- ICH GCP
- Реестр клинических исследований США
- Клиническое испытание NCT07698418
Effect of Inspiratory Muscle Training on Knee Osteoarthritis Pain
Effect of Inspiratory Muscle Training on Pain in Patients With Knee Osteoarthritis: A Randomized Controlled Trial
Knee osteoarthritis (KOA) is a common joint disease that causes chronic pain and limits daily activities. Current treatments, such as painkillers or surgery, have limitations like side effects or high costs. This study will test whether a safe, non-drug intervention-inspiratory muscle training (breathing exercises against resistance)-can reduce knee pain in people with KOA. The training may work by lowering inflammation and improving the brain's modulation of pain.
Eighty patients aged ≥55 years with confirmed KOA and frequent knee pain will be enrolled. Participants will be randomly assigned to either an 8-week inspiratory muscle training program (5 sessions per week, with gradually increasing resistance) or a sham (very low resistance) training program. Neither the patients nor the researchers assessing the outcomes will know who is in which group.
The main outcome is change in knee pain measured by a visual analog scale (VAS). Secondary outcomes include blood markers of inflammation (TNF-α, IL-6, IL1β), physical function, the Knee injury and Osteoarthritis Outcome Score (KOOS), inspiratory muscle strength, activity level, sleep quality, and quality of life. To explore underlying mechanisms, outcomes included heart rate variability (HRV) as an indicator of autonomic nervous system function, and brain functional connectivity in the prefrontal cortex using functional near-infrared spectroscopy (fNIRS) are collected. These mechanistic assessments will be performed at baseline and at the end of 8-week intervention. Additional follow-up assessments for clinical outcomes will be done at 3 and 6 months after the training ends. Any side effects or adverse events will be recorded.
This study will provide high-quality evidence on whether inspiratory muscle training is an effective and safe complementary treatment for knee pain in people with knee OA, and will offer new insights into the mechanisms underlying its analgesic effects.
Обзор исследования
Статус
Вмешательство/лечение
Тип исследования
Регистрация (Оцененный)
Фаза
- Непригодный
Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
- Взрослый
- Пожилой взрослый
Принимает здоровых добровольцев
Описание
Inclusion Criteria:
- Aged 55 years or older.
- Knee osteoarthritis (Kellgren-Lawrence grade ≥ 2).
- Knee pain (Visual Analogue Scale, VAS ≥ 3) on the most days in the past month.
- Able to walk independently without assitive devices.
Exclusion Criteria:
- History of knee replacement surgery, meniscus surgery, or ligament surgery.
- Received corticosteroid injection within the previous three weeks.
- Diagnosed with rheumatoid arthritis.
- Unstable angina, recent myocardial infarction, uncontrolled cardiac arrhythmia, or severe heart failure.
- History of stroke.
- Currently receiving steroid therapy, hormonal therapy, or cancer chemotherapy.
- Pneumothorax, pulmonary bullae, lung surgery within the past 12 months, unstable asthma, or severe dyspnea at rest.
- Unable to understand the study procedures and potential risks.
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Уход
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Тройной
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
|---|---|
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Экспериментальный: Inspiratory Muscle Training
5 sessions/week for 8 weeks.
Load starts at 50% MIP for 40 reps, increases to 80% MIP for 60 reps from week 5, then adjusted weekly to 80% of updated MIP.
Device: threshold inspiratory muscle trainer.
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Participants will perform home-based inspiratory muscle training using a threshold-loading device (POWERbreathe Medic Plus).
Training is conducted 5 times per week for 8 weeks.
The initial inspiratory load is set at 50% of the individual's maximum inspiratory pressure (MIP), measured weekly at the study site.
The load is progressively increased to 80% MIP over the first 4 weeks and maintained at 80% MIP for the remaining 4 weeks.
Each session consists of 40-60 breaths.
Adherence is monitored via an electronic training log and weekly on-site visits.
This protocol is individualized, progressive, and home-based, distinguishing it from fixed-load or supervised-only breathing interventions.
Другие имена:
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Фальшивый компаратор: Sham Inspiratory Muscle Training
Participants perform sham inspiratory muscle training with the same frequency and duration as the experimental group, but the inspiratory load is fixed at 10% of maximal inspiratory pressure (MIP) and does not progress.
