessments
- Individuals with severe obesity, defined as a body mass index (BMI) > 50 kg/m²
- Individuals currently receiving active cancer treatment or experiencing severe systemic frailty
- Individuals with hemiplegia that prevents participation in the prescribed exercise program
- Individuals who are anticipated by the investigator to be unable to complete the study procedures or follow-up assessments
- Individuals unable to understand or comply with study instructions provided in Korean
- Individuals considered unsuitable for study participation at the discretion of the investigator for any other reason
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Dvojnásobek
Počet zbraní
Zbraně a zásahy
Skupina účastníků / ArmSkupina účastníků / Arm |
Intervence / LéčbaIntervence / Léčba |
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Experimentální: Experimental Device Group (Home-based DTx exercise group after training)
Participants perform personalized resistance exercises using a digital therapeutic device (mobile application) at home for 12 weeks, with sessions conducted at least 3 times per week, 50 minutes per session (≥150 minutes/week). The program includes exercise automatic intensity adjustment, exercise recording/analysis, and physician monitoring |
Experimental group (exoDTx): After baseline on-site training, participants perform personalized resistance exercises at home using a mobile app ≥3 times/week, 50 min/session, for 12 weeks (≥150 min/week). The program provides grip strength-based automatic intensity adjustment, exercise recording, feedback, and physician monitoring. Delivery: Nonpharmacological, non-invasive, home-based exercise program. The experimental group uses a mobile app; the control group uses educational materials. Initial instruction occurs on-site. Visits & Monitoring: Screening/Baseline (week 0), In-treatment (weeks 4, 8), Post-treatment (week 12), and Follow-up (week 24). |
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Aktivní komparátor: Control Group (Self-exercise)
No mobile application is used. Participants perform the same type of exercise using QR code-based educational materials, self-regulating their exercise time, at least 3 times per week, 50 minutes per session, for a total of 12 weeks, with frequency and duration identical to the experimental group. |
Control group (Self-exercise): No app is used. Participants perform the same exercise guided by QR code-based educational materials, ≥3 times/week, 50min/session, for 12 weeks, maintaining exercise logs without automatic adjustment or remote monitoring. Delivery: Non-pharmacological, non-invasive, homebased exercise program. The experimental group uses a mobile app; the control group uses educational materials. Initial instruction occurs on-site. Visits & Monitoring: Screening/Baseline (week 0), In-treatment (weeks 4, 8), Post-treatment (week 12), and Follow-up (week 24). |
Co je měření studie?
Primární výstupní opatření
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
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Change in peak knee extension strength (Nm) from baseline to 12 weeks
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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Between-group comparison of mean change in knee extensor strength measured by lower extremity dynamometer. |
12 weeks after Visit 1 (treatment initiation)
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Sekundární výstupní opatření
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Change in peak isometric knee extension strength (Nm) from baseline to 4, 8, and 24 weeks
Časové okno: Baseline, 4 weeks, 8 weeks, and 24 weeks after Visit 1 (treatment initiation)
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To evaluate longitudinal changes in knee extensor muscle strength at weeks 4, 8, and 24 compared with baseline using an lower extremity dynamometer. |
Baseline, 4 weeks, 8 weeks, and 24 weeks after Visit 1 (treatment initiation)
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Change in body composition (skeletal muscle mass index, fat mass)
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To evaluate changes in muscle and fat mass measured by dual-energy x-ray absorptiometry(DXA) or bioelectrical impedance analysis (BIA) after 12 weeks of intervention. |
12 weeks after Visit 1 (treatment initiation)
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Change in Manual Muscle Test (MMT) scores of major limb muscles
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To assess changes in muscle strength based on standardized MMT grading (0-5 scale) after 12 weeks of intervention.. |
12 weeks after Visit 1 (treatment initiation)
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Change in handgrip strength (kg) from baseline
Časové okno: Baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks
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To assess longitudinal changes in handgrip strength measured by hand dynamometer at weeks 4, 8, 12, and 24. |
Baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks
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Change in calf circumference (cm) from baseline
Časové okno: Baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks
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To assess longitudinal changes in calf circumference measured at the maximum girth of the dominant or less-affected lower leg at weeks 4, 8, 12, and 24. |
Baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks
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Change in Muscle Function Index (MFI) from surface EMG analysis
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To quantify changes in muscle fatigue characteristics derived from surface electromyography (EMG) during resistance exercises. |
12 weeks after Visit 1 (treatment initiation)
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Change in Fugl-Meyer Assessment (upper/lower extremities; CNS-related sarcopenia subgroup)
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To examine motor recovery and coordination improvements using the Fugl-Meyer Assessment in participants with CNS-related sarcopenia. |
12 weeks after Visit 1 (treatment initiation)
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Change in 30-second chair stand test (repetitions) from baseline
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To assess changes in lower limb functional strength and endurance measured by the number of sit-to-stand repetitions completed in 30 seconds after 12 weeks of intervention. |
12 weeks after Visit 1 (treatment initiation)
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Change in Functional Ambulation Category (FAC) score
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To assess improvement in walking independence level using the Functional Ambulation Category (0-5 scale). |
12 weeks after Visit 1 (treatment initiation)
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Change in Berg Balance Scale (BBS) and Timed Up and Go (TUG) performance
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To evaluate dynamic and static balance performance using BBS score and TUG test time. |
12 weeks after Visit 1 (treatment initiation)
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Change in Short Physical Performance Battery (SPPB) total score and subscores (chair stand, gait speed, balance)
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To assess lower extremity function using SPPB, including 5-time chair stand, 6-meter gait speed, and balance tests. SPPB - 5-time chair stand (time) 6-meter gait speed (SPPB gait speed) SPPB balance - score SPPB balance - time in seconds |
12 weeks after Visit 1 (treatment initiation)
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Change in Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls Questionnaire Score
Časové okno: Baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks
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To assess changes in self-reported sarcopenia risk using the full Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls questionnaire. The SARC-F consists of 5 items, each scored from 0 to 2, resulting in a total score ranging from 0 to 10, with higher scores indicating worse sarcopenia severity and greater functional limitation. |
Baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks
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Change in Sarcopenia Quality of Life score
Časové okno: Baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks
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To measure sarcopenia-specific quality of life changes using Sarcopenia Quality of Life total score and domain subscores. Sarcopenia Quality of Life contains 55 items generating a total score from 0 to 100, with higher scores indicating better quality of life. |
Baseline, 4 weeks, 8 weeks, 12 weeks, and 24 weeks
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Change in EuroQol Five-Dimension Five-Level (EQ-5D-5L) Questionnaire Score
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To assess changes in self-reported health-related quality of life using the full EuroQol Five-Dimension Five-Level (EQ-5D-5L) questionnaire. The EQ-5D-5L consists of 5 items, each scored from 1 to 5, resulting in a total score ranging from 5 to 25, with lower scores indicating better health-related quality of life and higher scores indicating greater health impairment. |
12 weeks after Visit 1 (treatment initiation)
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Change in Self-Efficacy for Home Exercise Programs Scale score
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To evaluate participants' confidence in independently performing prescribed home-based exercises. |
12 weeks after Visit 1 (treatment initiation)
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System Usability Scale (SUS) total score of the exoDTx mobile application
Časové okno: 12 weeks after Visit 1 (treatment initiation)
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To assess user satisfaction and perceived usability of the exoDTx digital therapeutic application using SUS. |
12 weeks after Visit 1 (treatment initiation)
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Spolupracovníci a vyšetřovatelé
Sponzor
Sponzor
Spolupracovníci
Spolupracovníci
Vyšetřovatelé
Vyšetřovatelé
- Vrchní vyšetřovatel: Sangui Choi, CPO, Exosystems
Publikace a užitečné odkazy
Termíny studijních záznamů
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Termíny zápisu do studia
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Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
Další identifikační čísla studie
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- HC25DDDS0072
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