- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07698418
Effect of Inspiratory Muscle Training on Knee Osteoarthritis Pain
Effect of Inspiratory Muscle Training on Pain in Patients With Knee Osteoarthritis: A Randomized Controlled Trial
Knee osteoarthritis (KOA) is a common joint disease that causes chronic pain and limits daily activities. Current treatments, such as painkillers or surgery, have limitations like side effects or high costs. This study will test whether a safe, non-drug intervention-inspiratory muscle training (breathing exercises against resistance)-can reduce knee pain in people with KOA. The training may work by lowering inflammation and improving the body's nervous system control of pain.
We plan to enroll 80 patients aged ≥55 years with confirmed KOA and frequent knee pain. Participants will be randomly assigned to either an 8-week inspiratory muscle training program (5 sessions per week, with gradually increasing resistance) or a sham (very low resistance) training program. Neither the patients nor the researchers assessing the outcomes will know who is in which group.
The main outcome is change in knee pain measured by a visual analog scale (VAS). Secondary outcomes include blood markers of inflammation (TNF-α, IL-6, IL1β), physical function, WOMAC score (a KOA-specific questionnaire), activity level, sleep quality, and quality of life. To explore underlying mechanisms, we will also measure heart rate variability (HRV) as an indicator of autonomic nervous system function, and brain functional connectivity in the prefrontal cortex using functional near-infrared spectroscopy (fNIRS). These mechanistic assessments will be performed at baseline and at the end of 8-week intervention. Additional follow-up assessments for clinical outcomes will be done at 3 and 6 months after the training ends. We will also record any side effects or adverse events.
This study will provide high-quality evidence on whether inspiratory muscle training is an effective and safe complementary treatment for knee pain in people with knee OA, and will offer new insights into the mechanisms underlying its analgesic effects.
Přehled studie
Postavení
Intervence / Léčba
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Aged 55 years or older.
- Knee osteoarthritis (Kellgren-Lawrence grade ≥ 2).
- Knee pain (Visual Analogue Scale, VAS ≥ 3) on the most days in the past month.
- Able to walk independently without assitive devices.
Exclusion Criteria:
- History of knee replacement surgery, meniscus surgery, or ligament surgery.
- Received corticosteroid injection within the previous three weeks.
- Diagnosed with rheumatoid arthritis.
- Unstable angina, recent myocardial infarction, uncontrolled cardiac arrhythmia, or severe heart failure.
- History of stroke.
- Currently receiving steroid therapy, hormonal therapy, or cancer chemotherapy.
- Pneumothorax, pulmonary bullae, lung surgery within the past 12 months, unstable asthma, or severe dyspnea at rest.
- Unable to understand the study procedures and potential risks.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Trojnásobný
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Experimentální: Inspiratory Muscle Training
5 sessions/week for 8 weeks.
Load starts at 50% MIP for 40 reps, increases to 80% MIP for 60 reps from week 5, then adjusted weekly to 80% of updated MIP.
Device: threshold inspiratory muscle trainer.
|
Participants will perform home-based inspiratory muscle training using a threshold-loading device (POWERbreathe Medic Plus).
Training is conducted 5 times per week for 8 weeks.
The initial inspiratory load is set at 50% of the individual's maximum inspiratory pressure (MIP), measured weekly at the study site.
The load is progressively increased to 80% MIP over the first 4 weeks and maintained at 80% MIP for the remaining 4 weeks.
Each session consists of 40-60 breaths.
Adherence is monitored via an electronic training log and weekly on-site visits.
This protocol is individualized, progressive, and home-based, distinguishing it from fixed-load or supervised-only breathing interventions.
Ostatní jména:
|
|
Falešný srovnávač: Sham Inspiratory Muscle Training
Participants perform sham inspiratory muscle training with the same frequency and duration as the experimental group, but the inspiratory load is fixed at 10% of maximal inspiratory pressure (MIP) and does not progress.
All other procedures (weekly MIP measurement for sham load adjustment) are identical to maintain blinding.
|
Participants will perform home-based inspiratory muscle training using a threshold-loading device (POWERbreathe Medic Plus).
Training is conducted 5 times per week for 8 weeks.
The initial inspiratory load is set at 50% of the individual's maximum inspiratory pressure (MIP), measured weekly at the study site.
The load is progressively increased to 80% MIP over the first 4 weeks and maintained at 80% MIP for the remaining 4 weeks.
Each session consists of 40-60 breaths.
Adherence is monitored via an electronic training log and weekly on-site visits.
