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Respiratory, Limb Muscle Properties, and Physical Performance in Adult Lung Transplant Recipients

30. juli 2026 opdateret af: University of Florida
The goal of this observational study is to evaluate respiratory and limb muscle properties in adults awaiting lung transplantation and determine how these measures relate to physical performance, symptoms, and recovery after transplantation. Respiratory and limb muscle weakness may contribute to impaired mobility, frailty, and delayed postoperative recovery, but their specific role in lung transplant candidates is not well understood. Participants will undergo muscle ultrasound imaging at weekly basis, respiratory and limb strength testing, physical performance assessments, and symptom questionnaires once before and after transplantation. Researchers will also collect information from medical records regarding intensive care unit stay, hospital length of stay, rehabilitation participation, and postoperative recovery outcomes.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Respiratory and peripheral muscle dysfunction are common in individuals with advanced lung disease awaiting lung transplantation. Muscle weakness, atrophy, and impaired contractile function may contribute to reduced physical performance, frailty, symptom burden, and delayed recovery after transplantation. Although physical function tests provide an overall assessment of performance, they provide limited information regarding specifics of respiratory and limb muscle impairments. Ultrasound imaging is a noninvasive and reliable method to evaluate muscle structure, quality, and contractile function and has been associated with clinical outcomes in several critically ill populations, including prolonged mechanical ventilation, longer intensive care unit (ICU) and hospital stays, and increased morbidity.

The purpose of this study is to characterize respiratory and limb muscle properties before and after lung transplantation and determine how these measures relate to physical performance, patient-reported outcomes, and postoperative recovery. Respiratory muscle function will be assessed using maximal respiratory pressure testing and ultrasound evaluation of the diaphragm and abdominal muscles. Limb muscle function will be assessed using ultrasound imaging and strength testing of the quadriceps muscles. Physical performance, frailty, dyspnea, pain, fatigue, anxiety, and ICU/hospital-related outcomes will also be evaluated.

The central hypothesis of this study is that respiratory and limb muscle weakness, atrophy, and impaired contractile function are associated with poorer physical performance, greater symptom burden, and delayed postoperative recovery after lung transplantation. To test this hypothesis, a prospective observational study of adult lung transplant candidates will be conducted from their hospital admission to their post-operative day 14. Participants will undergo serial ultrasound imaging assessments before transplantation and during the early postoperative period along with symptom questionnaires; while respiratory and limb strength testing, functional assessments, symptom questionnaires will be collected on the first and last day of research visit. Collection of ICU and hospital outcomes will occur from the electronic medical record. The central hypothesis will be evaluated through the following aims:

Aim 1: Evaluate relationships between respiratory strength and ultrasound measurements of contractile dysfunction in candidates awaiting lung transplant.

Aim 2: Characterize the associations between respiratory and limb muscle properties (atrophy, strength), physical performance, and patient-centered outcomes (dyspnea, frailty, pain, fatigue, and anxiety) in pre-lung transplant candidates.

Aim 3: Identify the influence of preoperative respiratory and quadriceps contractile function on the early postoperative mobility progression in lung transplant recipients Aim 4: Determine relationships between postoperative diaphragm dysfunction and functional status at hospital discharge

Undersøgelsestype

Observationel

Tilmelding (Anslået)

36

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Barbara K Smith, PhD, PT
  • Telefonnummer: 352-294-5315
  • E-mail: bksmith@ufl.edu

Undersøgelse Kontakt Backup

Studiesteder

    • Florida
      • Gainesville, Florida, Forenede Stater, 32608
        • Rekruttering
        • UF Health Shands Medical Center
        • Kontakt:
        • Kontakt:
          • Mohammad A. Aladaileh, MBBS, MRCSI, EBCTS, FRCSIC-Th
          • Telefonnummer: (352) 265-5470
          • E-mail: maladaileh@ufl.edu
        • Ledende efterforsker:
          • Barbara K Smith, PhD
        • Underforsker:
          • Wagner Souza Leite, PT
        • Underforsker:
          • Sandra Morgan, RN, PhD
        • Underforsker:
          • Jessica Cornman, PT
        • Underforsker:
          • May Smith-Hublou, PhD, CCC-SLP
        • Underforsker:
          • Ushna Khan, MD
        • Underforsker:
          • Amir M Emtiazjoo, MD, MSc
        • Underforsker:
          • Marc O Maybauer, MD, PhD, EDIC, FCCP, FACC, FAS

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult lung transplant candidates receiving care at UF Shands hospital. Participants are individuals with advanced lung disease undergoing evaluation and treatment while awaiting lung transplantation in the hospital. The study population includes adults who are able to complete study assessments of respiratory and limb muscle function before transplantation and during the early postoperative recovery period.

