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Feasibility and Effects of Inspiratory Muscle Training Combined With Blood Flow Restriction for Frail Older Adults

1. května 2026 aktualizováno: Pei-Shan, Tsai, Taipei Medical University

Feasibility and Effects of Inspiratory Muscle Training Combined With Blood Flow Restriction for Frail Older Adults: A Pilot Randomized Controlled Trial

This randomized controlled trial study aims to evaluate the feasibility and preliminary efficacy of a combined inspiratory muscle training (IMT) and blood flow restriction (BFR) intervention in frail older adults. Outcomes of interest include feasibility, physical function, respiratory muscle strength, handgrip strength, five-times sit-to-stand performance, body composition, frailty level, fall efficacy, blood pressure, and adverse events.

Přehled studie

Detailní popis

This is a parallel randomized controlled trial. 30 participants who are older adults with frailty will be enrolled.

Eligible participants who complete the baseline measurements will be randomly allocated to a combined BFR and IMT intervention group (N=15) or in the control group with BFR and sham IMT (N=15).

Primary outcomes include feasibility and physical function (i.e., the Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT), and Time Up and Go (TUG) test). Secondary outcomes include respiratory muscle strength, handgrip strength, five-times sit-to-stand performance, body composition, frailty level, fall efficacy, blood pressure, and adverse events. All outcomes will be assessed at baseline (T0) and immediately after the 6-week intervention period (T1) in both groups.

Typ studie

Intervenční

Zápis (Odhadovaný)

30

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

  • Jméno: Pei-Shan Tsai Professor, PhD
  • Telefonní číslo: 6321 +886227361661
  • E-mail: ptsai@tmu.edu.tw

Studijní místa

      • Taipei, Tchaj-wan, 11031
        • Taipei Medical University
        • Kontakt:
          • Pei-Shan Tsai Professor, PhD
          • Telefonní číslo: 6321 +886227361661
          • E-mail: ptsai@tmu.edu.tw

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Starší dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Inclusion Criteria:

  • Community-dwelling adults aged 65 years and older who are classified as at least "vulnerable" using the Clinical Frailty Scale (score ≥4).
  • Participants must have no cognitive impairment and be able to follow commands, as assessed by the Mini-Mental State Examination (MMSE).

Exclusion Criteria:

  • (1) are unable to participate in exercise (e.g., due to severe musculoskeletal disorders)
  • (2) have high-risk factors for exercise, such as uncontrolled hypertension (>150 mmHg systolic blood pressure (SBP) / >90 mmHg diastolic blood pressure (DBP), coagulation disorders, and deep venous thrombosis
  • (3) have hematological disorders or are using hematology related-medications
  • (4) have significant comorbidities, including a history of stroke, diabetes with severe complications, or cardiovascular diseases
  • (5) chronic lung conditions (e.g., obstructive pulmonary disease, asthma), and
  • (6) have participated in a structured exercise training program within the past 3 months at a frequency exceeding three sessions per week.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Léčba
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Dvojnásobek

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Intervention group
Participants in the experimental group will receive a 6 week combined BFR and IMT intervention

Each session will last approximately 60 minutes and will include three components: (1) an initial 3-minute IMT exercise performed at an intensity corresponding to rating of perceived exertion (RPE) 11-13 on the Borg 6-20 scale, (2) a 50-minute low-intensity exercise program combined with BFR, and (3) a second 3-minute IMT session at the same target intensity.

For the IMT, the protocol follows a progressive intensity model, starting with 30% of the maximum inspiratory pressure (MIP) in Week 1 to allow participants to become familiar with the technique. The intensity will gradually increase to a target of 60% MIP by Week 6, based on the participants' tolerance.

For the BFR, during weeks 1-2, participants will train at constant loads. From weeks 2-6, training loads will be increased. Cuff pressure will be prescribed relative to the calculated arterial occlusion pressure (AOP): 50% in weeks 1-2, 60% in weeks 3-4, and 70% in weeks 5-6 for both lower- and upper-body exercises.

Falešný srovnávač: Control group
Participants in the control group will receive a 6-week combined combined BFR and sham IMT intervention.
Participants in the control group will perform the identical BFR exercise protocol as the intervention group. However, IMT will be delivered at 2% of MIP, which is considered a sham condition and has not been shown to improve respiratory muscle function