This protocol is individualized, progressive, and home-based, distinguishing it from fixed-load or supervised-only breathing interventions.
Ostatní jména:
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Visual analogue scale
Časové okno: Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Self-rated pain intensity of knee (0-10), "0" indicate no pain, "10" indicate worst pain.
|
Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Western Ontario and McMaster Universities Osteoarthritis Index
Časové okno: Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Patient-reported outcomes in symptoms and function, total scores range from 0-96, the higher scores indicating the worse symptom and function.
|
Baseline, week 8, 3-month after intervention, 6-month after intervention
|
|
Serum levels of inflammatory markers
Časové okno: Baseline, up to week 8
|
Systemic inflammation
|
Baseline, up to week 8
|
|
Heart rate variability
Časové okno: Baseline, up to week 8
|
Vagus nerve activity
|
Baseline, up to week 8
|
|
Prefrontal cortex activity
Časové okno: Baseline, up to week 8
|
Functional near-infrared spectroscopy was used to assess prefrontal cortex activity
|
Baseline, up to week 8
|
|
40-meter walk test
Časové okno: Baseline, up to week 8
|
Physical function
|
Baseline, up to week 8
|
|
30-sec chair stand test
Časové okno: Baseline, up to week 8
|
Physical function
|
Baseline, up to week 8
|
|
Physical Activity Scales for the Elderly
Časové okno: Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Total scores range from 0-793, the higher scores indicating a higher level of physical activity.
|
Baseline, week 8, 3-month after intervention, 6-month after intervention
|
|
Pittsburgh Sleep Quality Index
Časové okno: Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Total scores range from 0-21, '0' indicating no difficulty and '21' indicating severe difficulties in all areas.
|
Baseline, week 8, 3-month after intervention, 6-month after intervention
|
|
12-Item Short Form Health Survey
Časové okno: Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Total scores range from 0-100, the higher scores indicating better physical and mental health functioning.
|
Baseline, week 8, 3-month after intervention, 6-month after intervention
|
|
Maximal inspiratory pressure
Časové okno: Baseline, up to week 8
|
Inspiratory muscle strength
|
Baseline, up to week 8
|
Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Adherence
Časové okno: Up to week 8
|
Adherence was calculated from logbooks as completed versus prescribed sessions
|
Up to week 8
|
|
Adverse events
Časové okno: Up to week 8
|
Adverse events were defined as any symptom or abnormal sign during training and graded by the Common Terminology Criteria for Adverse Events (CTCAE v6.0, 2025): Mild: resolved with rest, no medical intervention; Moderate: require minimal medical intervention (e.g., analgesics); Severe: requires medical attention or hospitalization (e.g., clinic visit)
|
Up to week 8
|
Spolupracovníci a vyšetřovatelé
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Bolest
- Neurologické projevy
- Nemoci pohybového aparátu
- Artritida
- Onemocnění kloubů
- Revmatická onemocnění
- Osteoartróza
- Patologické stavy, příznaky a symptomy
- Příznaky a symptomy
- Osteoartróza, koleno
- Chronická bolest
- Terapeutika
- Terapie mysli a těla
- Doplňkové terapie
- Techniky pohybu cvičení
- Modality fyzikální terapie
- Dýchací cvičení
Další identifikační čísla studie
- ZHSC-1-(2026)014
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .
Klinické studie na Inspiratory muscle training
-
Trinitas Comprehensive Cancer CenterAptium Oncology Research NetworkNeznámýRakovina prsuSpojené státy
-
Florida State UniversityNational Institute of Mental Health (NIMH); National Institutes of Health (NIH)Dokončeno
-
University of CincinnatiEunice Kennedy Shriver National Institute of Child Health and Human Development...DokončenoCévní mozková příhoda, ischemická | Dysfagie, orální fázeSpojené státy
-
University Hospital, Basel, SwitzerlandDokončenoVývoj dítěte | Studie proveditelnosti | Primární zdravotní péče | Svalová síla | Odporový trénink | Školy | Preventivní zdravotní služby | Školy / organizace a správaŠvýcarsko
-
Bayburt UniversityZatím nenabírámeStrach z porodu | Všímavost | Self-Efficacy | Příloha | Haptonomie
-
Selcan SuicmezDokončeno
-
Northwestern UniversityNáborObstrukční spánková apnoe (OSA)Spojené státy
-
Inés Llamas-RamosNáborRoztroušená skleróza | Svalová slabost | Tréninková skupina, CitlivostŠpanělsko