Physiotherapy in Hypoxic AECOPD Patients
2 mars 2020 uppdaterad av: Marie Carmen Valenza, Universidad de Granada
Feasibility and Efficacy of Physiotherapy in Hypoxic AECOPD Patients
Hypoxia is considered a key player in many of the comorbidities that characterize COPD, such as pulmonary hypertension, skeletal muscle dysfunction, and systemic inflammation.
These comorbidities are worsened during an exacerbation due to prolonged bed rest and treatment with steroids, showing a reduction in the quality of life, exercise tolerance, and a greater risk of death in these patients.
Therefore, a better understanding of the safety and effectiveness of exercise training for AECOPD patients with resting hypoxemia is needed.
Studieöversikt
Status
Okänd
Betingelser
Intervention / Behandling
Studietyp
Interventionell
Inskrivning (Förväntat)
36
Fas
- Inte tillämpbar
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
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Granada
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Granada., Granada, Spanien, 18071
- Rekrytering
- Faculty of Health Sciences. University of Granada.
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Kontakt:
- Marie Carmen Valenza, PT
- Telefonnummer: 958 248035
- E-post: cvalenza@ugr.es
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Huvudutredare:
- Marie Carmen Valenza, PT, PhD
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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
40 år och äldre (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Beskrivning
Inclusion Criteria:
- Patients of both sexes
- A diagnosis of COPD made according to the criteria of the American Thoracic Society (ATS)
- With hypoxemia at rest defined as mean arterial oxygen saturation below 90%
- Agreed to participate
Exclusion Criteria:
- Unstable cardiovascular disease
- Orthopedic diseases in the upper and lower limbs
- Being in ICU or use of mechanical ventilation
- Motor sequelae from a neurological or cognitive impairment that interfere with the evaluation and the treatment
- Contraindications of electrotherapy
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 |
|---|---|
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Experimentell: Global Exercise Group
all patients received the Control Group treatment added to global exercise treatment.
The program included 15 minutes of deep breathing exercises and 20-30 minutes of limb exercises.
The exercises included global active range of motion (ROM) exercises and muscle strengthening like upper and lower limbs flexion-extension do single-leg stance, and sit to stand exercises.
The number of repetitions was adapted to the subject's response taken into account the perceived dyspnea and fatigue during the exercise performance.
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The program included 15 minutes of deep breathing exercises and 20-30 minutes of limb exercises.
The exercises included global active range of motion (ROM) exercises and muscle strengthening like upper and lower limbs flexion-extension do single-leg stance, and sit to stand exercises
|
|
Experimentell: Functional Electrostimulation Group
all patients received the Control Group treatment plus neuromuscular stimulation therapy (SEFAR Rehab X2, DJO France S.A.S., France) on quadriceps accompanied by lower limb exercises. The intervention was performed following the protocol described by Valenza et al (2017). Valenza MC, Torres-Sánchez I, López-López L, Cabrera-Martos I, Ortiz-Rubio A, Valenza-Demet G. Effects of home-based neuromuscular electrical stimulation in severe chronic obstructive pulmonary disease patients: a randomized controlled clinical trial. Eur J Phys Rehabil Med. 2018 Jun;54(3):323-332. doi: 10.23736/S1973-9087.17.04745-1. Epub 2017 Nov 16. PubMed PMID: 29144103. |
The program included a neuromuscular stimulation therapy on quadriceps accompanied by lower limb exercises. The intervention was performed following the protocol described by Valenza et al (2017). Valenza MC, Torres-Sánchez I, López-López L, Cabrera-Martos I, Ortiz-Rubio A, Valenza-Demet G. Effects of home-based neuromuscular electrical stimulation in severe chronic obstructive pulmonary disease patients: a randomized controlled clinical trial. Eur J Phys Rehabil Med. 2018 Jun;54(3):323-332. doi: 10.23736/S1973-9087.17.04745-1. Epub 2017 Nov 16. PubMed PMID: 29144103. |
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Aktiv komparator: Standard treatment
Patients received standard medical and pharmacological care that consisted in systemic steroids, inhaled bronchodilators, oxygen, and a regimen of oral prednisone or its equivalent in doses of 40 to 60 mg per day for the duration of therapy as well as anti-biotic therapy.