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Recruitment rate
Časové okno: T0 = baseline; T1 = immediately after intervention
The recruitment rate will be calculated by dividing the number of recruited participants by the number of eligible participants
T0 = baseline; T1 = immediately after intervention
Attrition rate
Časové okno: T0 = baseline; T1 = immediately after intervention
Attrition rate is the proportion of randomized participants who withdraw from the study or are lost to follow-up before completing the final assessment.
T0 = baseline; T1 = immediately after intervention
Exercise Enjoyment
Časové okno: T0 = baseline; T1 = immediately after intervention
Enjoyment will be assessed using a single-item Exercise Enjoyment Scale, which asks participants, "How much did you enjoy the exercise session?). Responses are rated on a 7 Likert scale ranging from 1 (not at all) to 7 (extremely)
T0 = baseline; T1 = immediately after intervention
Short Physical Performance Battery (SPPB)
Časové okno: T0 = baseline; T1 = immediately after intervention
The SPPB consists of three components-standing balance, gait speed, and repeated chair stands-each scored from 0 to 4 and summed to a total score ranging from 0 (worst performance) to 12 (best performance). Lower SPPB scores indicate poorer physical function and a higher risk of adverse outcomes, with scores below 10 predictive of all-cause mortality in older adults.
T0 = baseline; T1 = immediately after intervention
6-Minute Walk Test (6MWT)
Časové okno: T0 = baseline; T1 = immediately after intervention
The 6MWT will be used to assess functional exercise capacity. Participants will be instructed to walk as far as possible along a flat, straight course for 6 minutes, and the total distance is recorded.
T0 = baseline; T1 = immediately after intervention
Time Up to Go (TUG)
Časové okno: T0 = baseline; T1 = immediately after intervention
The TUG test is used to assess functional mobility, balance, and fall risk in older adults, incorporating a series of dynamic activities. Participants will be instructed to rise from a chair, walk three meters at a comfortable pace, turn around, walk back to the chair, and sit down. The total time taken to complete the task is recorded, with longer times indicating poorer functional mobility and higher fall risk
T0 = baseline; T1 = immediately after intervention

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Respiratory Muscle Strength
Časové okno: T0 = baseline; T1 = immediately after intervention
We will use the S-Index Test to evaluate the respiratory muscle function based on maximum dynamic inspiratory pressure, which is a recommended tool developed by POWERbreathe. Participants will be advised to avoid strenuous exercise for 24h and to rest in a sitting position for 15 minutes before the assessment. Then, they performed eight inspiratory maneuvers in a standing position, divided into three to four series of two to three repetitions.
T0 = baseline; T1 = immediately after intervention
Handgrip Strength
Časové okno: T0 = baseline; T1 = immediately after intervention
Handgrip strength will be evaluated to estimate the maximum upper-limb muscle function in older adults. Participants will be seated with the shoulder adducted, the elbow flexed to 90°, and the forearm and wrist in a neutral position. They will then be instructed to squeeze the dynamometer as forcefully as possible.
T0 = baseline; T1 = immediately after intervention
Five-times sit-to-stand
Časové okno: T0 = baseline; T1 = immediately after intervention
The five-times sit-to-stand test is simple to administer and has been widely applied in both clinical and research settings. Participants will sit with their backs against the chair and be instructed to stand and sit five times as quickly as possible.
T0 = baseline; T1 = immediately after intervention
Frailty level
Časové okno: T0 = baseline; T1 = immediately after intervention
The Clinical Frailty Scale (CFS) is a 9-point global clinical measure ranging from 1 (very fit) to 9 (terminally ill), used to classify frailty severity in older adults. A traditional Chinese version of the CFS has been validated in Taiwanese older adults, demonstrating acceptable inter-rater reliability and good criterion validity against established frailty measures
T0 = baseline; T1 = immediately after intervention
Fall Efficacy
Časové okno: T0 = baseline; T1 = immediately after intervention
The short form of the Falls Efficacy Scale-International (FES-I) includes 7 items rated on a 4-point Likert scale from 1 (not at all concerned) to 4 (very concerned). The total score ranges from 7 to 28, with higher values indicating greater concern about falling
T0 = baseline; T1 = immediately after intervention
Adverse events
Časové okno: T0 = baseline; T1 = immediately after intervention
The study team will record adverse events during the intervention caused by the exercise, including falls, fractures, exercise-related pain, dizziness, muscle strain, sprains, respiratory and cardiac adverse events, and hospitalization.
T0 = baseline; T1 = immediately after intervention
Fat mass
Časové okno: T0 = baseline; T1 = immediately after intervention
Fat mass will be assessed using a body composition analyzer and recorded in kilograms
T0 = baseline; T1 = immediately after intervention
Fat-free mass
Časové okno: T0 = baseline; T1 = immediately after intervention
Fat-free mass will be assessed using a body composition analyzer and recorded in kilograms.
T0 = baseline; T1 = immediately after intervention

Další výstupní opatření

Měření výsledku
Popis opatření
Časové okno
The Borg Rating of Perceived Exertion (RPE) Scale
Časové okno: T0 = baseline; T1 = immediately after intervention
The Borg RPE scale reflects an individual's subjective perception of exercise intensity, integrating sensations of physical effort, breathlessness, and fatigue. The scale ranges from 6 to 20, where 6 indicates "no exertion at all" and 20 indicates "maximal exertion." This RPE score will be assessed every training session
T0 = baseline; T1 = immediately after intervention
Automated Office Blood Pressure
Časové okno: T0 = baseline; T1 = immediately after intervention
Automated Office Blood Pressure will be monitored before and after intervention to minimize cardiovascular risks and ensure that timely medical assistance is available for participants who experience any discomfort. Upon arrival at the lab, participants will be asked to sit for at least 5 minutes before the first blood pressure reading; the average of two readings will be used for that visit
T0 = baseline; T1 = immediately after intervention

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

1. května 2026

Primární dokončení (Odhadovaný)

1. října 2026

Dokončení studie (Odhadovaný)

1. října 2026

Termíny zápisu do studia

První předloženo

23. dubna 2026

První předloženo, které splnilo kritéria kontroly kvality

1. května 2026

První zveřejněno (Aktuální)

7. května 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

7. května 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

1. května 2026

Naposledy ověřeno

1. května 2026

Více informací

Termíny související s touto studií

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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