Physiotherapy in Hypoxic AECOPD Patients
2 mars 2020 mis à jour par: Marie Carmen Valenza, Universidad de Granada
Feasibility and Efficacy of Physiotherapy in Hypoxic AECOPD Patients
Hypoxia is considered a key player in many of the comorbidities that characterize COPD, such as pulmonary hypertension, skeletal muscle dysfunction, and systemic inflammation.
These comorbidities are worsened during an exacerbation due to prolonged bed rest and treatment with steroids, showing a reduction in the quality of life, exercise tolerance, and a greater risk of death in these patients.
Therefore, a better understanding of the safety and effectiveness of exercise training for AECOPD patients with resting hypoxemia is needed.
Aperçu de l'étude
Statut
Inconnue
Les conditions
Intervention / Traitement
Type d'étude
Interventionnel
Inscription (Anticipé)
36
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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Granada
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Granada., Granada, Espagne, 18071
- Recrutement
- Faculty of Health Sciences. University of Granada.
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Contact:
- Marie Carmen Valenza, PT
- Numéro de téléphone: 958 248035
- E-mail: cvalenza@ugr.es
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Chercheur principal:
- Marie Carmen Valenza, PT, PhD
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
40 ans et plus (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Patients of both sexes
- A diagnosis of COPD made according to the criteria of the American Thoracic Society (ATS)
- With hypoxemia at rest defined as mean arterial oxygen saturation below 90%
- Agreed to participate
Exclusion Criteria:
- Unstable cardiovascular disease
- Orthopedic diseases in the upper and lower limbs
- Being in ICU or use of mechanical ventilation
- Motor sequelae from a neurological or cognitive impairment that interfere with the evaluation and the treatment
- Contraindications of electrotherapy
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Global Exercise Group
all patients received the Control Group treatment added to global exercise treatment.
The program included 15 minutes of deep breathing exercises and 20-30 minutes of limb exercises.
The exercises included global active range of motion (ROM) exercises and muscle strengthening like upper and lower limbs flexion-extension do single-leg stance, and sit to stand exercises.
The number of repetitions was adapted to the subject's response taken into account the perceived dyspnea and fatigue during the exercise performance.
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The program included 15 minutes of deep breathing exercises and 20-30 minutes of limb exercises.
The exercises included global active range of motion (ROM) exercises and muscle strengthening like upper and lower limbs flexion-extension do single-leg stance, and sit to stand exercises
|
|
Expérimental: Functional Electrostimulation Group
all patients received the Control Group treatment plus neuromuscular stimulation therapy (SEFAR Rehab X2, DJO France S.A.S., France) on quadriceps accompanied by lower limb exercises. The intervention was performed following the protocol described by Valenza et al (2017). Valenza MC, Torres-Sánchez I, López-López L, Cabrera-Martos I, Ortiz-Rubio A, Valenza-Demet G. Effects of home-based neuromuscular electrical stimulation in severe chronic obstructive pulmonary disease patients: a randomized controlled clinical trial. Eur J Phys Rehabil Med. 2018 Jun;54(3):323-332. doi: 10.23736/S1973-9087.17.04745-1. Epub 2017 Nov 16. PubMed PMID: 29144103. |
The program included a neuromuscular stimulation therapy on quadriceps accompanied by lower limb exercises. The intervention was performed following the protocol described by Valenza et al (2017). Valenza MC, Torres-Sánchez I, López-López L, Cabrera-Martos I, Ortiz-Rubio A, Valenza-Demet G. Effects of home-based neuromuscular electrical stimulation in severe chronic obstructive pulmonary disease patients: a randomized controlled clinical trial. Eur J Phys Rehabil Med. 2018 Jun;54(3):323-332. doi: 10.23736/S1973-9087.17.04745-1. Epub 2017 Nov 16. PubMed PMID: 29144103. |
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Comparateur actif: Standard treatment
Patients received standard medical and pharmacological care that consisted in systemic steroids, inhaled bronchodilators, oxygen, and a regimen of oral prednisone or its equivalent in doses of 40 to 60 mg per day for the duration of therapy as well as anti-biotic therapy.
