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Treatment Response to Different Lymphoedema Compression Programs Using a Pneumatic Compression Device

29. juni 2021 opdateret af: Tactile Medical

Physiologic Response to Varying Lymphoedema Compression Programs With the Flexitouch System

Proof of principle study in order to determine if there is a difference in treatment effect across the 3 study groups when treating lower extremity lymphoedema using a pneumatic compression device.

Studieoversigt

Detaljeret beskrivelse

This is a single center, 3 arm, prospective, randomized, clinical trial to assess the difference between 3 treatment options for achieving a measurable physiologic effect on lower extremity lymphedema with pneumatic compression device. Each intervention arm will include 10 completed subjects for a total of 30 completed subjects.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

21

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiesteder

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

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Subjects must be ≥ 18 years old
  • Subjects must have a diagnosis of primary or secondary Stage 2 unilateral or bilateral lower extremity lymphoedema
  • Must currently be using adequate compression garment(s) as determined by the clinician: (Garments must be at least 20mmHg and no more than 3 months old and must be worn upon rising and removed at bedtime)
  • Subjects must have clinically relevant excess limb swelling as determined by clinician "pitting test"
  • Must be able to attend all required in-clinic treatment visits

Exclusion Criteria:

  • Diagnosis of active or recurrent cancer, or less than 3 months at the time of initial evaluation from the completion of chemotherapy, radiation therapy, or primary surgery for the treatment of cancer
  • Active infection or inflammation
  • Active thrombophlebitis (within the last 2 months)
  • History of pulmonary embolism (within the last 2 months)
  • Documented history of deep chronic venous insufficiency or deep venous obstruction with a reflux duration of > 2 second in the deep system or any history of deep vein thrombosis (DVT)
  • History of pulmonary edema
  • History of congestive heart failure
  • History of chronic kidney disease with a glomerular filtration rate (GFR) of less than 30 mls per minute
  • Poorly controlled asthma
  • Symptomatic or severe peripheral artery disease (defined by current lifestyle-limiting claudication or critical limb ischemia)
  • Presence of an open wound or ulcer of any etiology
  • Diagnosis of lipoedema and lipolymphoedema
  • Currently using an in-home pneumatic compression device
  • Metal implant(s) that would interfere with bioimpedance equipment
  • Pacemaker or other implanted electronic device(s)
  • Unable or unwilling to remove bandaging from treatment regimen while participating in the study
  • Pregnant
  • Any condition where increased venous and lymphatic return is undesirable
  • Unable or unwilling to participate in all aspects of the study protocol and/or unable to provide informed consent
  • Currently participating in another clinical trial
  • Currently using diuretics
  • BMI > 40

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: pneumatic compression - 1 hour per day
Pneumatic compression device - 12 consecutive days undergoing a 1 hour treatment regimen.
Pneumatic compression treatment once per day (1 hour)
Andre navne:
  • Flexitouch pump
  • Flexitouch device
Eksperimentel: pneumatic compression - 2 hours per day
Pneumatic compression device - 5 consecutive days undergoing 1 hour treatment in the am and 1 hour of treatment in the pm.
pneumatic compression treatment twice per day in the AM & PM (2 hours)
Andre navne:
  • Flexitouch pump
  • Flexitouch device
Eksperimentel: pneumatic compression - 4 hours per day
Pneumatic compression device - 5 consecutive days undergoing treatment twice per day consisting of 2 consecutive 1 hour treatments in the am and the pm (4 hours total)
pneumatic compression treatment twice per day consisting of 2 consecutive 1 hour treatments in the AM & PM (4 hours)
Andre navne:
  • Flexitouch pump
  • Flexitouch device

