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Individualized Physical Exercise Training and Enhanced Protein Intake in Older Citizens During Municipality-based Rehabilitation

Not Applicable
Completed
Conditions
Rehabilitation
Interventions
Other: Usual Care
Other: Individualized Physical Exercise Training with Protein Supplementation
Other: Usual Care with Protein Supplementation
Registration Number
NCT04091308
Lead Sponsor
University College Absalon
Brief Summary

The study will investigate if: 1) individualized physical exercise training in combination with extra protein intake can increase measures on all three ICF-levels? 2) extra protein intake alone increases outcomes of usual care treatment?

Detailed Description

Successful rehabilitation of the growing number of elderly citizens can lead to preservation of functional independence and improvement in the quality of life.

The aim of the study is to investigate the effect of an individually tailored physical exercise training program combined with increased protein intake in order to improve measures on all three ICF levels (International Classification of Functioning, Disability, and Health). By conducting the study in a real-life clinical setting, research is translated into practice involving health professionals and the target group in the development of new knowledge on how to enhance the outcome of rehabilitation, thereby increasing the overall capacity of the elderly citizen, and decreasing the expenditure of health-services.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria

All citizens that are referred to the health/rehabilitation center age 65 years and older from Slagelse municipality will be invited to a screening interview with a physiotherapist after which the participant will be asked to join the study if not subject to one of the following exclusion criteria's:

Exclusion Criteria
  • inability to speak or read Danish,
  • renal diseases,
  • active cancer,
  • upper or lower limp amputations,
  • milk/lactose allergy or intolerance,
  • hypertension >180/110,
  • pacemaker/other implanted electrical stimulants (due to Bio-Impedance Analysis),
  • progressive somatic or psychiatric diseases which can affect the course of training,
  • referred to rehabilitation primarily due to gynecological and neurological conditions (apoplexies) or surgeries where movement restrictions are recommended,
  • daily medication that may have an impact on muscle protein synthesis,
  • alcohol intake greater than 14 units per week,
  • discouragement from a general practitioner.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Usual CareUsual CareUsual care involves physiotherapeutic rehabilitation in an unknown format, and will, therefore, be monitored closely and described accordingly.
Individualized Physical Exercise Training with Protein Supl.Individualized Physical Exercise Training with Protein SupplementationThis group is also called EXER group, and will receive individually tailored physical exercise programs, based on their strength and weaknesses from the baseline testing.
Usual Care with Protein Supl.Usual Care with Protein SupplementationUsual care involves physiotherapeutic rehabilitation in an unknown format, and will, therefore, be monitored closely and described accordingly.
Primary Outcome Measures
NameTimeMethod
Short Musculoskeletal Function Assessment (SMFA) - Dysfunction IndexChange from: baseline to 3 months (primary endpoint) and 12 months

Self reported

Secondary Outcome Measures
NameTimeMethod
Balance and reaction time for upper and lower extremityChange from: baseline to 3 months and 12 months

Measures for balance and reaction time will be collected using the "Fysiometer," and the protocols within the "Fysiometer" software will be followed.

Mean change from baseline in function measured with the 2 minutes walk test (2MWT)Change from: baseline to 3 months and 12 months

The 2MWT will measure the distance (in meters) a person can walk in 2 minutes. Gaits speed will be calculated by dividing the covered distance with the time (120 seconds).

Mean change from baseline in mobility with The New Mobility ScoreChange from: baseline to 3 months and 12 months

The New Mobility Score assesses the patient's walking function inside, outside, and during shopping. Including whether a walking aid is used. The NMS provides a composed score of the participants' mobility. Each question is scored between 0-3 points, depending on the degree of help. The total possible score is between 0 and 9 points.

Mean change from baseline in health-related quality of life on SF-36Change from: baseline to 3 months and 12 months

The SF-36 is a generic questionnaire that measures health-related quality of life in the past four weeks. The questionnaire consists of 36 questions which are divided into eight sub-scales and summarized in 2 sum scores.

Mean change from baseline in the PRISMA-7 scoreChange from: baseline to 3 months and 12 months

The PRISMA-7 questionnaire is composed of seven items and is used to indicate frailty among participants - each question scores either 0 or 1 points. The total possible score is between 0 and 7 points.

Measure of pain, physical activity level and educational levelChange from: baseline to 3 months and 12 months

A survey with self-formulated questions regarding name, sex, personal ID (CPR number), educational level, the region of pain the last three months (marked on a body chart), pain intensity at the site of pain, and physical activity level will also be collected.

