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Feasibility and Effects of Inspiratory Muscle Training Combined With Blood Flow Restriction for Frail Older Adults

1. maj 2026 opdateret af: Pei-Shan, Tsai, Taipei Medical University

Feasibility and Effects of Inspiratory Muscle Training Combined With Blood Flow Restriction for Frail Older Adults: A Pilot Randomized Controlled Trial

This randomized controlled trial study aims to evaluate the feasibility and preliminary efficacy of a combined inspiratory muscle training (IMT) and blood flow restriction (BFR) intervention in frail older adults. Outcomes of interest include feasibility, physical function, respiratory muscle strength, handgrip strength, five-times sit-to-stand performance, body composition, frailty level, fall efficacy, blood pressure, and adverse events.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a parallel randomized controlled trial. 30 participants who are older adults with frailty will be enrolled.

Eligible participants who complete the baseline measurements will be randomly allocated to a combined BFR and IMT intervention group (N=15) or in the control group with BFR and sham IMT (N=15).

Primary outcomes include feasibility and physical function (i.e., the Short Physical Performance Battery (SPPB), 6-minute walk test (6MWT), and Time Up and Go (TUG) test). Secondary outcomes include respiratory muscle strength, handgrip strength, five-times sit-to-stand performance, body composition, frailty level, fall efficacy, blood pressure, and adverse events. All outcomes will be assessed at baseline (T0) and immediately after the 6-week intervention period (T1) in both groups.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

30

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiekontakt

  • Navn: Pei-Shan Tsai Professor, PhD
  • Telefonnummer: 6321 +886227361661
  • E-mail: ptsai@tmu.edu.tw

Studiesteder

  • Taiwan
      • Taipei, Taiwan, 11031
        • Taipei Medical University
        • Kontakt:
          • Pei-Shan Tsai Professor, PhD
          • Telefonnummer: 6321 +886227361661
          • E-mail: ptsai@tmu.edu.tw

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

  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Community-dwelling adults aged 65 years and older who are classified as at least "vulnerable" using the Clinical Frailty Scale (score ≥4).
  • Participants must have no cognitive impairment and be able to follow commands, as assessed by the Mini-Mental State Examination (MMSE).

Exclusion Criteria:

  • (1) are unable to participate in exercise (e.g., due to severe musculoskeletal disorders)
  • (2) have high-risk factors for exercise, such as uncontrolled hypertension (>150 mmHg systolic blood pressure (SBP) / >90 mmHg diastolic blood pressure (DBP), coagulation disorders, and deep venous thrombosis
  • (3) have hematological disorders or are using hematology related-medications
  • (4) have significant comorbidities, including a history of stroke, diabetes with severe complications, or cardiovascular diseases
  • (5) chronic lung conditions (e.g., obstructive pulmonary disease, asthma), and
  • (6) have participated in a structured exercise training program within the past 3 months at a frequency exceeding three sessions per week.

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: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Intervention group
Participants in the experimental group will receive a 6 week combined BFR and IMT intervention
Adfærdsmæssigt: Exercise

Each session will last approximately 60 minutes and will include three components: (1) an initial 3-minute IMT exercise performed at an intensity corresponding to rating of perceived exertion (RPE) 11-13 on the Borg 6-20 scale, (2) a 50-minute low-intensity exercise program combined with BFR, and (3) a second 3-minute IMT session at the same target intensity.

For the IMT, the protocol follows a progressive intensity model, starting with 30% of the maximum inspiratory pressure (MIP) in Week 1 to allow participants to become familiar with the technique. The intensity will gradually increase to a target of 60% MIP by Week 6, based on the participants' tolerance.

For the BFR, during weeks 1-2, participants will train at constant loads. From weeks 2-6, training loads will be increased. Cuff pressure will be prescribed relative to the calculated arterial occlusion pressure (AOP): 50% in weeks 1-2, 60% in weeks 3-4, and 70% in weeks 5-6 for both lower- and upper-body exercises.
Sham-komparator: Control group
Participants in the control group will receive a 6-week combined combined BFR and sham IMT intervention.
Adfærdsmæssigt: Sham Control
Participants in the control group will perform the identical BFR exercise protocol as the intervention group. However, IMT will be delivered at 2% of MIP, which is considered a sham condition and has not been shown to improve respiratory muscle function

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Recruitment rate
Tidsramme: T0 = baseline; T1 = immediately after intervention
The recruitment rate will be calculated by dividing the number of recruited participants by the number of eligible participants
T0 = baseline; T1 = immediately after intervention
Attrition rate
Tidsramme: T0 = baseline; T1 = immediately after intervention
Attrition rate is the proportion of randomized participants who withdraw from the study or are lost to follow-up before completing the final assessment.
T0 = baseline; T1 = immediately after intervention
Exercise Enjoyment
Tidsramme: T0 = baseline; T1 = immediately after intervention
Enjoyment will be assessed using a single-item Exercise Enjoyment Scale, which asks participants, "How much did you enjoy the exercise session?). Responses are rated on a 7 Likert scale ranging from 1 (not at all) to 7 (extremely)
T0 = baseline; T1 = immediately after intervention
Short Physical Performance Battery (SPPB)
Tidsramme: T0 = baseline; T1 = immediately after intervention
The SPPB consists of three components-standing balance, gait speed, and repeated chair stands-each scored from 0 to 4 and summed to a total score ranging from 0 (worst performance) to 12 (best performance). Lower SPPB scores indicate poorer physical function and a higher risk of adverse outcomes, with scores below 10 predictive of all-cause mortality in older adults.
T0 = baseline; T1 = immediately after intervention
6-Minute Walk Test (6MWT)
Tidsramme: T0 = baseline; T1 = immediately after intervention
The 6MWT will be used to assess functional exercise capacity. Participants will be instructed to walk as far as possible along a flat, straight course for 6 minutes, and the total distance is recorded.
T0 = baseline; T1 = immediately after intervention
Time Up to Go (TUG)
Tidsramme: T0 = baseline; T1 = immediately after intervention
The TUG test is used to assess functional mobility, balance, and fall risk in older adults, incorporating a series of dynamic activities. Participants will be instructed to rise from a chair, walk three meters at a comfortable pace, turn around, walk back to the chair, and sit down. The total time taken to complete the task is recorded, with longer times indicating poorer functional mobility and higher fall risk
T0 = baseline; T1 = immediately after intervention

