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

2026年7月30日 更新者：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.

調査の概要

状態

募集

条件

介入・治療

詳細な説明

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

研究の種類

観察的

入学 (推定)

36

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。

研究連絡先

  • 名前：Barbara K Smith, PhD, PT
  • 電話番号：352-294-5315
  • メール：bksmith@ufl.edu

研究連絡先のバックアップ

研究場所

  • アメリカ
    • Florida
      • Gainesville、Florida、アメリカ、32608
        • 募集
        • UF Health Shands Medical Center
        • コンタクト：
        • コンタクト：
          • Mohammad A. Aladaileh, MBBS, MRCSI, EBCTS, FRCSIC-Th
          • 電話番号：(352) 265-5470
          • メール：maladaileh@ufl.edu
        • 主任研究者：
          • Barbara K Smith, PhD
        • 副調査官：
          • Wagner Souza Leite, PT
        • 副調査官：
          • Sandra Morgan, RN, PhD
        • 副調査官：
          • Jessica Cornman, PT
        • 副調査官：
          • May Smith-Hublou, PhD, CCC-SLP
        • 副調査官：
          • Ushna Khan, MD
        • 副調査官：
          • Amir M Emtiazjoo, MD, MSc
        • 副調査官：
          • Marc O Maybauer, MD, PhD, EDIC, FCCP, FACC, FAS

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

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

サンプリング方法

非確率サンプル

調査対象母集団

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.

説明

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.

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
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.
診断テスト：Respiratory and Limb Muscle Assessment
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.

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
Diaphragm structure
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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)

二次結果の測定

結果測定
メジャーの説明
時間枠
Five-Repetition Sit-to-Stand Test
時間枠：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
時間枠：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
時間枠：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
時間枠：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
時間枠：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.

その他の成果指標

結果測定
メジャーの説明
時間枠
Duration of Mechanical Ventilation
時間枠：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
時間枠：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
時間枠：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.

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。

スポンサー

University of Florida

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

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 (実際)

2026年2月5日

一次修了 (推定)

2026年12月1日

研究の完了 (推定)

2027年7月1日

試験登録日

最初に提出

2026年7月27日

QC基準を満たした最初の提出物

2026年7月30日

最初の投稿 (実際)

2026年8月5日

学習記録の更新

投稿された最後の更新 (実際)

2026年8月5日

QC基準を満たした最後の更新が送信されました

2026年7月30日

最終確認日

2026年7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

  • IRB202501059

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?

はい

IPD プランの説明

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

IPD 共有時間枠

9 months and ending 36 months following article publication.

IPD 共有アクセス基準

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

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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