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Clinical Trials/NCT04675502
NCT04675502CompletedNot Applicable

Comparison of the Effects of a Supervised Exercise Program and a Home Exercise Program in Patients With Systemic Sclerosis

Dokuz Eylul University1 site in 1 country37 target enrollmentStarted: June 10, 2018Last updated:
Conditions
Interventions

Trial Snapshot

Phase
Not Applicable
Status
Completed
Enrollment
37
Locations
1
Primary Endpoint
Change in Forced expiratory volume in one second / Forced vital capacity

Study Overview

Brief Summary

Scleroderma, also called systemic sclerosis (SSc); It is a heterogeneous multiorgan disease of unknown etiology characterized by vasculopathy, autoimmunity and fibrous tissue. It is stated in studies that cardiac and pulmonary systems are affected in patients with SSc and these effects affect the aerobic capacity, physical functions and quality of life of patients negatively by disrupting their pulmonary and musculoskeletal functions. However, considering the treatment approaches in scleroderma patients, the number of studies evaluating the effectiveness of pulmonary rehabilitation and exercises is limited. Therefore, the purpose of our study; Comparison of the effects of a supervised exercise program and a home exercise program in patients with Systemic Sclerosis.

Detailed Description

Cases are divided into two groups as supervised exercise and home exercise program by closed envelope randomization method. All patients are informed about risk factors and risk factor management. All patients are trained 3 days in the first week under the supervision of a physiotherapist to learn individual exercise programs. Supervised exercise programs including warm-up, loading, cooling, and relaxation exercises are shown. The warm-up period is consist of light-paced walking, active movements of several large muscle groups. During the loading period respiratory control training, breathing exercises (Shrunken lip breathing exhaustion, diaphragmatic, thoracic expansion exercises), posture exercises with respiratory control (pectoral stretching, four-way trunk exercises, head-neck exercises, bilateral shoulder flexion and abduction exercises, sitting on a chair, standing up exercise. ), walking on the treadmill for 5-15 minutes without inclination and at a constant speed, starting with 3 minutes without load, continuing with a load of 20 watts and 3 minutes, and reaching a submaximal load with 3 watt increments every 10 seconds, pedaling in the bicycle ergometer is taken. Stretching exercises are done during the cooling period. This group was included in an exercise program 2 days a week, 45-90 minutes, for 12 weeks, accompanied by a specialist physiotherapist in the pulmonary rehabilitation unit in the chest diseases ward. The same exercises (respiratory control training, shrunken lip breathing exhaustion, diaphragmatic, thoracic expansion exercises, posture exercises with respiratory control (pectoral stretching, four-way trunk exercises, head and neck exercises, bilateral shoulder flexion and abduction exercises), sitting and standing exhaustion, and brisk walking to reach 60-85% of the person's maximum heart rate.)) were taught to the home exercise group and given in the form of a brochure and they were asked to do these exercises at home 2 days a week for 12 weeks. Participants of the home exercise group are contacted every two weeks via communication methods such as e-mail, message and telephone conversation. Exercise diary is given to all patients and is taken from them at the end of the study

Study Design

Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel
Primary Purpose
Treatment
Masking
Single (Outcomes Assessor)

Eligibility Criteria

Ages
35 Years to 65 Years (Adult, Older Adult)
Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • •Stable clinical status for at least two weeks
  • •Walking independently
  • •Volunteer for research study

Exclusion Criteria

  • •Having unstable angina
  • •Having uncontrolled hypertension
  • •Having hemodynamic instability
  • •Participating in any exercise program in the last six months
  • •Having a major orthopedic or neurological problem that limits functionality

Arms & Interventions

Supervised Exercise Group

Experimental

Exercise programs including warm-up, loading, cooling, and relaxation exercises are shown. The warm-up period is consist of light-paced walking, active movements of several large muscle groups. In this loading program; respiratory control training, breathing exercises, posture exercises with respiratory control , walking on the treadmill for 20 minutes without inclination , pedaling in the bicycle ergometer for 10 minutes is taken. Stretching exercises are done during the cooling period. This group was included in an exercise program 2 days a week, 45-90 minutes, for 12 weeks, accompanied by a specialist physiotherapist to the pulmonary rehabilitation unit in the chest diseases ward.

