Stratification Protocols and Clinical, Physical and Biochemical Parameters to Forecast Cardiovascular Intercurrences.
2018年3月8日 更新者:Luiz Carlos Marques Vanderlei、Universidade Estadual Paulista Júlio de Mesquita Filho
Effectiveness of Stratification Protocols and Clinical, Physical and Biochemical Parameters to Forecast Intercurrences in Cardiovascular Rehabilitation Programs.
Introduction: Despite the various beneficial effects, cardiovascular rehabilitation programs (CVRP) have been associated with the appearance of signs and symptoms.
Risk stratification protocols are used to stratify into risk trials for an occurrence of events during physical exercise, although studies investigating their efficacy in predicting signs and symptoms during VCTV are inconclusive.
In addition, several clinical, physical and biochemical parameters have been used in the literature as risk markers for the appearance of adverse events, and to investigate whether these parameters are capable of predicting a possibility of intercurrences during PRCV sessions.Objectives: 1) to evaluate the efficacy of risk stratification protocols in predicting signs and symptoms during the performance of a PRCV; 2) to analyze the correlation between clinical, physical and biochemical parameters measured at rest with the presence of signs / symptoms in participants of a PRCV; 3) to evaluate whether changes in clinical, physical or biochemical parameters induced by PRCV influence the appearance of signs and symptoms during PRCV.
Materials and Methods: To perform this study, data from 70 patients inserted in a PRCV will be evaluated.
The study will be divided into three subprojects that can be divided into three stages: 1) risk stratification of patients who will participate in the study by two independent evaluators (Study 1) and evaluation of clinical parameters (cardiorespiratory parameters and autonomic modulation evaluation); (maximal isometric resistance, maximal isometric contraction, functional capacity and level of physical activity) and biochemical (IL-6, TNF-alpha and IL-10) (Studies 2 and 3).
Patients will then be followed up by 24 sessions during the PRCV routines to evaluate signs and symptoms, for posterior correlation with the risk stratification obtained in each protocol (Study 1), and with resting values of clinical, physical and biochemical studies (Studies 2 and 3); 2) Patients perform the normal routines of their PRCV for a period of 6 months (Study 3); 3) The patients will again have their clinical, physical and biochemical parameters evaluated and then will be followed up for another 2 months (24 sessions) during the routines of the PRCV sessions to evaluate signs and symptoms, which will allow to evaluate if gains / losses in these parameters exert influence on the appearance of signs and symptoms during PRCV sessions.
調査の概要
研究の種類
観察的
入学 (予想される)
72
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
はい
受講資格のある性別
全て
サンプリング方法
非確率サンプル
調査対象母集団
Individuals, regardless of gender, who participate in the cardiovascular rehabilitation program developed at the Center for Studies and Attendance in Physiotherapy and Rehabilitation of the São Paulo State University.
説明
Inclusion Criteria:
- To present clinical diagnosis of cardiovascular disease and/or cardiovascular risk factors;
- Be able to perform all the proposed evaluations;
- Agree to participate in the studies.
Exclusion Criteria:
- Patients who miss more than six consecutive sessions of the program or those who total more than 12 absences during the two months that total the period of analysis of the signs and symptoms will be excluded from the analyzes.
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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Cardiovascular rehabilitation group
Initially all patients will have their charts analyzed, from which data will be extracted for characterization of the population, and anthropometric data will be measured for calculation of body mass index.
Afterwards, patients will have their clinical, physical and biochemical parameters.
They will be followed up for a period of 2 months during the routines of the cardiovascular rehabilitation sessions for assessment of signs and symptoms.
In the second stage the patients will perform the normal routines of their cardiovascular rehabilitation program for a period of 6 months.
In the third stage, patients will have their clinical, physical and biochemical parameters and then followed up for another 2 months during the routines of the sessions of the cardiovascular rehabilitation program to evaluate signs and symptoms, which will allow to evaluate if gains/losses in the physical parameters can exert influences in the appearance of signs and symptoms during the sessions.
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The cardiovascular rehabilitation program is performed three times weekly on alternate days and each session lasts approximately 60 minutes divided as follows: 5 minutes to the initial rest where blood pressure (BP), heart rate (HR) and signs and symptoms are assessed; 15 minutes of warm-up, composed by global stretches, lower and upper limb exercises, and exercises combining the two modes; then, patients go to the resistance phase (30 minutes), where are performed an individualized aerobic protocol according to their HR reserve values using bicycle and treadmill (at the 4th and 10th minute of both ergometers at HR is evaluated, and in the bicycle is also evaluated the BP of all the patients).
The end of the protocol is composed of 10-minute relaxation, during which the patients perform a small cardiovascular deceleration (a few laps around the room, with free speed) and, finally, lie down at rest.
The presence of signs and symptoms is assessed at all stages of the program.
