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OBese Patients With Obstructive Sleep Apnea Syndrome(OSAS) and EXercise Training (OBEX1)

1 oktober 2018 uppdaterad av: AGIR à Dom

Comparison of 3 Exercise Training Modalities in Obese Patient With Sleep Apnea Syndrome Treated by Continue Positive Airway Pressure : a Randomized Controlled Study

The study was designed to test the following hypotheses:

In obese patients with OSAS, the benefit of the combination of exercise training + continuous positive airway pressure (CPAP) will be higher than CPAP alone in term of functional capacity, metabolic, inflammatory, cardiovascular and sleep parameters and quality of life.

In obese patients with OSAS, the benefit of training using ventilatory assistance (NIV) during cycloergometer [cycloergometer with NIV] or respiratory muscles training (spirotiger) in addition to cycloergometer [cycloergometer + spirotiger] will be higher than cycloergometer training alone [cycloergometer] in term of functional and exercise capacities.

Dyspnea during walking test and respiratory muscle strength at baseline could influence the response to combined exercise training such as [cycloergometer + NIV] or [cycloergometer + spirotiger]

Studieöversikt

Status

Okänd

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Background: Obesity and sleep apnea syndrome lead to metabolic troubles and increasing cardiovascular risk. Furthermore, both diseases are associated with reduced exercise tolerance. We hypothesized that exercise training could be complementary to nocturnal ventilatory treatment in restoring metabolic disturbances, exercise tolerance and sleep parameters in obese patients with SAS.

Objective: To evaluate the effect of training on exercise tolerance (walking distance and dyspnea during walk)(main objective), systemic inflammation, vascular endothelial function, insulin resistance, quality of sleep and quality of life in obese patients treated by CPAP for OSAS (secondary objectives)

Methods: We proposed to conduct a controlled, randomized clinical trial comparing the efficacy of 3 different modalities of training in obese patients with SAS. After a 6-week control pre-inclusion period, patients are included in either [cycloergometer] vs. [cycloergometer with ventilatory assistance] vs. [cycloergometer + respiratory muscle exercises]. Before and after the control period, and both immediately and 9 month after training, patients perform walking test, maximal incremental test on cycloergometer, blood sampling and cardiovascular function, body composition, muscle function, quality of sleep and quality of life assessments as well as spontaneous physical activity measurement. During the 5 years following inclusion in the training program, the number of cardiovascular event is recorded every year.

An interim analysis will be carried out when 30 will have completed the third evaluation session (after the training program). The Peto's method will be used to correct the p-values.

Studietyp

Interventionell

Inskrivning (Faktisk)

60

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

      • Grenoble, Frankrike, 38043
        • Hopital Universitaire de Grenoble
      • Quebec, Kanada, GIV 4G5
        • Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ)

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 80 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • OSAS (AHI > 30 before CPAP treatment)
  • > 4h/d CPAP treatment adherence
  • Obese patients with 35 < BMI < 45 kg/m2
  • Patients who give written consent
  • Patients who subscribed social insurance

Exclusion Criteria:

  • Cardiovascular or respiratory failure discovered at the moment of the inclusion in the study
  • Contraindication to exercise
  • Pregnant or breast-feed woman
  • Patients under guardianship
  • Imprisoned patients

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Aktiv komparator: ERGO
General endurance training on cycloergometer

12 weeks : 3 sessions per week (2 supervised sessions and 1 session at home)

1 technical visit and 1 nursing visit every two months at home for the CPAP

Aktiv komparator: ERGONIV/ ERGOSPIRO
General endurance training on cycloergometer using ventilatory assistance (ERGONIV) or additional respiratory muscle training (ERGOSPIRO)

12 weeks : 3 sessions per week (2 supervised sessions and 1 session at home)

1 technical visit and 1 nursing visit every two months at home for the CPAP

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Change in exercise tolerance during walking test
Tidsram: After control period (6th wk) vs. after training period (18th wk)
  • walking distance
  • dyspnea score
After control period (6th wk) vs. after training period (18th wk)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Changes in Aerobic capacity
Tidsram: After control period (6th wk) vs. after training period (18th and 52th wks)
Maximal oxygen consumption
After control period (6th wk) vs. after training period (18th and 52th wks)
Changes in cardiovascular and metabolic function
Tidsram: After control period (6th wk) vs. after training period (18th and 52th wks)
Pulse wave velocity, peripheral arterial tone, BP, inflammatory and metabolic plasmatic markers
After control period (6th wk) vs. after training period (18th and 52th wks)
Changes in sleep parameters and Quality Of life
Tidsram: After control period (6th wk) vs. after training period (18th and 52th wks)
Nocturnal oxygen saturation, CPAP data, Epworth questionnaire, Short Form (36) Health Survey questionnaire
After control period (6th wk) vs. after training period (18th and 52th wks)
Number of cardiovascular events per year
Tidsram: Every year from the 1st to the 5th year
Questionnaire sent to the patient by mail
Every year from the 1st to the 5th year
Changes in body composition
Tidsram: After control period (6th wk) vs. after training period (18th and 52th wks)
Fat mass and fat-mass index Fat-free mass and fat-free mass index assessed by impedancemetry measurements
After control period (6th wk) vs. after training period (18th and 52th wks)
Change in physical activity and sleep duration
Tidsram: After control period (6th wk) vs. after training period (18th and 52th wks)
Number of hour per day of physical activity at 1, 2, 3 or 4 Metabolic Equivalents (METS); Number of steps per day; Sleep to lying position duration ratio
After control period (6th wk) vs. after training period (18th and 52th wks)
Change in exercise tolerance during walking test
Tidsram: After control period (6th wk) vs. after trainng (52th wk)
  • isotime dyspnea
  • isotime oxygen saturation
After control period (6th wk) vs. after trainng (52th wk)
Change in physiological variables during the control period
Tidsram: Before (1st) vs. after control period (6th wk)
  • functional and exercise parameters
  • cardiovascular parameters
  • metabolic parameters
  • sleep and quality of life parameters (Short Form (36) Health Survey)
  • physical activity
Before (1st) vs. after control period (6th wk)
Baseline characteristics
Tidsram: Before control period (1st week) or after the control period (6th week)
  • functional and exercise parameters
  • cardiovascular parameters
  • metabolic parameters
  • sleep and quality of life parameters (Short Form (36) Health Survey)
  • physical activity
Before control period (1st week) or after the control period (6th week)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Samarbetspartners

Utredare

  • Huvudutredare: Jean-Louis Pépin, MD, PhD, Laboratoire EFCR, CHU de Grenoble, 38043, Grenoble, France

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 juli 2010

Primärt slutförande (Faktisk)

1 december 2014

Avslutad studie (Förväntat)

1 december 2018

Studieregistreringsdatum

Först inskickad

30 juni 2010

Först inskickad som uppfyllde QC-kriterierna

30 juni 2010

Första postat (Uppskatta)

1 juli 2010

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

2 oktober 2018

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

1 oktober 2018

Senast verifierad

1 september 2018

Mer information

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