Intervention: supervised Exercise training (Other)

Home Exercise Group

Experimental

For patients to do at home (respiratory control training, shrunken lip breathing exhaustion, diaphragmatic, thoracic expansion exercises, posture exercises with respiratory control (pectoral stretching, four-way trunk exercises, head and neck exercises, bilateral shoulder flexion and abduction exercises), sitting and standing exhaustion, and brisk walking to reach 60-85% of the person's maximum heart rate.)), exercises is taught. Patients were asked to do the exercises at home for 45-90 minutes, 2 days a week, for 12 weeks. Participants of the control group are contacted every two weeks via communication methods such as e-mail, message and telephone conversation.Exercise diary is given to all patients and is taken from them at the end of the study.

Intervention: home exercise trainig (Other)

Outcomes

Primary Outcomes

Change in Forced expiratory volume in one second / Forced vital capacity

Time Frame: Baseline, 12th week

Pulmonary function test was applied by Sensor Medics Vmax 22 0,6-2B version spirometer (ERS 1993 Uptake + Zapleta, SensorMedics, Inc, Anaheim, CA, USA). Forced expiratory volume in one second (FEV1)/Forced vital capacity (FVC) ratio percent was recorded according to the American Thoracic Society (ATS) / European Respiratory Society (ERS) criteria

Change in peripheral muscle strength

Time Frame: Baseline, 12th week

The Jamar Handgrip Dynamometer is an instrument for measuring the maximum isometric strength of the hand and forearm muscles. Quadriceps isometric muscle strength is measured with a Hand Held Dynamometer.

Change in Maximal Inspiratory Pressure

Time Frame: Baseline, 12th week

Electronic mouth pressure measuring device was used for respiratory muscle strength. Maximal inspiratory pressure (MIP) was measured. MIP was measured from residual volume upon a maximal inspiratory effort against an occluded airway. occluded airway. MIP measurements was repeated three times, and the maximum percent achieved was recorded.

Change in diffusion capacity

Time Frame: Baseline, 12th week

Single breath carbon monoxide method was used in diffusion capacity for carbon monoxide (DLCO) percent measurement

Change in Forced Expiratory Volume in One Second

Time Frame: Baseline, 12th week

Pulmonary function test was applied by Sensor Medics Vmax 22 0,6-2B version spirometer (ERS 1993 Uptake + Zapleta, SensorMedics, Inc, Anaheim, CA, USA). Forced expiratory volume in one second (FEV1) percent was recorded according to the American Thoracic Society (ATS) / European Respiratory Society (ERS) criteria

Change in Forced Vital Capacity

Time Frame: Baseline, 12th week

Pulmonary function test was applied by Sensor Medics Vmax 22 0,6-2B version spirometer (ERS 1993 Uptake + Zapleta, SensorMedics, Inc, Anaheim, CA, USA). Forced vital capacity (FVC) percent was recorded according to the American Thoracic Society (ATS) / European Respiratory Society (ERS) criteria

Change in Maximal Expiratory Pressure

Time Frame: Baseline, 12th week

Electronic mouth pressure measuring device was used for respiratory muscle strength. Maximal expiratory pressure (MEP) was measured. MEP was measured from total lung capacity performing a maximal expiratory effort against an occluded airway. MEP measurements was repeated three times, and the maximum percent achieved was recorded

Change in functional capacity

Time Frame: Baseline, 12th week

Six-minute walk test (6MWT) is a valid, reliable and useful test for assessing functional capacity of patients. This test assesses distance walked over 6 minutes as a sub maximal test of aerobic capacity/endurance.

Secondary Outcomes

  • Change in quality of life: Scleroderma Health Assessment Questionnaire(Baseline, 12th week)
  • Change in fatigue(Baseline, 12th week)
  • Change in quality of life: Short Form-36 Quality of Life Questionnaire(Baseline, 12th week)
  • Change in quality of life:Health Assessment Questionnaire Disability Index(Baseline, 12th week)
  • Change in severity of dyspnoea(Baseline, 12th week)

Investigators

Sponsor Class
Other
Responsible Party
Principal Investigator
Principal Investigator

Hazal Yakut

Principal investigator

Dokuz Eylul University

Study Sites (1)

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