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DiaSport - Endurance-orientated Training Program With Children and Adolescents on Maintenance Hemodialysis (DiaSport)

6 listopada 2017 zaktualizowane przez: Prof. Dr. B. Hoppe, University Hospital, Bonn

DiaSport - Ausdauerorientiertes Trainingsprogramm Mit Kindern Und Jugendlichen an Der Dialyse (DiaSport - Endurance-orientated Training Program With Children and Adolescents on Maintenance Hemodialysis)

Physical activity is considered essential for optimal health, development, socialization and well-being of children. However patients with end-stage renal disease (ESRD) are often restricted from participation in exercise activities. This is especially true for children on hemodialysis (HD). As a consequence their exercise capacity is reduced, both before, but most impressively after HD. In a nationwide randomized, multi-center design this study aims to proof the influence of an individualised endurance training program by bicycle ergometer performed during dialysis on the efficacy of HD, measured as single pool Kt/V. Secondary goals are to enhance physical performance, physical and mental well-being, and to improve measurable blood and treatment parameters (e.g. haemoglobin level, amount of medication). A positive impact of physical activity was observed in adults on HD, although most studies did not address this issue in a randomised protocol. Despite this beneficial evidence in adults, sport is still not integrated as part of standard care in patients on maintenance HD. The study protocol, developed in close collaboration with the German Sport University Cologne, differs substantially from previously published reports as it uses bicycle ergometer training in an upright position outside the dialysis couch and adapts the intensity of intervention to the patient's capabilities. Based on the expected results the investigators will develop an individualised training program to be integrated in the standard care of (pediatric) patients on maintenance HD.

Przegląd badań

Typ studiów

Interwencyjne

Zapisy (Rzeczywisty)

66

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Lokalizacje studiów

      • Bonn, Niemcy, 53113
        • University Hospital Bonn. Department of Pediatric and Adolescent Medicine, Division of Pediatric Nephrology

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

6 lat do 19 lat (Dziecko, Dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

  • End stage renal disease with need of renal replacement therapy
  • children and adolescents aged ≥6 to ≤19 years
  • maintenance hemodialysis for at least 3 months
  • Stable and appropriate dialysis condition in the last 4 weeks before inclusion to the study (basically stable blood and dialysate flow rate and same dialyser)
  • single pool Kt/V according to Dialysestandard 2006 > 1.2
  • Informed consent

Exclusion Criteria:

  • Participation in another interventional clinical trial
  • severe primary neurologic, orthopaedic or cardiac disease, or secondary disease known as a contraindication for endurance training
  • uncontrolled hyper- or hypotension, or cardiac disease
  • Recurrent uncontrolled epileptic seizures
  • dialysis shunt at the lower limbs
  • pregnancy
  • already planned medical intervention, for example living donor kidney transplantation or any other surgery, within the first period of the trial which will cause cancelation of more then 3 training units in a row
  • Subjects who are in dependency to the sponsor or the PI of the trial, or confined to an institution on judicial or official behalf

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Inny
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Bicycle-Ergometer Training Group

Performance adapted, hence individualised three times weekly bicycle-ergometer training during hemodialysis. Each training will last 30 to 50 minutes, with 70-80% of the patient specific maximum workload over 12 weeks (36 training sessions).

In the second part of the study intervention will be prolonged for another 12 weeks.

Performance adapted, hence individualised three times weekly bicycle-ergometer training during hemodialysis. Each training will last 30 to 50 minutes with 70-80% of the patient specific maximum workload over 12 weeks (36 training sessions - first part of the study compared to no intervention).

In the second part of the study both groups get the opportunity for another 12 weeks of individualised three times weekly bicycle-ergometer training during hemodialysis.

Inny: Control

No intervention during hemodialysis during the first 12 weeks of the study.

In the second part of the study a training program, according to that of the intervention group, will be performed with a performance adapted, hence individualised three times weekly bicycle-ergometer training during hemodialysis. Each training will last 30 to 50 minutes, with 70-80% of the patient specific maximum workload over 12 weeks (36 training sessions).

Performance adapted, hence individualised three times weekly bicycle-ergometer training during hemodialysis. Each training will last 30 to 50 minutes with 70-80% of the patient specific maximum workload over 12 weeks (36 training sessions - first part of the study compared to no intervention).

