Multicomponent Exercise to Prevent Hospitalization-Associated Disability (FIS_Prevention)
Prevention of Disability in Older Adults: From the Patient to the Molecule - A Randomized Controlled Trial (RCT)
The study is a randomized controlled trial conducted in the Geriatrics Department of a tertiary hospital in Spain (Hospital Universitario de Navarra). Participants aged 75 years or older will be recruited within the first 48 hours of admission to the acute care ward. Eligible hospitalized patients will be randomly assigned to either the intervention or control group using permuted block randomization (block sizes of 8 and 10), with consideration of gender balance.
Data will be collected at four time points: baseline assessment, hospital discharge, 1 month, and 3 months post-discharge.
Inclusion criteria include age ≥75 years and admission to the acute care unit. Exclusion criteria include refusal or inability to provide informed consent, life expectancy <3 months or terminal illness (oncological or non-oncological), inability to complete follow-up, medical contraindications to exercise, severe neurocognitive impairment (GDS-FAST stage 7), or severe disability (Barthel Index <35).
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
General Objective
To determine whether an intervention consisting of a multicomponent physical exercise program based on strength, balance, and aerobic training can prevent hospitalization-associated disability in adults aged 75 years and older admitted for acute medical conditions, while improving functional and cognitive capacity.
Specific Objectives
- To analyze and identify the patient subgroups that derive the greatest benefit from the intervention in order to optimize healthcare resource allocation (e.g., frail patients, patients with cognitive impairment, malnourished patients), and to characterize these subgroups.
- To identify the sociodemographic, clinical, functional, and cognitive characteristics associated with greater responsiveness to the intervention, as well as the type of intervention that provides the greatest benefit.
- To integrate clinical and molecular approaches through the assessment of epigenetic and inflammatory biomarkers, enabling the evaluation of parameters that have not previously been incorporated into studies of this kind.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Nicolas Martinez-Velilla
- Telefonnummer: +34 848422287
- E-mail: nicolas.martinez.velilla@navarra.es
Undersøgelse Kontakt Backup
- Navn: Fabricio Zambom-Ferraresi
- Telefonnummer: +34 848422287
- E-mail: fabricio.zambom.ferraresi@navarra.es
Studiesteder
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Pamplona, Spanien, 31008
- Rekruttering
- Hospital Universitario de Navarra
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Kontakt:
- Nicolas Martinez-Velilla
- Telefonnummer: +34 848422287
- E-mail: nicolas.martinez.velilla@navarra.es
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Age equal to or greater than 75 years, admitted to the acute care unit for medical conditions.
Exclusion Criteria:
- Explicit refusal expressed verbally or refusal to sign the informed consent by the patient/main caregiver/legal guardian or inability to obtain it.
- Life expectancy of less than 3 months or terminal oncological or non -oncological disease.
- Inability to follow up.
- Inability to participate in a multicomponent exercise program.
- Medical contraindication to exercise.
- Major neurocognitive disorder at moderate to severe stage (GDS - Fast Reisberg 5-7).
- Moderate to severe disability (measured by the Barthel Index (BI <60)). Expected hospital stay of less than 6 days.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: Randomiseret
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Ingen indgriben: No exercise during hospitalization
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Eksperimentel: Exercise during hospitalization
Multicomponent individualized exercise intervention As mentioned earlier, patients in the control group (G0) will receive the usual care currently provided to other patients, which includes a referral to physical therapy if needed.
The intervention for the multicomponent physical exercise intervention group (G1) will consist of a multicomponent physical training program that includes progressive and supervised aerobic endurance, strength, and balance training lasting 4-7 days during their hospitalization.
This will be supervised by the research team from the Geriatrics Unit.
Additionally, after hospital discharge, they will receive individualized guidelines to engage in multicomponent physical exercise for 3 months, along with individualized recommendations from the Nutrition and Dietetics Service of HUN.
The multicomponent physical training program will consist of chair squat exercises.
The main part of the training will utilize machines for strength training for the lower extremit
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Multicomponent individualized exercise intervention As mentioned earlier, patients in the control group (G0) will receive the usual care currently provided to other patients, which includes a referral to physical therapy if needed.
The intervention for the multicomponent physical exercise intervention group (G1) will consist of a multicomponent physical training program that includes progressive and supervised aerobic endurance, strength, and balance training lasting 4-7 days during their hospitalization.
This will be supervised by the research team from the Geriatrics Unit.
Additionally, after hospital discharge, they will receive individualized guidelines to engage in multicomponent physical exercise for 3 months, along with individualized recommendations from the Nutrition and Dietetics Service of HUN.
The multicomponent physical training program will consist of chair squat exercises.
The main part of the training will utilize machines for strength training for the lower extremit
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Funktionel status
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Kort ydeevne fysisk batteri (SPPB)
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Mini-Mental State Examination (MMSE)
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Kognition
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Trail Making Test A
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Kompleks opmærksomhed
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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GDS YESAVAGE
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Depression
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Euroqol-5D-3L
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Livskvalitet
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Antal medicin
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Antal medicin før og efter de intervention
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Falder
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Antal fald under undersøgelsen
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Dødelighed
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Dødelighed under undersøgelsen
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Håndgreb
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Maksimal isometrisk styrke
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Sæt skala
Tidsramme: Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Ændringer i søvnkvalitet
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Gennem undersøgelsesafslutning, i gennemsnit 3 måneder
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Barthel Index
Tidsramme: Through study completion, an average of 3 months]
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Basic activities of daily living
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Through study completion, an average of 3 months]
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Hospital Readmissions
Tidsramme: Through study completion, an average of 3 months
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Number of Hospital Readmissions
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Through study completion, an average of 3 months
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Length of stay
Tidsramme: Through study completion, an average of 3 months
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Average length of hospital stay
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Through study completion, an average of 3 months
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Changes in plasma/serum proteomic profiles.
Tidsramme: Through study completion, an average of 3 months
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Protein expression profiles will be assessed to identify changes in circulating proteins associated with the intervention and to explore potential biological pathways involved in the observed effects
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Through study completion, an average of 3 months
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Changes in DNA methylation profiles and epigenetic age
Tidsramme: Through study completion, an average of 3 months
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Buffy coat samples will be used for DNA extraction.
Extracted DNA will be hybridized on DNA methylation arrays to assess genome-wide methylation profiles and identify differentially methylated regions/sites associated with the intervention.
DNA methylation data will also be used to estimate biological age through established epigenetic clocks, allowing the evaluation of changes in epigenetic age and/or epigenetic age acceleration.
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Through study completion, an average of 3 months
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Nicolas Martinez-Velilla, Navarrabiomed-Fundación Miguel Servet-Hospital de Navarra
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
- FIS_PreventionDisability
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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