Den akutte kardiorespiratoriske reaktion på blodgennemstrømningsbegrænset versus traditionelle træningsregimer (CaRe BFR) (CaRe-BFR)
Den akutte kardiorespiratoriske reaktion på blodgennemstrømningsbegrænset versus traditionelle træningsregimer (CaRe BFR): 4 randomiserede crossover-undersøgelser
Efterforskerne antager, at BFR træningsregimer resulterer i et andet akut kardiorespiratorisk responsmønster sammenlignet med traditionelle træningsregimer. Endvidere antager efterforskerne, at disse mønstre adskiller sig mellem raske deltagere og deltagere med KOL.
Med hensyn til sekundært mål antager efterforskerne, at BFR resulterer i lavere blodtryksreaktioner sammenlignet med traditionel træningstræning hos både raske og KOL-deltagere.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Efterforskerne udfører et monocentrisk projekt med 4 randomiserede krydsningsstudier.
CaRe-BFR Sund og KOL:
Styrketræning udføres bilateralt på en Leg Press-maskine (Leg Press VR2, Cybex International Inc. Medway, MA, USA) ved hjælp af de tre sæt-metoder, som har vist sig at være mest effektiv til at øge muskelstyrken.16 Hvert sæt udføres til muskelsvigt, som bør nås inden for 8-12 gentagelser. Træningsrytmen er indstillet til 1-0-1-0 (dvs. et sekund for den koncentriske fase, ingen pause, et sekund for den excentriske fase, ingen pause) og eksternt paceret af en metronom. Træningsbelastningen er 80% af 1RM. Hvile mellem sæt er 1 minut og deltagere forbliver
Styrketræning BFR udføres bilateralt på en Leg Press maskine (Leg Press VR2, Cybex International Inc. Medway, MA, USA) i overensstemmelse med evidensbaserede retningslinjer for anvendelse for at anvende den mest effektive metode til at øge muskelstyrken.17 Øvelsen består af i alt 75 gentagelser fordelt på 4 sæt. Træningsrytmen er indstillet til 1-0-1-0 (dvs. et sekund for den koncentriske fase, ingen pause, et sekund for den excentriske fase, ingen pause) og eksternt paceret af en metronom. Sæt 1 dækker 30 gentagelser, og de efterfølgende sæt 15 gentagelser hver. Træningsbelastningen er 30% af 1RM. Manchetter monteres bilateralt i den mest proksimale del af låret og pustes op til 70 % af den individuelle AOP. Hvile mellem sæt er 1 minut, og deltagerne bliver siddende med manchetterne oppustede.
-Udholdenhed udføres bilateralt på et stationært cykelergometer (kardiomed 521, proxomed Medizintechnik GmbH, Alzenau, Tyskland) i en intervalindstilling med belastningsfaser på 1 sæt med 3 intervaller af hver 2 minutter; træningsbelastning er 65 % af peak work rate (PWR). I mellem intervallerne er pauserne standardiseret til 1 minut. Før træningskampen udføres opvarmningscykling ved 30 % PWR i 5 minutter for at nå en stabil tilstand i HR og RER.
Endurance BFR udføres bilateralt på et stationært cykelergometer (kardiomed 521, proxomed Medizintechnik GmbH, Alzenau, Tyskland) i en intervalindstilling med belastningsfaser på 1 sæt med 3 intervaller af 2 minutter og 18 sekunder hver (svarende til det samlede arbejde udført i DA); træningsbelastningen er 50 % af PWR, mens lemmerblodstrømmen er begrænset til 50 % af AOP. I mellem intervallerne er pauserne standardiseret til 1 minut (manchetten oppustet). Før træningskampen udføres opvarmningscykling (uden BFR) ved 30 % PWR i 5 minutter for at nå en stabil tilstand i HR og RER.
Mål:
Under træning indsamler efterforskerne vejrtrækningsdata (Ergostik, Geratherm Respiratory GmbH, Bad Kissingen, Tyskland). Derudover indsamles kontinuerlige SpO2- og HR-data via en øreflip-sonde og BP-respons umiddelbart efter træningssæt
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Christan Clarenbach, Dr. med
- Telefonnummer: 044 255 22 21
- E-mail: Christian.clarenbach@usz.ch
Undersøgelse Kontakt Backup
- Navn: Manuel Kuhn, PhD Student
- Telefonnummer: 0798526722
- E-mail: manuel.kuhn@usz.ch
Studiesteder
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Canton of Zurich
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Zurich, Canton of Zurich, Schweiz, 8091
- Rekruttering
- University Hospital Zurich
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Kontakt:
- Manuel Kuhn, MSc
- Telefonnummer: 0432532681
- E-mail: manuel.kuhn@usz.ch
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Kontakt:
- Alexandra Arvaji
- Telefonnummer: 0432530131
- E-mail: alexandra.arvaji@usz.ch
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Beskrivelse
Inklusion og eksklusion for de raske deltagere er defineret af følgende kriterier.