Mean change from baseline of Waist-To-Hip ratioChange from: baseline to 3 months and 12 months

The circumference of the waist (in centimeters) will be divided with the circumference of the hip (in centimeters) to report the Waist-to-hip ratio.

Mean change from baseline in the Tilburg Frailty Scale scoreChange from: baseline to 3 months and 12 months

The Tilburg Frailty Scale is a questionnaire with a bio-psycho-social approach, which measures frailty. It is composed of 15 multidimensional questions, regarding the physical, psychological, and social aspects of human functioning.

Scoring range is between 0-15 points.

Measure of height at baselineBaseline

Height (in meters). Weight and height will be combined to report BMI in kg/m\^2.

Mean change from baseline in blood pressureChange from: baseline to 3 months and 12 months

Systolic and diastolic blood pressure (mmHg) will be measured using the Omron HBP 1100 blood pressure and resting heart rate monitor.

Mean change from baseline in body composition measured with a bioimpedance deviceChange from: baseline to 3 months and 12 months

The electrical bioimpedance device used in the present study to measure changes in body composition is the "Tanita 9MC-780U Multi Frequency Segmental Body Composition Analyzer".

Lean body mass (in kilograms), fat percentage (described as a percentage of the total body mass), total body water (described as a percentage of the total body mass), a visceral fat indicator will be reported

Mean change from baseline in knee extension strengthChange from: baseline to 3 months and 12 months

Five repetitions maximum (RM) strength tests will be performed in knee extension (in kilograms) to calculate 1 RM.

Mean change from baseline in weightChange from: baseline to 3 months and 12 months

Weight (in kilograms). Weight and height will be combined to report BMI in kg/m\^2.

Mean change from baseline in resting heart rateChange from: baseline to 3 months and 12 months

Resting heart rate (in beats per minute) will be measured using the Omron HBP 1100 blood pressure and resting heart rate monitor.

Mean change from baseline in calf extension strengthChange from: baseline to 3 months and 12 months

Five repetitions maximum (RM) strength tests will be performed in the calf extension (in kilograms) to calculate 1 RM.

Mean change from baseline in The Borg Rating of Perceived Exertion before and after the 2 minutes walk test (2MWT)Change from: baseline to 3 months and 12 months

The Borg Rating of Perceived Exertion will be used to estimate the activity intensity before and right after the 2MWT.

Mean change from baseline in heart rate during 2 minutes walk test (2MWT)Change from: baseline to 3 months and 12 months

Heart rate (in BPM) will be measured (using the Apple Watch serie 5) before and right after the 2MWT.

Mean change from baseline in heart rate before and after the 2 minutes walk test (2MWT)Change from: baseline to 3 months and 12 months

Heart rate (in BPM) will be measured (using the Apple Watch serie 5) before and right after the 2MWT.

Mean change from baseline in function measured with the Timed Up and Go test (TUG)Change from: baseline to 3 months and 12 months

Time is noted (in seconds) on how long it takes to get up from a chair, walk 3 meters, turn around and go back to the chair and sit down again.

Mean change from baseline in the basic metabolic rate (BMR)Change from: baseline to 3 months and 12 months

BMR will be estimated by a bioelectrical impedance analysis device "Tanita 9MC-780U Multi Frequency Segmental Body Composition Analyze".

Mean change from baseline in maximal isometric voluntary contraction of leg extensionChange from: baseline to 3 months and 12 months

A maximal isometric voluntary contraction (in newtons) for knee extension will be performed using a strain gauge.

Mean change from baseline in handgrip strengthChange from: baseline to 3 months and 12 months

The handgrip strength (in kilograms) will be measured using a hydraulic handgrip dynamometer (SAEHAN).

Mean change from baseline in leg press strengthChange from: baseline to 3 months and 12 months

Five repetitions maximum (RM) strength tests will be performed in the leg press (in kilograms) to calculate 1 RM.

Mean change from baseline in balance measured with the Tandem testChange from: baseline to 3 months and 12 months

A measure of static balance will be performed using a Tandem test. The participants will be tested in three positions for 10 seconds each (feet together, semi tandem and full tandem). Time is noted (in seconds) for how long the participant can stand in each position.

Protein and energy intakeChange from: baseline, week 3, week 6, week 9, 3 months and 12 months

During the 12-week intervention period, protein and energy intake will be estimated based on the average of four 24-hour dietary recall interviews, either by home visits or by phone. Dietary interviews will also be conducted at 12 month follow-up.

Trial Locations

Locations (1)

Sundhed og Træning

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Slagelse, Zealand, Denmark

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