In-hospital and Post-discharge Training of Older Medical Patients
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|ClinicalTrials.gov Identifier: NCT01964482|
Recruitment Status : Completed
First Posted : October 17, 2013
Last Update Posted : December 5, 2018
The project aims to investigate the clinical value of simple strength training during hospitalization and after discharge as part of an enhanced recovery programme for acutely admitted older medical patients, in order to prevent mobility decline following acute hospitalization.
Note 11/23/16: As noted in the protocol (doi: 10.1186/s13063-016-1309-1) we have obtained funding and ethical approval (H-2-2012-115/09-12-2016) to extend the study to achieve sufficient power to look more deeply into our secondary outcomes. This will constitute a secondary part of the trial (started Nov. 2016). The primary trial report will include data for the pre-specified sample size for which the last patient was assessed Oct. 2016. Hence, the primary completion date for part 1 was April 2016 and the study completion date for part 1 was Oct 2016. The trial status is still "recruiting" although this applies to part 2 of the study.
|Condition or disease||Intervention/treatment||Phase|
|Hospitalized Older Medical Patients||Other: Strength training||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||158 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Single (Outcomes Assessor)|
|Official Title:||In-hospital and Post-discharge Training of Older Medical Patients|
|Study Start Date :||October 2013|
|Actual Primary Completion Date :||October 2016|
|Actual Study Completion Date :||October 2018|
Experimental: Strength training
Supervised strength training daily during hospitalization and 3 times per week for 4 weeks after discharge in the participant's home
Other: Strength training
Strength training followed by intake of a protein drink
No Intervention: Usual care
- Mobility using the de Morton Mobility Index (DEMMI) [ Time Frame: Admittance (baseline), discharge, 4 weeks after discharge (primary analysis), and 26 weeks after discharge ]The DEMMI is an advanced instrument for accurately measuring the mobility of older people across clinical settings (www.demmi.org.au). The primary analysis for the primary outcome is the change in the DEMMI score from baseline to the assessment 4 weeks after discharge (end of intervention). The primary analysis will follow the intention-to-treat principle (last observation carried forward) and be unadjusted in order to determine a systematic group-difference in the change from baseline to 4 weeks post discharge (end of training) for the primary outcome.
- Isometric knee-extension strength in dominant leg [ Time Frame: At admittance (baseline), at discharge, 4 weeks after discharge and 26 weeks after discharge ]Isometric knee-extension strength will be measured using an externally fixated handheld dynamometer (Power Track II Commander; JTech Medical, Utah). A stap will be attached to the bed/chair and the patient's ankle (perpendicular to the lower leg), ensuring 90 degrees of knee flexion and an isometric contraction. The transducer will be placed under the strap at ankle level, just proximal to the malleolus, and the participant will be asked to extend the leg as forcefully as possible. Knee-extension strength will be expressed as the maximal voluntary torque per kilo body mass ([NIm]/kg), using the distance between the lateral femoral epicondyle and the center of the transducer and the body mass of each patient.
- Hand-grip strength of dominant hand [ Time Frame: Admittance (baseline), discharge, 4 weeks post discharge and 26 weeks post discharge ]Isometric handgrip strength will be measured in the dominant hand using a handheld dynamometer (Digi-II; Saehan). The patient will be placed in a sitting position in an armchair, with the lower arm placed on the arm rest and an elbow flexion of 90 degrees. The patients will be asked to squeeze the handle as forcefully as possible for 5 secs. Handgrip strength will be expressed in kilograms.
- 30-sec sit to stand test [ Time Frame: Admittance (baseline), discharge, 4 weeks post discharge, 26 weeks post discharge ]The patients will be asked to stand up and sit down as many times as possible in 30 secs with their arms across their chest.
- Habitual gait speed [ Time Frame: Admittance (baseline), discharge, 4 weeks post discharge, 26 weeks post discharge ]Patients will be asked to walk a 4-meter straight walk at their usual pace starting from a standing position.
- 24-hour mobility [ Time Frame: Admittance to discharge, discharge to 1 week post discharge, 4 weeks post discharge to 5 weeks post discharge, 26 weeks post discharge to 27 weeks post discharge (4 x 1 week) ]The patients will be asked to wear an ActivPAL3 activity monitor (PAL Technologies Ltd, Scotland) on the thigh during hospitalization, the first week after discharge, the first weeks after the 4-week assessment and the first week after the 26-week assessment.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01964482
|Copenhagen University Hospital, Hvidovre|
|Hvidovre, Denmark, 2650|
|Principal Investigator:||Mette M Pedersen, PhD Student||Hvidovre Hospital, University of Copenhagen|
|Study Director:||Thomas Q Bandholm, PhD||Hvidovre Hospital, University of Copenhagen|
|Study Director:||Janne Petersen, PhD||Hvidovre Hospital, University of Copenhagen|