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Autonomic modulation
時間枠:6 months
|
The autonomic modulation will be evaluated by heart rate variability method
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6 months
|
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Blood pressure
時間枠:6 months
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The blood pressure will be evaluated with a non invasive method
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6 months
|
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Heart rate
時間枠:6 months
|
The heart rate will be evaluated with an pulse oximeter with the volunteers at rest
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6 months
|
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Spirometric parameters
時間枠:6 months
|
The spirometric parameters will be evaluated by spirometry method.
|
6 months
|
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Maximum expiratory and inspiratory pressure
時間枠:6 months
|
The maximum expiratory and inspiratory pressure will be evaluated by manovacuometry method.
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6 months
|
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maximum isometric muncle strength
時間枠:6 months
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The vollunteers will realize the maximum isometric strength with a dominant member during 5 seconds, and the maximum value obtained will be registered.
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6 months
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voluntary isometric contraction
時間枠:6 months
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The volunteers will do a maximum voluntary isometric contraction and instructed to maintain this contraction as longer they can.
The maximum time obtained will be registered.
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6 months
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Cardiorrespiratory fitness
時間枠:6 months
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The vollunters will be submited to a maximum effort test to define their cardiorrespiratory fitness.
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6 months
|
|
Physical activity level
時間枠:6 months.
|
The physical activity of the volunteers will be registered during one week to determine their physical activity level.
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6 months.
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Biochemical parameters
時間枠:6 months
|
Inflamatory (TNF-alpha, IL-6) and anti-inflamatory cytokines (IL-10) will be analysed by blood samples.
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6 months
|
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Cardiovascular risk stratification protocols
時間枠:2 months
|
The cardiovascular risk stratification will be evaluated by seven diferent protocols and the volunteers will be stratified like less, medium and high cardiovascular risk.
There will be used protocols of the organizations below: American College of Sports Medicine, Sociedade Brasileira de Cardiologia, American Heart Association, Frederic J. Pashkow protocol, American Association of Cardiovascular and Pulmonary Rehabilitation, Société Française de Cardiologie and Sociedad Española de Cardiología
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2 months
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Cardiovascular signals
時間枠:6 months
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Signals like pulse rate changes, increased SBP and DBP during exercise, tachipnea, pallor will be observed by the evaluator and the presence or absence will be registered.
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6 months
|
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Cardiovascular symptoms
時間枠:6 months
|
Symptoms like dizziness, angina pectoris, cramp, muscle pain, fatigue, nausea will be related for the volunteers, and the presence or absence will be registered.
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6 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
oxygen saturation
時間枠:6 months
|
The respiratory parameter oxigen saturation of the volunteers will be evaluated with a pulse oximeter with the volunteers at rest.
|
6 months
|
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Respiratory frequency
時間枠:6 months
|
The respiratory parameters respiratory frequency will the evaluated by number of tract per minute with the volunteers at rest.
|
6 months
|
協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
捜査官
- スタディディレクター:Luiz Carlos M Vanderlei, PhD、Universidade Estadual Paulista - UNESP campus de Presidente Prudente
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
一般刊行物
- Ribeiro F, Takahashi C, Vanzella LM, Laurino MJL, Lima IM, Silva VEDS, Silva JPLN, Valente HB, da Silva AKF, Christofaro DGD, Vanderlei LCM. An investigation into whether cardiac risk stratification protocols actually predict complications in cardiac rehabilitation programs? Clin Rehabil. 2021 May;35(5):775-784. doi: 10.1177/0269215520978499. Epub 2020 Dec 8.
- Vanzella LM, Takahashi C, Ribeiro F, Lima IM, Silva AKFD, Christofaro DGD, Vanderlei LCM. Efficacy of risk stratification protocols and clinical, physical, and biochemical parameters to previse signals and symptoms during cardiovascular rehabilitation programs: Protocol for an observational trial. Medicine (Baltimore). 2019 Jun;98(24):e15700. doi: 10.1097/MD.0000000000015700.
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始 (予想される)
2018年3月10日
一次修了 (予想される)
2018年9月30日
研究の完了 (予想される)
2019年2月1日
試験登録日
最初に提出
2018年1月29日
QC基準を満たした最初の提出物
2018年2月20日
最初の投稿 (実際)
2018年2月27日
学習記録の更新
投稿された最後の更新 (実際)
2018年3月12日
QC基準を満たした最後の更新が送信されました
2018年3月8日
最終確認日
2018年3月1日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- 79213417.0.0000.5402
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
いいえ
IPD プランの説明
I don't have plans.
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Cardiovascular rehabilitationの臨床試験
-
Eodyne Systems SLUniversidad Miguel Hernandez de Elche募集
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Fondazione Don Carlo Gnocchi OnlusUniversità Campus Bio-Medico di Roma (UCBM); Khymeia Group S.r.l.まだ募集していません
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Bahçeşehir UniversityNevsehir Haci Bektas Veli Universityまだ募集していません