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Limb Volume (ml)
Tidsramme: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Limb volume changes measured via perometry reported in change of ml of fluid. A negative value is associated with the clinically-desirable decrease in fluid.
Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Limb Volume (% Change)
Tidsramme: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Limb volume changes measured via perometry reported in percent reduction. A negative value is associated with the clinically-desirable decrease in fluid.
Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Change in Skin Tone
Tidsramme: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Change in skin tone (fibrosis) measured via tonometry. The tonometer is a mechanical device that gives an indication of the resistance of tissue to compression. It is used in lymphedema to give an estimate of the extent of pitting and fibrotic induration. Tonometry measures were collected at 5 anatomical locations. A negative value is associated with a clinically desirable decrease in tone.
Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Patient Reported Outcomes - MYMOP
Tidsramme: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

Changes in patient-determined symptoms* and change in affect the symptoms had on the subject. Measured via MYMOP (Measure Yourself Medical Outcome Profile) questionnaire. A low score indicates a good outcome. Scores range from 0 (as good as can be) to 6 (as bad as can be).

*Recorded symptoms were: Gr A, 1st symptom: none, abdominal pain and discomfort, swelling, physical, and worrying about granddaughters Gr B, 1st symptom: arthritis, hayfever, look of fat foot, right hand area of neck and shoulder, stairs, and swelling Gr C, 1st symptom: none, energy during dancing and gardening, frustration of not going out on own, swelling, mild longstanding depression, and MPT joint at base of small toe Gr A, 2nd symptom: fatigue, heaviness of leg, mental, and pain under knee Gr B, 2nd symptom: narrowed choice of footwear, shower in bath, and swollen left foot Gr C, 2nd symptom: being tired and aching all over, and shoes and clothing

Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Cellular Fluid Changes (Ohms)
Tidsramme: Change after initial treatment on day 1 and change baseline to end of day 5 for all groups
Changes in extra cellular fluid (ECF) on treated leg measured by bioimpedance. A negative number is indicative of a clinically desirable reduction in ECF.
Change after initial treatment on day 1 and change baseline to end of day 5 for all groups
Cellular Fluid Changes (% Change)
Tidsramme: Change after initial treatment on day 1 and change baseline to end of day 5 for all groups
Changes in extra cellular fluid (ECF) on treated leg measured by bioimpedance. A negative number is indicative of a clinically desirable reduction in ECF.
Change after initial treatment on day 1 and change baseline to end of day 5 for all groups
Incidence of Complications
Tidsramme: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Number of complications experienced. Incidence based on clinician assessment.
Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Activity Level
Tidsramme: Day 1 compared to final treatment day (day 12 for Group A and day 5 for Groups B and C)
Change in number of steps as accumulated each day monitored through use of a pedometer. A positive number indicates an increase in step count (activity) while a negative number indicates a decrease in step count.
Day 1 compared to final treatment day (day 12 for Group A and day 5 for Groups B and C)

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Skin Thickness
Tidsramme: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Change in skin thickness measured by ultrasound. Ultrasound measures were collected at 5 anatomical locations. A negative value is associated with a clinically desirable reduction in skin thickness (a surrogate measure of oedema).
Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Change in Local Tissue Water (LTW)
Tidsramme: Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)
Change in local tissue water (LTW) within the skin measured by MoistureMeterD (MMD). MMD measures were collected at 5 anatomical locations using 2 probes: medium (M25) and large (L50). A negative value is associated with a clinically desirable decrease in LTW (a surrogate measure of oedema).
Change baseline to final day (day 12 for Group A and day 5 for Groups B and C)

Samarbejdspartnere og efterforskere

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

Sponsor

Efterforskere

  • Ledende efterforsker: Vaughan Keeley, PhD, FRCP, Royal Derby Hospital

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)

11. november 2013

Primær færdiggørelse (Faktiske)

31. marts 2019

Studieafslutning (Faktiske)

30. juni 2019

Datoer for studieregistrering

Først indsendt

7. januar 2014

Først indsendt, der opfyldte QC-kriterier

7. januar 2014

Først opslået (Skøn)

9. januar 2014

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

20. juli 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. juni 2021

Sidst verificeret

1. juni 2021

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 4010 FlexDose

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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