Inklusionskriterier:
- Alder ≥ 18 år
- Klinisk sund
Ekskluderingskriterier:
- Fysisk eller intellektuel svækkelse, der udelukker informeret samtykke eller protokoloverholdelse
- Ikke-tysktalende (udelukker informeret samtykke)
- Smerter under træning af enhver oprindelse
- Graviditet
- Anamnese med tromboembolisk hændelse i underekstremiteten
- Hvilesystolisk blodtryk <100 mmHg
Inklusion og eksklusion for KOL-deltagere er defineret af følgende kriterier.
Inklusionskriterier:
- Alder ≥ 18 år
- Diagnosticeret KOL efter GULD-vejledning12
Ekskluderingskriterier:
- Fysisk eller intellektuel svækkelse, der udelukker informeret samtykke eller protokoloverholdelse
- Ikke-tysktalende (udelukker informeret samtykke)
- Akut eller nylig (inden for de sidste 6 uger) eksacerbation af KOL
- Smerter under træning af enhver oprindelse
- Graviditet
- Anamnese med tromboembolisk hændelse i underekstremiteten
- Hvilesystolisk blodtryk <100 mmHg
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Crossover opgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Endurance Exercise - COPD and Healthy Participants (Fixed-Duration Protocol)
Both COPD patients and healthy participants will complete two endurance exercise conditions in a randomized, crossover design:
BFR-CYC: Three intervals of 2 minutes at 50% PWR, separated by 1-minute recovery periods, with bilateral thigh cuffs inflated to 50% LOP during exercise intervals. Control: Time- and structure-matched protocol (3 × 2 minutes) without blood flow restriction at 65% PWR, with identical recovery periods. |
BFR-CYC: Three intervals of 2 minutes at 50% PWR, separated by 1-minute recovery periods, with bilateral thigh cuffs inflated to 50% LOP during exercise intervals.
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Eksperimentel: Resistance Exercise - COPD and Healthy Participants (BFR vs Control, Fixed Protocol)
Both COPD patients and healthy participants will complete two resistance exercise conditions in a randomized, crossover design:
Control: Bilateral leg press at 40% 1RM, 3 sets of 15 repetitions, without blood flow restriction. |
BFR-RE: Unilateral right-leg press at 40% of one-repetition maximum (1RM) with cuffs inflated to 80% LOP.
Protocol: 4 sets (30-15-15-15 repetitions).
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Eksperimentel: Endurance Exercise - COPD Participants (Exhaustive Protocol)
Patients with COPD will complete three cycling exercise conditions in a randomized, crossover design:
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BFR-CYC: Continuous cycling at 50% peak work rate (PWR) with bilateral thigh cuffs inflated to 50% limb occlusion pressure (LOP).
A maximum duration of 30 minutes is applied as a safety limit.
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Eksperimentel: Resistance Exercise - Healthy Participants (LOP Comparison Arm)
Healthy participants will complete two BFR resistance exercise conditions in a randomized, crossover design:
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Participants will perform unilateral right-leg press exercise at 40% 1RM using a standardized protocol of 4 sets (30-15-15-15 repetitions) with fixed rest intervals. The protocol will be completed as prescribed (not to volitional exhaustion) unless predefined safety criteria require early termination. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Endurance Exercise:(Fixed-Duration Protocol):
Tidsramme: Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
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Minute ventilation (VE) will be continuously assessed during cycling exercise across all conditions to evaluate ventilatory demand.
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Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
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Resistance Exercise - Healthy Participants (LOP Comparison Arm): Within-subject difference change in Maximal Voluntary Contraction (MVC)
Tidsramme: Pre-exercise and immediately post-exercise (within minutes after completion of the exercise protocol)
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Maximal voluntary contraction (MVC) of the knee extensors will be assessed before and immediately after unilateral leg press exercise performed with blood flow restriction at 40% and 80% limb occlusion pressure (LOP).
MVC will be measured using an isometric setup, and voluntary activation will be evaluated using the twitch interpolation technique with supramaximal electrical stimulation.
The primary outcome is the change in MVC from pre- to post-exercise, reflecting exercise-induced neuromuscular fatigue.
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Pre-exercise and immediately post-exercise (within minutes after completion of the exercise protocol)
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Endurance Exercise - COPD Participants (Exhaustive Protocol): Within-subject difference in maximal minute ventilation (VE) between BFR and traditional exercise regimens
Tidsramme: Continuously during exercise, at end of exercise (peak value), and within 4 minutes post-exercise
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Minute ventilation (VE) will be continuously assessed during cycling exercise across all conditions to evaluate ventilatory demand and response.
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Continuously during exercise, at end of exercise (peak value), and within 4 minutes post-exercise
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Resistance Exercise:(Healthy and COPD): Ventilatory Response (Ventilation, VE)
Tidsramme: Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
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Minute ventilation (VE) will be continuously assessed during cycling exercise across all conditions to evaluate ventilatory demand.
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Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Resistance Exercise - Healthy Participants (LOP Comparison Arm): Muscle Oxygenation (NIRS)
Tidsramme: Continuously during exercise and immediately post-exercise
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Muscle oxygenation of the knee extensors will be continuously assessed using near-infrared spectroscopy (NIRS) during unilateral leg press exercise performed with blood flow restriction at 40% and 80% limb occlusion pressure (LOP).