In the second part of the study both groups get the opportunity for another 12 weeks of individualised three times weekly bicycle-ergometer training during hemodialysis.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Change of single pool Kt/V (KDOQI Guidelines) - expressed as the change of single pool Kt/V from week 0 to 12 of intervention (period 1)
Ramy czasowe: 12 weeks
Change of single pool Kt/V (spKt/V) measured at week 12 (V1) compared to baseline (V0). Single pool Kt/V is the standard measure to assess dialysis efficacy. As dialysis efficacy is the primary aim of dialysis treatment and the spKt/V is the best way to measure efficacy this figure has an important clinical relevance for the patient.
12 weeks

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Change of the possible workload (maximum physical performance) achieved
Ramy czasowe: 12 and 24 weeks
The maximal possible workload will be determined by an exercise evaluation program with increasing power on a leg bicycle ergometer before a hemodialysis session, measuring the peak oxygen uptake (VO2-peak), heart rate, blood pressure and lactate levels during exercise.
12 and 24 weeks
Quality of Life
Ramy czasowe: 12 and 24 weeks
For quality of life assessment the validated and standardized PedsQL® questionnaires will be filled in by patients and parents.
12 and 24 weeks
Change of solute removal during hemodialysis
Ramy czasowe: 12 and 24 weeks
Solute removal during hemodialysis has a clear impact on the patient's health and well-being, as it reduces sequelae and offers the patient less restrictions on their diet, which would lead to a better compliance.
12 and 24 weeks
Change of solute removal in the two compartment model (assessed in a subgroup of patients)
Ramy czasowe: 12 and 24 weeks
Solute removal in the two compartment model will only be analyzed in patients 12 years of age or older with explicit consent to a second blood drawing 30 minutes after end of hemodialysis session. It was previously used showing a significant enhancement during exercise, explained by an increase of skeletal muscles perfusion during exercise.
12 and 24 weeks
Inflammation, nutritional status and bone metabolism
Ramy czasowe: 12 and 24 weeks
The nutritional status and bone metabolism will be determined as they are important for optimal health and growth of paediatric hemodialysis patients. Evidence is based on studies that showed trends towards a better nutritional status and less chronic inflammation.
12 and 24 weeks
Body Composition Monitoring (BCM)
Ramy czasowe: 12 and 24 weeks
Body Cpomposition Monitoring (BCM) will be performed to exermine further information on nutrional status, overhydration and muscle growth.
12 and 24 weeks
Change of number and dose of medication needed
Ramy czasowe: 12 and 24 weeks
Number and dose of medication will be recorded, changes will be evaluated, and data will be correlated to e.g. the measured blood pressure (antihypertensive drugs) or haemoglobin levels (EPO or EPO stimulating agents).
12 and 24 weeks
Telomere length and Telomerase activity
Ramy czasowe: 12 and 24 weeks
Telomere length and telomerase activity [units] will be used as markers for cell survival, which may be influenced by endurance training.
12 and 24 weeks

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Śledczy

  • Krzesło do nauki: Bernd Hoppe, MD, University Hospital of Bonn
  • Krzesło do nauki: Bettina Schaar, PhD, German Sport University, Cologne

Publikacje i pomocne linki

Osoba odpowiedzialna za wprowadzenie informacji o badaniu dobrowolnie udostępnia te publikacje. Mogą one dotyczyć wszystkiego, co jest związane z badaniem.

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów

1 września 2012

Zakończenie podstawowe (Rzeczywisty)

1 października 2017

Ukończenie studiów (Rzeczywisty)

1 października 2017

Daty rejestracji na studia

Pierwszy przesłany

20 marca 2012

Pierwszy przesłany, który spełnia kryteria kontroli jakości

20 marca 2012

Pierwszy wysłany (Oszacować)

22 marca 2012

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

7 listopada 2017

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

6 listopada 2017

Ostatnia weryfikacja

1 listopada 2017

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • Uni-Koeln-1137
  • DFG HO 1272/21-1 (Inny numer grantu/finansowania: DFG HO 1272/21-1)

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

Badania kliniczne na Bicycle-Ergometer Training

3
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