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Resistance Training to Prehabilitate Patients With Chronic Obstructive Pulmonary Disease

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ClinicalTrials.gov Identifier: NCT02860728
Recruitment Status : Recruiting
First Posted : August 9, 2016
Last Update Posted : November 9, 2017
Sponsor:
Information provided by (Responsible Party):
Neil Eves, University of British Columbia

Brief Summary:
Structural changes in skeletal muscles of patients with chronic obstructive pulmonary disease (COPD) have been linked to impaired muscle function, reduced exercise capacity, and increased mortality associated with this disease. Muscle dysfunction also contributes to dyspnea intensity and the ability to sustain exercise, making aerobic exercise training intolerable at the intensity and/or volume required to achieve clinically important changes. Resistance training (RT) is an attractive exercise modality because it is efficacious and more tolerable initially. No work has examined whether a short-term RT program can reduce exertional symptoms and improve exercise tolerance (dyspnea and leg fatigue) in patients with COPD.

Condition or disease Intervention/treatment Phase
Chronic Obstructive Pulmonary Disease Behavioral: Individualized Resistance Training Not Applicable

Detailed Description:
Skeletal muscle dysfunction is common in patients with COPD and has been recognized as a contributing factor to reduced exercise capacity, health related quality of life and increased mortality associated with this disease. Several structural changes in the limb muscles of patients have previously been reported and have been linked to the known reductions in muscle strength and endurance commonly reported in COPD. Muscle dysfunction, lower extremity muscle strength, and muscle fatigue also contribute to the intensity of dyspnea and the ability to sustain exercise mostly through stimulation of type III and IV muscle afferents. As such, many patients who primarily perform aerobic exercise training as part of pulmonary rehabilitation are unable to tolerate the intensity and/or volume of exercise required to achieve clinically important changes in exercise capacity or symptom relief. Resistance training (RT) is an attractive exercise modality for patients with COPD because it is efficacious and often more tolerable initially. To our knowledge no one has examined whether similar benefits to those elicited by longer RT programs can be attained in just 4 weeks using multi-joint, multi-muscle exercises and individualized progression. If a short term RT program can improve muscle quality, enhance endurance, and reduce type III and IV afferent activity then it would reduce the drive to breathe and thus dyspnea. These adaptations would likely translate into improved exercise tolerance making it feasible to "pre-habilitate" COPD patients with tolerable RT, allowing them to achieve a higher volume/intensity of endurance training, thus making pulmonary rehabilitation more effective.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Novel Individualized Resistance Training Program to Prehabilitate Patients With Chronic Obstructive Pulmonary Disease
Study Start Date : August 2016
Estimated Primary Completion Date : August 2018
Estimated Study Completion Date : August 2018

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Resistance training
Patients with COPD will participate in 4 weeks (12 sessions) of individualized, non-linear, lower body resistance training.
Behavioral: Individualized Resistance Training
Lower body resistance exercises will be prescribed in various combinations over multiple days and individually modified and progressed to achieve advances in both movement pattern, intensity, and exercise volume.




Primary Outcome Measures :
  1. Dyspnea [ Time Frame: Baseline and post 4 weeks (12 sessions) of resistance training ]
    The change in the sensory intensity of dyspnea measured at an iso-time during the constant load exercise trials post RT


Secondary Outcome Measures :
  1. Exercise Tolerance [ Time Frame: Baseline and post 4 weeks (12 sessions) of resistance training ]
    The change in the time to exhaustion during constant load exercise on a stationary cycle ergometer.

  2. Secondary Dyspnea Outcomes [ Time Frame: Baseline and post 4 weeks (12 sessions) of resistance training ]
    The change in the unpleasantness and sensory qualities of dyspnea measured at an iso-time during the constant load exercise trials post RT

  3. Quadriceps Fatigue [ Time Frame: Baseline and post 4 weeks (12 sessions) of resistance training ]
    Change in the amount of decline in force production after 3 minutes of electrical stimulation of femoral nerve at 25% of maximal voluntary contraction

  4. Muscle Strength and Endurance [ Time Frame: Baseline and post 4 weeks (12 sessions) of resistance training ]
    The change in 6RM quadriceps muscle strength and quadricep muscle endurance at 50% of predicted 1 RM



Information from the National Library of Medicine

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Ages Eligible for Study:   40 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Non-smokers >6 months
  • FEV1/FVC <0.7 and lower limit of normal
  • 30%< FEV1 pred <70%
  • Stable (no exacerbation for >3 months)

Exclusion Criteria:

  • Cardiovascular and cerebrovascular disease
  • Diabetes
  • Cardiovascular contraindications to exercise
  • Uncontrolled hypertension
  • Currently performing regular structured exercise >3x/week for 30 minutes

Information from the National Library of Medicine

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): NCT02860728


Contacts
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Contact: Neil Eves, PhD 1-250-807-9676 neil.eves@ubc.ca

Locations
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Canada, British Columbia
University of British Columbia Recruiting
Kelowna, British Columbia, Canada, V1V 1V7
Contact: Neil Eves, PhD    1-250-807-9676    neil.eves@ubc.ca   
Sponsors and Collaborators
University of British Columbia
Investigators
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Principal Investigator: Neil Eves, PhD University of British Columbia

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Responsible Party: Neil Eves, Associate Professor, University of British Columbia
ClinicalTrials.gov Identifier: NCT02860728     History of Changes
Other Study ID Numbers: H16-01019
First Posted: August 9, 2016    Key Record Dates
Last Update Posted: November 9, 2017
Last Verified: November 2017

Keywords provided by Neil Eves, University of British Columbia:
COPD
Resistance Training
Exercise Training
Dyspnea

Additional relevant MeSH terms:
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Lung Diseases
Lung Diseases, Obstructive
Pulmonary Disease, Chronic Obstructive
Respiratory Tract Diseases