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Patients received standard medical and pharmacological care that consisted in systemic steroids, inhaled bronchodilators, oxygen, and a regimen of oral prednisone or its equivalent in doses of 40 to 60 mg per day for the duration of therapy as well as anti-biotic therapy
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Lower limb strength
Tidsram: Baseline
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Quadriceps strength was assessed with a portable hand-held dynamometer (Lafayette Manual Muscle Testing System, model 01163, Lafayette, IN, USA).
The test was performed with the patient seated with his/her knees and hips flexed at 90°.
Resistance was applied to the anterior tibia during 5 seconds of maximal muscle contraction.
The test was repeated alternatively 3 times on the leg, allowing participants to rest between measurements.
The highest value in Newton was selected for the analysis.
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Baseline
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Lower limb strength
Tidsram: Up to 9 days
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Quadriceps strength was assessed with a portable hand-held dynamometer (Lafayette Manual Muscle Testing System, model 01163, Lafayette, IN, USA).
The test was performed with the patient seated with his/her knees and hips flexed at 90°.
Resistance was applied to the anterior tibia during 5 seconds of maximal muscle contraction.
The test was repeated alternatively 3 times on the leg, allowing participants to rest between measurements.
The highest value in Newton was selected for the analysis.
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Up to 9 days
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Balance
Tidsram: Baseline
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Balance was evaluated by the one-leg standing balance test (OLS), that measured the time that the patient balances on one leg as long as possible.
The patient choose a leg to stand on (whichever he felt more comfortable with), flex the opposite knee allowing the foot to clear the floor, and balance on one leg.
Higher values mean better balance.
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Baseline
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Balance
Tidsram: Up to 9 days
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Balance was evaluated by the one-leg standing balance test (OLS), that measured the time that the patient balances on one leg as long as possible.
The patient choose a leg to stand on (whichever he felt more comfortable with), flex the opposite knee allowing the foot to clear the floor, and balance on one leg.
Higher values mean better balance.
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Up to 9 days
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Dyspnea
Tidsram: Baseline
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Dyspnea was assessed at rest using the modified Borg scale.
Patients classified their breathlessness from 0 (no dyspnea) to10 (maximal dyspnea)
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Baseline
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Dyspnea
Tidsram: Up to 9 days
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Dyspnea was assessed at rest using the modified Borg scale.
Patients classified their breathlessness from 0 (no dyspnea) to10 (maximal dyspnea)
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Up to 9 days
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Fatigue
Tidsram: Baseline
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Fatigue was evaluated using the Piper Fatigue Scale (PFS) that consists of 22 numerical items which assess multidimensional aspects of fatigue.
The scale measures four dimensions of subjective fatigue: "behavioral/severity", relating to the severity, distress, and degree of disruption in activity of daily living; "affective meaning", relating to the emotional meaning attributed to fatigue; "sensory", relating to the physical symptoms of fatigue; and "cognitive/mood", relating to mental and mood states
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Baseline
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Fatigue
Tidsram: Up to 9 days
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Fatigue was evaluated using the Piper Fatigue Scale (PFS) that consists of 22 numerical items which assess multidimensional aspects of fatigue.
The scale measures four dimensions of subjective fatigue: "behavioral/severity", relating to the severity, distress, and degree of disruption in activity of daily living; "affective meaning", relating to the emotional meaning attributed to fatigue; "sensory", relating to the physical symptoms of fatigue; and "cognitive/mood", relating to mental and mood states
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Up to 9 days
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Samarbetspartners och utredare
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Sponsor
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 (Faktisk)
1 december 2019
Primärt slutförande (Faktisk)
1 januari 2020
Avslutad studie (Förväntat)
1 april 2020
Studieregistreringsdatum
Först inskickad
17 februari 2020
Först inskickad som uppfyllde QC-kriterierna
2 mars 2020
Första postat (Faktisk)
4 mars 2020
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
4 mars 2020
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
2 mars 2020
Senast verifierad
1 mars 2020
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- DF0089UG
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