Influence of Muscular Atrophy on Biological and Functional Benefit of Respiratory Rehabilitation in Patients With Chronic Respiratory Failure (INSPIRE)
The prevalence of chronic respiratory failure (CRF) is increasing worldwide and will become the 3rd cause of death by 2020. At the stage of the disease requiring ventilatory assistance, this relates to 50,000 patients in France, life expectancy is very limited, and quality of life is poor.
CRF led to a reduction in muscle mass, which is found in 35 and 55% of patients, in some to a profound cachexia. A reduced fat free mass (FFM) is a factor associated with a poor tolerance to exercise and an halved survival. The exact causes and mechanisms leading to cachexia are not yet established. Recently, a chronic inflammatory condition has been quoted as a putative cause. This chronic inflammation would involve the molecular mechanisms leading to poor regulation of the balance of synthesis / protein degradation in muscle. A decrease in plasma and muscle amino acids was found among patients with a low FFM.. In addition, a decrease of plasma levels of some anabolic hormones, GH and androgens or IGF-1 has been found that could explain a lack of protein synthesis.
It is now well established that respiratory rehabilitation, including a program of exercise reconditioning, increases tolerance to exercise and improve the quality of life. Besides the classical type of endurance exercises stimulating the cardio-respiratory system, it is suggested to add resistance exercises. Several studies have reported the benefit of this strategy but the link with intracellular molecular pathways has not been described; moreover, it is unknown whether the existence of an initial muscular atrophy influences the gain in muscle strength/mass.
研究概览
详细说明
We therefore propose to explore the effect of a rehabilitation program including endurance and resistance exercises on muscle biopsies.
The present study should help to know the molecular pathways implicated in muscle atrophy in CRF patients and to assess their evolution with rehabilitation. This could lead to individualized recommendation for exercise program according to the muscle mass of the patients.
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Saint-etienne、法国、42055
- CHU de Saint-Etienne
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Prescription of an exercise training program as part of a respiratory rehabilitation
- Existence of an obstructive ventilatory deficit
- Signature of written consent
Exclusion Criteria:
- Exacerbation of COPD
- Patient with a long-term oxygen therapy
- Active smoker
- Lower limb locomotor limitation preventing to achieve the full respiratory rehabilitation program
- Lower limbs arteritis
- Myocardial infarction or pulmonary embolism of less than 3 months
- Long term anticoagulant
- Type 1 diabetes
学习计划
研究是如何设计的?
设计细节
- 主要用途:基础科学
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Respiratory rehabilitation
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The training begins 5 days after the initial assessment.
It consists of 3 weekly sessions for 8 consecutive weeks, including the following activities interspersed with periods of rest, according to the needs of patients
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
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Gain in exercise tolerance (relative variation of the 6 min walking distance and maximal exercise capacity on bicycle (peak VO2) combined with activation of the pathway for muscle protein synthesis
大体时间:before and at the outcome of the reconditioning program in the effort
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before and at the outcome of the reconditioning program in the effort
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次要结果测量
结果测量 |
大体时间 |
---|---|
Quality of life assessed by questionnaire
大体时间:before and at the outcome of the reconditioning program in the effort
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before and at the outcome of the reconditioning program in the effort
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合作者和调查者
调查人员
- 首席研究员:Frédéric COSTES, MD PhD、CHU de Saint-Etienne
出版物和有用的链接
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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Respiratory rehabilitation的临床试验
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IRCCS Eugenio Medea招聘中