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Effects of a Partially Supervised Conditioning Program in CF

Not Applicable
Completed
Conditions
Cystic Fibrosis
Interventions
Behavioral: Exercise Intervention
Registration Number
NCT01744561
Lead Sponsor
Wuerzburg University Hospital
Brief Summary

Physical activity and exercise have become an accepted and valued component of Cystic Fibrosis care. Regular physical activity and exercise can slow the rate of decline of pulmonary function, improve physical fitness, and enhance quality of life. However, motivating people to be more active is challenging. Supervised exercise programs are expensive and labor intensive, and adherence falls off significantly once supervision ends. Unsupervised or partially supervised programs are less costly and more flexible, but compliance can be more problematic. The primary objective of this study is to evaluate the effects of a 12-months partially supervised exercise intervention along with regular motivation on forced expiratory volume in 1 second (FEV1) in a large international group of cystic fibrosis patients. Secondary endpoints include patient reported quality of life, as well as levels of anxiety and depression, and control of blood sugar. A total of 292 patients with cystic fibrosis 12 years and older with a FEV1 ≥35% predicted will be recruited. Following baseline assessments (2 visits) patients will be randomized into an intervention and a control group. Thereafter, they will be seen every 3 months for assessments in their centre for one year (4 follow-up visits). Along with individual counseling to increase vigorous physical activity by at least 3 hours per week on each clinic visit, the intervention group will document daily exercise and inactivity time and will receive a step counter and they will record their progress with a web-based program. They will also receive monthly phone calls from the study staff. After 6 months, they will continue with the step counter and web-based program for a further 6 months. The control group will receive access to this intervention after 12 months of standardized care. Should this relatively simple program prove successful, this will be made available on a wider scale internationally.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
155
Inclusion Criteria
  • Confirmed diagnosis of Cystic Fibrosis
  • Age ≥12 years
  • Forced expiratory volume in 1 second (FEV1) ≥ 35% predicted
  • Access to the internet
Exclusion Criteria
  • Participation in another clinical trial up to 4 weeks prior to the first baseline visit
  • Pregnancy/Breastfeeding
  • Inability to exercise
  • More than 4 hours of reported strenuous physical activities per week currently or up to 3 months prior to baseline measurements and not already planned within the coming 6 months.
  • Unstable condition precluding exercise (major hemoptysis or pneumothorax within the last 3 months, acute exacerbation and iv-antibiotics during the last 4 weeks, planned surgery, listed for lung transplantation, major musculoskeletal injuries such as fractures or sprains during the last 2 months, others according to the impression of the doctor)
  • Cardiac arrhythmias with exercise
  • Requiring additional oxygen with exercise
  • Recent diagnosis of diabetes 3 months prior to screening or at screening
  • Recent changes in medication 1 month or less prior to screening (systemic steroids, ibuprofen, inhaled antibiotics, mannitol, DNAse, hypertonic saline)
  • At least one G551D mutation and not on ivacaftor (VX770) yet but planned start or planned stop of ivacaftor during the trial
  • Colonization with Burkholderia cenocepacia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Exercise InterventionExercise InterventionAdd three hours of intense physical activities per week to baseline activities. Weekly exercise should include at least 30 minutes of strength building activities and at least two hours of aerobic activities. Exercise bouts lasting 20 min or longer will be counted with respect to total weekly training time.
Primary Outcome Measures
NameTimeMethod
Change in forced expiratory volume in 1 second (FEV1; in % predicted using the average of two baseline measurements) from baseline to 6 months in the intervention group compared to controls.baseline and 6 months
Secondary Outcome Measures
NameTimeMethod
Change in measured steps per daybaseline to 6 months and baseline to 12 months
Change in exercise steps per daybaseline to 6 months and baseline to 12 months
Days on additional oral / intravenous antibioticsbaseline to 6 months and baseline to 12 months

from questionnaire

Change in percent body fatbaseline to 6 months and baseline to 12 months

estimated from skinfold thickness

Change in depression, anxiety and stress scoresbaseline to 6 months and baseline to 12 months

from Depression Anxiety Stress Scales

Serious adverse eventsbaseline to 6 months and baseline to 12 months
Change in reported physical activitybaseline to 6 months and baseline to 12 months
Change in forced vital capacity (FVC; % predicted)baseline to 6 months and baseline to 12 months
Change in body mass index (kg/m2)baseline to 6 months and baseline to 12 months
Change in muscle mass (kg)baseline to 6 months and baseline to 12 months