All other procedures (weekly MIP measurement for sham load adjustment) are identical to maintain blinding.
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Participants will perform home-based inspiratory muscle training using a threshold-loading device (POWERbreathe Medic Plus).
Training is conducted 5 times per week for 8 weeks.
The initial inspiratory load is set at 10% of the individual's maximum inspiratory pressure (MIP), measured weekly at the study site.
The load is maintained 10% MIP over 8 weeks.
Each session consists of 40-60 breaths.
Adherence is monitored via an electronic training log and weekly on-site visits.
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Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Visual analogue scale
Временное ограничение: Baseline, week 8, 3-month after intervention, 6-month after intervention
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Self-rated pain intensity of knee (0-100), "0" indicate no pain, "100" indicate worst pain.
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Baseline, week 8, 3-month after intervention, 6-month after intervention
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Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Serum levels of inflammatory markers
Временное ограничение: Baseline, up to week 8
|
Systemic inflammation
|
Baseline, up to week 8
|
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Heart rate variability
Временное ограничение: Baseline, up to week 8
|
Vagus nerve activity
|
Baseline, up to week 8
|
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40-meter walk test
Временное ограничение: Baseline, up to week 8
|
Physical function
|
Baseline, up to week 8
|
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30-sec chair stand test
Временное ограничение: Baseline, up to week 8
|
Physical function
|
Baseline, up to week 8
|
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Pittsburgh Sleep Quality Index
Временное ограничение: Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Total scores range from 0-21, '0' indicating no difficulty and '21' indicating severe difficulties in all areas.
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Baseline, week 8, 3-month after intervention, 6-month after intervention
|
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Maximal inspiratory pressure
Временное ограничение: Baseline, up to week 8
|
Inspiratory muscle strength
|
Baseline, up to week 8
|
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The Knee injury and Osteoarthritis Outcome Score
Временное ограничение: Baseline, week 8, 3-month after intervention, 6-month after intervention
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Patient-reported outcomes in pain, symptoms, daily living activities, sports and recreational activities, and quality of life, with the score of each subscale ranging from 0-100, where higher scores indicate worse conditions.
|
Baseline, week 8, 3-month after intervention, 6-month after intervention
|
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Prefrontal cortex activity
Временное ограничение: Baseline, up to week 8
|
Functional near-infrared spectroscopy is used to assess prefrontal cortex activity
|
Baseline, up to week 8
|
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Physical Activity Scales for the Elderly
Временное ограничение: Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Total scores range from 0-793, where the higher scores indicate a higher level of physical activity.
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Baseline, week 8, 3-month after intervention, 6-month after intervention
|
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12-Item Short Form Health Survey
Временное ограничение: Baseline, week 8, 3-month after intervention, 6-month after intervention
|
Total scores range from 0-100, where the higher scores indicate better physical and mental health function.
|
Baseline, week 8, 3-month after intervention, 6-month after intervention
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Другие показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Adherence
Временное ограничение: Up to week 8
|
Adherence is calculated from logbooks as completed versus prescribed sessions
|
Up to week 8
|
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Adverse events
Временное ограничение: Up to week 8
|
Adverse events are defined as any symptom or abnormal sign during training and graded by the Common Terminology Criteria for Adverse Events (CTCAE v6.0, 2025): Mild: resolved with rest, no medical intervention; Moderate: require minimal medical intervention (e.g., analgesics); Severe: requires medical attention or hospitalization (e.g., clinic visit)
|
Up to week 8
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Соавторы и исследователи
Соавторы
Даты записи исследования
Изучение основных дат
Начало исследования (Оцененный)
Первичное завершение (Оцененный)
Завершение исследования (Оцененный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
- Боль
- Неврологические проявления
- Заболевания опорно-двигательного аппарата
- Артрит
- Заболевания суставов
- Ревматические заболевания
- Остеоартрит
- Патологические состояния, признаки и симптомы
- Признаки и симптомы
- Остеоартрит, Колено
- Хроническая боль
- Терапия
- Терапия разума и тела
- Дополнительная терапия
- Методы движения упражнений
- Физиотерапия
- Дыхательные упражнения
Другие идентификационные номера исследования
- ZHSC-1-(2026)014
Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
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