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Feasibility and Acceptability of Non Weight-bearing Physical Activity for People With Diabetic Foot Ulceration

Not Applicable
Active, not recruiting
Conditions
Diabetic Foot
Cardiopulmonary
Physical Inactivity
Interventions
Behavioral: Non weight-bearing physical activity program
Registration Number
NCT06092827
Lead Sponsor
Université du Québec à Trois-Rivières
Brief Summary

Intervention in the form of a PA (physical activity) program combining aerobic, resistance, and flexibility exercises adapted for wearing a lower limb offloading device and limiting weight-bearing on the feet, with a duration of twelve (12) weeks, consisting of two supervised sessions and one unsupervised home session per week.

Detailed Description

Objectives:

1. Evaluate the acceptability of a non-weight bearing physical activity (PA) program;

2. Assess the feasibility of the PA program and the data collection procedure;

3. Evaluate the feasibility of a submaximal exercise test for cardiorespiratory capacity; and

4. Verify the sensitivity of dependent variables to respond to a physical activity program (e.g., cardiorespiratory capacity, cardiovascular and metabolic risk factors, quality of life, PA level).

Type of study:

Feasibility and acceptability study with a pre-post evaluative design.

Intervention:

Intervention in the form of a PA (physical activity) program combining aerobic, resistance, and flexibility exercises adapted for wearing a lower limb offloading device and limiting weight-bearing on the feet, with a duration of twelve (12) weeks, consisting of two supervised sessions and one unsupervised home session per week.

Subjects:

* 10-12 persons with an active diabetic foot ulcer

* 2-3 kinesiologists

Data collection:

* Sociodemographic and health questionnaire (age, sex, gender, marital status, education level, employment status, average annual family income, medical and health history, pharmacological and non-pharmacological treatments);

* Feasibility assessment: PA (physical activity) logbook including 1) the number of supervised and unsupervised sessions completed, 2) the duration of each session, 3) participation rate (number of patients recruited/number of eligible patients), 4) attrition rate (number of participants who completed the follow-ups/number of participants recruited), and 5) perceived facilitators and barriers;

* Acceptability assessment: 1) Treatment Acceptability and Preference (TAP) Questionnaire, seven to nine additional questions to assess the use of provided material resources and required safety checks (capillary blood glucose and wound inspection) and collection of participants' feedback, and 2) Client Satisfaction Questionnaire (CSQ-8);

* Assessment of the sensitivity of dependent variables to respond to the PA program\*: 1) estimation of VO2max by a submaximal exercise test on a stationary bike (Aerobic Power Index submaximal exercise test), 2) average daily step count over seven days at the waist and in the offloading boot at times 0, 4, 8, and 12 weeks, 3) Global Physical Activity Questionnaire (GPAQ), 3) clinical examination (height, weight, body mass index, waist circumference, body fat percentage, blood pressure, resting heart rate, characteristics of the DFU and classification (SINBAD), 4) paraclinical examinations (venous blood glucose, glycated hemoglobin, lipid profile), 5) neuropathic pain questionnaire (DN4), 6) Epworth sleepiness scale, quality of life questionnaire (EQ-5D-5L), 7) questionnaire on motivation to practice PA.

* Health and safety parameter measurements: electrocardiogram, oxygen saturation, estimated glomerular filtration rate, urine albumin/creatinine ratio, complete blood count.

* Data collection at 24 and 36 weeks is also planned for participants who agree to be contacted after completing the 12-week PA program.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
12
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Physical activityNon weight-bearing physical activity programAdults 18 to 75 with an active diabetic foot ulcer
Primary Outcome Measures
NameTimeMethod
Acceptability of physical activity interventionAt time 12 weeks

Treatment Acceptability and Preference (TAP) Questionnaire, minimum score 0/maximum score 16 with higher score meaning a greater acceptability

Feasibility of physical activity interventionAt time 12 weeks

Physical activity logbook, number of sessions completed with higher number meaning a greater feasibility

Satisfaction towards physical activity interventionAt time 12 weeks

Client Satisfaction Questionnaire (CSQ-8), minimum score 8/maximum score 32 with higher score meaning a higher satisfaction

Secondary Outcome Measures
NameTimeMethod
WeightAt times 0 and 12 weeks

Standing on beam balance scale, kg

Body fat percentageAt times 0 and 12 weeks

With bio-impedance balance, %

Average daily step count over seven daysAt times 0, 4, 8, and 12 weeks

At the waist and in the offloading boot using a FitBit Zip, number of steps

Waist circumferenceAt times 0 and 12 weeks

With flexible measuring tape above ombilic, cm

Resting heart rateAt times 0 and 12 weeks

With automatic blood pressure monitor, bpm

HeightAt time 0

Standing with rigid measuring rod, cm

Arterial blood pressureAt times 0 and 12 weeks

With automatic blood pressure monitor, mm Hg

Glycated hemoglobinAt times 0 and 12 weeks

With venipuncture, %

Neuropathic pain (if present)At times 0 and 12 weeks

Neuropathic pain (DN4) Questionnaire, 10 yes/no questions, higher number of yes indicates more severe neuropathic pain

Estimated VO2maxAt times 0 and 12 weeks

submaximal exercise test on a stationary bike (Aerobic Power Index submaximal exercise test), mL/kg/min

Physical activity levelAt times 0 and 12 weeks

Global Physical Activity Questionnaire (GPAQ), no minimum/maximum, details number of minutes/number of days per week of physical activity according to type of activity (work, leisures, commute, sedentary time)

Sleep apnea symptomsAt times 0 and 12 weeks

Epworth sleepiness scale, minimum score of 0/maximum score of 24, higher score makes sleep apnea more likely

Reported quality of lifeAt times 0 and 12 weeks

Quality of life questionnaire (EQ-5D-5L), minimum score of 5/maximum of 25 + 10cm visual analog scale, higher score represents a lower quality of life + 10cm being the best health condition possible

Lipid profile (total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, non-HDL cholesterol)At times 0 and 12 weeks

Venipuncture, g/L

Wound measurements (width, length, depth)At times 0, 4, 8 and 12 weeks

With flexible ruler

Classification of the ulcerAt times 0, 4, 8 and 12 weeks

Using SINBAD system, 6 categories graded 0 or 1 for a minimum of 0 and maximum of 6, with higher score meaning a more complicated ulcer

Non fasting venous blood glucoseAt times 0 and 12 weeks

With venipuncture, mmol/L

Questionnaire on motivation to practice physical activityAt times 0 and 12 weeks

With the Behavioural Regulation in Exercise revised Questionnaire (BREQ-2), 5 motivation categories graded from 0 to 4, Intrinsic (4 questions), Identified (3 questions), Introjected (3 questions), External (4 questions) and Amotivation (4 questions), with lower scores meaning lesser motivation for each category

Trial Locations

Locations (1)

Universite du Quebec à Trois-Rivieres

🇨🇦

Trois-Rivieres, Quebec, Canada

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