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Respiratory Muscle Strength
Tidsramme: T0 = baseline; T1 = immediately after intervention
We will use the S-Index Test to evaluate the respiratory muscle function based on maximum dynamic inspiratory pressure, which is a recommended tool developed by POWERbreathe. Participants will be advised to avoid strenuous exercise for 24h and to rest in a sitting position for 15 minutes before the assessment. Then, they performed eight inspiratory maneuvers in a standing position, divided into three to four series of two to three repetitions.
T0 = baseline; T1 = immediately after intervention
Handgrip Strength
Tidsramme: T0 = baseline; T1 = immediately after intervention
Handgrip strength will be evaluated to estimate the maximum upper-limb muscle function in older adults. Participants will be seated with the shoulder adducted, the elbow flexed to 90°, and the forearm and wrist in a neutral position. They will then be instructed to squeeze the dynamometer as forcefully as possible.
T0 = baseline; T1 = immediately after intervention
Five-times sit-to-stand
Tidsramme: T0 = baseline; T1 = immediately after intervention
The five-times sit-to-stand test is simple to administer and has been widely applied in both clinical and research settings. Participants will sit with their backs against the chair and be instructed to stand and sit five times as quickly as possible.
T0 = baseline; T1 = immediately after intervention
Frailty level
Tidsramme: T0 = baseline; T1 = immediately after intervention
The Clinical Frailty Scale (CFS) is a 9-point global clinical measure ranging from 1 (very fit) to 9 (terminally ill), used to classify frailty severity in older adults. A traditional Chinese version of the CFS has been validated in Taiwanese older adults, demonstrating acceptable inter-rater reliability and good criterion validity against established frailty measures
T0 = baseline; T1 = immediately after intervention
Fall Efficacy
Tidsramme: T0 = baseline; T1 = immediately after intervention
The short form of the Falls Efficacy Scale-International (FES-I) includes 7 items rated on a 4-point Likert scale from 1 (not at all concerned) to 4 (very concerned). The total score ranges from 7 to 28, with higher values indicating greater concern about falling
T0 = baseline; T1 = immediately after intervention
Adverse events
Tidsramme: T0 = baseline; T1 = immediately after intervention
The study team will record adverse events during the intervention caused by the exercise, including falls, fractures, exercise-related pain, dizziness, muscle strain, sprains, respiratory and cardiac adverse events, and hospitalization.
T0 = baseline; T1 = immediately after intervention
Fat mass
Tidsramme: T0 = baseline; T1 = immediately after intervention
Fat mass will be assessed using a body composition analyzer and recorded in kilograms
T0 = baseline; T1 = immediately after intervention
Fat-free mass
Tidsramme: T0 = baseline; T1 = immediately after intervention
Fat-free mass will be assessed using a body composition analyzer and recorded in kilograms.
T0 = baseline; T1 = immediately after intervention

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
The Borg Rating of Perceived Exertion (RPE) Scale
Tidsramme: T0 = baseline; T1 = immediately after intervention
The Borg RPE scale reflects an individual's subjective perception of exercise intensity, integrating sensations of physical effort, breathlessness, and fatigue. The scale ranges from 6 to 20, where 6 indicates "no exertion at all" and 20 indicates "maximal exertion." This RPE score will be assessed every training session
T0 = baseline; T1 = immediately after intervention
Automated Office Blood Pressure
Tidsramme: T0 = baseline; T1 = immediately after intervention
Automated Office Blood Pressure will be monitored before and after intervention to minimize cardiovascular risks and ensure that timely medical assistance is available for participants who experience any discomfort. Upon arrival at the lab, participants will be asked to sit for at least 5 minutes before the first blood pressure reading; the average of two readings will be used for that visit
T0 = baseline; T1 = immediately after intervention

Samarbejdspartnere og efterforskere

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

Sponsor

Taipei Medical University

Samarbejdspartnere

National Taiwan University
The University of Texas at Austin

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 (Anslået)

1. maj 2026

Primær færdiggørelse (Anslået)

1. oktober 2026

Studieafslutning (Anslået)

1. oktober 2026

Datoer for studieregistrering

Først indsendt

23. april 2026

Først indsendt, der opfyldte QC-kriterier

1. maj 2026

Først opslået (Faktiske)

7. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

7. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2025-UAAT-UTS02

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