estimated from skinfold thickness

Change in plasma glucose concentrations 1 and 2 hours after a standardized glucose loadbaseline to 9 months

standardized oral glucose tolerance test only patients without diabetes mellitus

Change in peak oxygen uptake (%predicted)baseline to 6 months and baseline to 12 months
Change in maximal aerobic power (%predicted)baseline to 6 months and baseline to 12 months
Change in residual volume in percent of total lung capacity (RV/TLC; %)baseline to 6 months and baseline to 12 months
Time to first exacerbationbaseline to 6 months and baseline to 12 months
Adverse events possibly or likely related to exercisebaseline to 6 months and baseline to 12 months

causality as judged by investigator

Change in forced expiratory volume in 1 second (FEV1; %predicted)baseline to 6 months and baseline to 12 months
Number of upper respiratory tract infectionsbaseline to 6 months and baseline to 12 months

from diary

Severe adverse eventsbaseline to 6 months and baseline to 12 months
Change in Quality of Life scalesbaseline to 6 months and baseline to 12 months

from the revised Cystic Fibrosis health-related quality of life Questionnaire (CFQ-R questionnaire)

Trial Locations

Locations (28)

Children's Hospital of Pittsburgh of UPMC

🇺🇸

Pittsburgh, Pennsylvania, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Hôpital Maison Blanche, Service : Maladies respiratoires

🇫🇷

Reims, France

Pediatric Pulmonology and CF centre, Children´s Hospital, Ruhr University

🇩🇪

Bochum, Germany

CF- Ambulanz, Kinderklinik, Pädiatrische Pneumologie, Allergologie und Neonatologie

🇩🇪

Hannover, Germany

CF Zentrum Hamburg-Altona, Kinderarztpraxis Runge, Sextro,Held

🇩🇪

Hamburg, Germany

Praxis für Lungen- und Bronchialheilkunde

🇩🇪

Munich, Germany

Kinderspital, Pneumologie

🇨🇭

Zurich, Switzerland

Royal Hospital for Sick Children

🇬🇧

Edinburgh, Scottland, United Kingdom

UniversitätsSpital, Klinik für Pneumologie

🇨🇭

Zurich, Switzerland

Zentrum für Kinder- und Jugendmedizin, Pädiatrische Pneumologie, Allergologie und Mukoviszidose

🇩🇪

Mainz, Germany

QuartierBleu, Praxis für Pneumologie am Lindenhofspital

🇨🇭

Bern, Switzerland

Mukoviszidose-Ambulanz, Universitätsklinik für Kinder- und Jugendheilkunde,

🇦🇹

Graz, Austria

Christiane Herzog CF-Zentrum, Goethe Universität

🇩🇪

Frankfurt, Germany

Cystische Fibrose Zentrum für Kinder, Jugendliche und Erwachsene

🇦🇹

Innsbruck, Austria

Hôpital Arnaud de Villeneuve, Service: Maladies respiratoires

🇫🇷

Montpellier cedex 5, France

University Medical Center, Child Development & Exercise Center, Wilhelmina Children's Hospital

🇳🇱

Utrecht, Netherlands

Montreal Children's Hospital, McGill University Health Centre - Glen Site

🇨🇦

Monrtreal, Quebec, Canada

Hôpital Renée Sabran, Service : Maladies respiratoires

🇫🇷

Hyeres, France

Hôpital Calmette, Service Pneumologie-immuno-allergologie boulevard du Pr Leclercq

🇫🇷

Lille cedex, France

Klinik und Poliklinik für Kinderheilkunde - Universitäts-Mukoviszidose-Centrum

🇩🇪

Dresden, Germany

Klinik für Kinder- und Jugendmedizin / Universitätsklinikum

🇩🇪

Münster, Germany

Hôpital Jeanne de Flandre, Service: Pneumologie et allergologie pédiatriques

🇫🇷

Lille cedex, France

Olgahospital, Klinikum Stuttgart

🇩🇪

Stuttgart, Baden-Württemberg, Germany

Children´s Hospital of the University

🇩🇪

Würzburg, Bavaria, Germany

Inselspital, Universitätsklinik für Kinderheilkunde, Pneumologie

🇨🇭

Bern, Switzerland

Hôpital Necker, Service : Pneumologie et allergologie pédiatriques

🇫🇷

Paris, France

Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Tübingen

🇩🇪

Tübingen, Baden-Württemberg, Germany

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