Beskrivelse

Inclusion Criteria:

  • 18 years or older.
  • Hospitalized as potential candidates for single- or bilateral-lung transplant surgery.
  • Hemodynamically stable for out-of-bed mobilization

Exclusion Criteria:

  • Baseline cognitive impairment
  • History of previous solid organ transplantation or thoracic surgery
  • Existing phrenic nerve lesion
  • Lower limb amputation or fracture
  • External fixators or open wounds of the lower extremities
  • Diagnosed neuromuscular disorder.
  • Morbid obesity (body mass index >45 kg/m²).
  • Any other medical condition that, in the opinion of the investigators, would make participation unsuitable.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Adult Lung Transplant Candidates
adults enrolled for in-hospital evaluation for lung transplant and listed for surgery who undergo serial assessments of respiratory and limb muscle properties before transplantation and during the early postoperative period. Assessments include ultrasound imaging, respiratory and limb strength testing, physical performance measures, patient-reported outcomes, and collection of clinical outcomes from the medical record.
Participants undergo serial assessments of respiratory and limb muscle structure and function before and after lung transplantation. Assessments include ultrasound imaging of the diaphragm, rectus abdominis, and quadriceps muscles; respiratory muscle strength testing; handgrip strength testing; knee extension strength testing; physical performance measures; and patient-reported outcome questionnaires.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Diaphragm structure
Tidsramme: Weekly from baseline through postoperative day 14 (±2 days)
Diaphragm thickness (unit of measure: mm) assessed by ultrasonography
Weekly from baseline through postoperative day 14 (±2 days)
Respiratory Muscle Strength
Tidsramme: Baseline and at postoperative day 14 (±2 days)
Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) obtained during maximal respiratory efforts against a one-way valve.
Baseline and at postoperative day 14 (±2 days)
Abdominal muscle structure
Tidsramme: Baseline through postoperative day 14 (±2 days)
Rectus abdominis muscle thickness (measurement unit: mm) assessed by ultrasonography.
Baseline through postoperative day 14 (±2 days)
Limb muscle strength
Tidsramme: At the first baseline visit and postoperative day 14 (±2 days)
Handgrip force and knee extension force measured using dynamometry.
At the first baseline visit and postoperative day 14 (±2 days)
Rectus femoris thickness
Tidsramme: Baseline through postoperative day 14 (±2 days)
Rectus femoris muscle thickness (unit of measurement: mm) assessed by ultrasonography.
Baseline through postoperative day 14 (±2 days)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Five-Repetition Sit-to-Stand Test
Tidsramme: Baseline and hospital discharge
Time required to complete five sit-to-stand repetitions as a measure of physical performance. Retrieved from the medical record.
Baseline and hospital discharge
Frailty Status
Tidsramme: Baseline and at postoperative day 14 (±2 days)
Frailty assessed using the Clinical Frailty Scale (CFS), a 9-point scale ranging from 1 to 9, where 1 = Very Fit and 9 = Terminally Ill. Higher scores indicate greater frailty and a worse clinical status.
Baseline and at postoperative day 14 (±2 days)
patient-reported symptoms
Tidsramme: Baseline and at postoperative day 14 (±2 days)
Dyspnea, physical fatigue, and pain assessed using an 11-point numeric rating scale ranging from 0 to 10, where 0 indicates no symptom and 10 indicates the worst symptom severity ever experienced. Higher scores indicate worse symptom burden.
Baseline and at postoperative day 14 (±2 days)
Six-Minute Walk Distance
Tidsramme: Baseline and at hospital discharge, an average of 3 weeks after surgery.
Distance walked during the Six-Minute Walk Test (6MWT), retrieved from the medical record.
Baseline and at hospital discharge, an average of 3 weeks after surgery.
Anxiety
Tidsramme: Baseline and at hospital discharge, up to an average of 3 weeks after surgery.
Anxiety assessed using the State-Trait Anxiety Inventory (STAI). The STAI score ranges from 20 to 80, with higher scores indicating greater anxiety and a worse outcome. Data will be retrieved from the medical record.
Baseline and at hospital discharge, up to an average of 3 weeks after surgery.

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Duration of Mechanical Ventilation
Tidsramme: From surgery through hospital discharge, up to an average of 3 weeks after surgery.
Total duration of postoperative invasive mechanical ventilation, measured in days.
From surgery through hospital discharge, up to an average of 3 weeks after surgery.
Intensive Care Unit Length of Stay
Tidsramme: From ICU admission through ICU discharge, up to an average of two weeks after surgery.
Number of days from intensive care unit (ICU) admission to ICU discharge.
From ICU admission through ICU discharge, up to an average of two weeks after surgery.
Hospital Length of Stay
Tidsramme: From ICU admission through hospital discharge, up to an average of 3 weeks after surgery.
Number of days from ICU admission to hospital discharge
From ICU admission through hospital discharge, up to an average of 3 weeks after surgery.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Publikationer og nyttige links

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Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

5. februar 2026

Primær færdiggørelse (Anslået)

1. december 2026

Studieafslutning (Anslået)

1. juli 2027

Datoer for studieregistrering

Først indsendt

27. juli 2026

Først indsendt, der opfyldte QC-kriterier

30. juli 2026

Først opslået (Faktiske)

5. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

30. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • IRB202501059

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

Participant data that underlie the results reported in this article after deidentification.

IPD-delingstidsramme

9 months and ending 36 months following article publication.

IPD-delingsadgangskriterier

Investigators whose proposed use of the data has been approved by an independent review committee.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL

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