Parameters such as tissue oxygen saturation will be analyzed to evaluate local muscular oxygenation responses.
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Continuously during exercise and immediately post-exercise
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Resistance Exercise - Healthy Participants (LOP Comparison Arm): Perceived Exertion / Dyspnea (Borg Scale)
Tidsramme: At baseline (pre-exercise), after each set, immediately post-exercise, and at 2 and 4 minutes post-exercise
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Perceived exertion will be assessed using the Borg rating of perceived exertion (RPE) scale during cycling exercise. Perceived breathlessness will be assessed using the Borg dyspnea scale during exercise. |
At baseline (pre-exercise), after each set, immediately post-exercise, and at 2 and 4 minutes post-exercise
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Endurance Exercise - COPD Participants (Exhaustive Protocol): Cardiorespiratory Response (Vo2 , VCO2)
Tidsramme: Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
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Oxygen uptake (VO₂) will be continuously measured during cycling exercise performed under three conditions (BFR-CYC, CONT-CYC, INT-CYC) to symptom limitation. The primary outcome will be the peak VO₂ achieved at end of exercise, reflecting maximal cardiorespiratory response. Carbon dioxide production (VCO₂) will be continuously measured during exercise to assess metabolic and ventilatory responses. |
Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
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Endurance Exercise - COPD Participants (Exhaustive Protocol):NIRS
Tidsramme: Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
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Muscle oxygenation will be assessed using near-infrared spectroscopy (NIRS) during cycling exercise to evaluate local muscular oxygenation under BFR and non-BFR conditions.
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Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
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Endurance Exercise - COPD Participants (Exhaustive Protocol): Blood Lactate Concentration
Tidsramme: At baseline (pre-exercise) at peak and 3 min wpost-exercise
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Capillary blood lactate concentration will be measured to assess metabolic stress induced by the different exercise conditions.
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At baseline (pre-exercise) at peak and 3 min wpost-exercise
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Endurance Exercise - COPD Participants (Exhaustive Protocol): Perceived Exertion and Dyspnea (Borg Scale)
Tidsramme: At baseline (pre-exercise), during exercise (at regular intervals), at end of exercise, and within 4 minutes post-exercise
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Perceived exertion will be assessed using the Borg rating of perceived exertion (RPE) scale during cycling exercise. Perceived breathlessness will be assessed using the Borg dyspnea scale during exercise. |
At baseline (pre-exercise), during exercise (at regular intervals), at end of exercise, and within 4 minutes post-exercise
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Endurance Exercise - COPD Participants (Exhaustive Protocol): Exercise Tolerance (Time to Exhaustion)
Tidsramme: During exercise (recorded at end of exercise)
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Exercise tolerance will be defined as the time from the start of exercise to symptom limitation (volitional exhaustion).
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During exercise (recorded at end of exercise)
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Endurance Exercise:(Fixed-Duration Protocol): Cardiorespiratory Response (Vo2 , VCO2)
Tidsramme: Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
|
Carbon dioxide production (VCO₂) will be continuously measured during exercise to assess metabolic and ventilatory responses Oxygen uptake (VO₂) will be continuously measured during cycling exercise performed under two conditions.
The primary outcome will be the peak VO₂ achieved at end of exercise, reflecting maximal cardiorespiratory response.
|
Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
|
|
Endurance Exercise:(Fixed-Duration Protocol): Borg Scale (Dyspnea/Perceived Exertion)
Tidsramme: At baseline (pre-exercise), during exercise (at regular intervals), at end of exercise, and within 4 minutes post-exercise
|
Perceived exertion will be assessed using the Borg rating of perceived exertion (RPE) scale during cycling exercise. Perceived breathlessness will be assessed using the Borg dyspnea scale during exercise. |
At baseline (pre-exercise), during exercise (at regular intervals), at end of exercise, and within 4 minutes post-exercise
|
|
Resistance Exercise:(Healthy and COPD): Cardiorespiratory Response
Tidsramme: Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
|
Oxygen uptake (VO₂) will be continuously measured during cycling exercise performed under two conditions. Carbon dioxide production (VCO₂) will be continuously measured during exercise to assess metabolic and ventilatory responses. |
Continuously during exercise and at end of exercise, with recovery measurements obtained within 4 minutes post-exercise
|
|
Resistance Exercise:(Healthy and COPD): Dyspnea (Borg Scale/ Perceived Exertion )
Tidsramme: At baseline (pre-exercise), during exercise (at regular intervals), at end of exercise, and within 4 minutes post-exercise
|
Perceived exertion will be assessed using the Borg rating of perceived exertion (RPE) scale during cycling exercise. Perceived breathlessness will be assessed using the Borg dyspnea scale during exercise. |
At baseline (pre-exercise), during exercise (at regular intervals), at end of exercise, and within 4 minutes post-exercise
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Christian Clarenbach, Dr. med, University of Zurich
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 2021-02038
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
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