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Patients received standard medical and pharmacological care that consisted in systemic steroids, inhaled bronchodilators, oxygen, and a regimen of oral prednisone or its equivalent in doses of 40 to 60 mg per day for the duration of therapy as well as anti-biotic therapy
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Lower limb strength
Délai: Baseline
|
Quadriceps strength was assessed with a portable hand-held dynamometer (Lafayette Manual Muscle Testing System, model 01163, Lafayette, IN, USA).
The test was performed with the patient seated with his/her knees and hips flexed at 90°.
Resistance was applied to the anterior tibia during 5 seconds of maximal muscle contraction.
The test was repeated alternatively 3 times on the leg, allowing participants to rest between measurements.
The highest value in Newton was selected for the analysis.
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Baseline
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Lower limb strength
Délai: Up to 9 days
|
Quadriceps strength was assessed with a portable hand-held dynamometer (Lafayette Manual Muscle Testing System, model 01163, Lafayette, IN, USA).
The test was performed with the patient seated with his/her knees and hips flexed at 90°.
Resistance was applied to the anterior tibia during 5 seconds of maximal muscle contraction.
The test was repeated alternatively 3 times on the leg, allowing participants to rest between measurements.
The highest value in Newton was selected for the analysis.
|
Up to 9 days
|
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Balance
Délai: Baseline
|
Balance was evaluated by the one-leg standing balance test (OLS), that measured the time that the patient balances on one leg as long as possible.
The patient choose a leg to stand on (whichever he felt more comfortable with), flex the opposite knee allowing the foot to clear the floor, and balance on one leg.
Higher values mean better balance.
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Baseline
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Balance
Délai: Up to 9 days
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Balance was evaluated by the one-leg standing balance test (OLS), that measured the time that the patient balances on one leg as long as possible.
The patient choose a leg to stand on (whichever he felt more comfortable with), flex the opposite knee allowing the foot to clear the floor, and balance on one leg.
Higher values mean better balance.
|
Up to 9 days
|
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Dyspnea
Délai: Baseline
|
Dyspnea was assessed at rest using the modified Borg scale.
Patients classified their breathlessness from 0 (no dyspnea) to10 (maximal dyspnea)
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Baseline
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Dyspnea
Délai: Up to 9 days
|
Dyspnea was assessed at rest using the modified Borg scale.
Patients classified their breathlessness from 0 (no dyspnea) to10 (maximal dyspnea)
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Up to 9 days
|
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Fatigue
Délai: Baseline
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Fatigue was evaluated using the Piper Fatigue Scale (PFS) that consists of 22 numerical items which assess multidimensional aspects of fatigue.
The scale measures four dimensions of subjective fatigue: "behavioral/severity", relating to the severity, distress, and degree of disruption in activity of daily living; "affective meaning", relating to the emotional meaning attributed to fatigue; "sensory", relating to the physical symptoms of fatigue; and "cognitive/mood", relating to mental and mood states
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Baseline
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Fatigue
Délai: Up to 9 days
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Fatigue was evaluated using the Piper Fatigue Scale (PFS) that consists of 22 numerical items which assess multidimensional aspects of fatigue.
The scale measures four dimensions of subjective fatigue: "behavioral/severity", relating to the severity, distress, and degree of disruption in activity of daily living; "affective meaning", relating to the emotional meaning attributed to fatigue; "sensory", relating to the physical symptoms of fatigue; and "cognitive/mood", relating to mental and mood states
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Up to 9 days
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
1 décembre 2019
Achèvement primaire (Réel)
1 janvier 2020
Achèvement de l'étude (Anticipé)
1 avril 2020
Dates d'inscription aux études
Première soumission
17 février 2020
Première soumission répondant aux critères de contrôle qualité
2 mars 2020
Première publication (Réel)
4 mars 2020
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
4 mars 2020
Dernière mise à jour soumise répondant aux critères de contrôle qualité
2 mars 2020
Dernière vérification
1 mars 2020
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- DF0089UG
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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