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Feasibility of Home-based Exercise Program for Adults With Cystic Fibrosis

Phase 2
Completed
Conditions
Cystic Fibrosis
Interventions
Diagnostic Test: Exercise
Registration Number
NCT05239611
Lead Sponsor
University of Kansas Medical Center
Brief Summary

The main objective of this clinical pilot study is to evaluate the feasibility and impact of a home-based exercise program on clinical and patient-centered outcomes in adult with cystic fibrosis (CF) and inform the design of a larger clinical trial.

Detailed Description

This pilot and feasibility study is a randomized controlled trial comparing exercise intervention with a usual care group. Participants will be randomized based on a randomization table developed by a biostatistician who is not involved in the study. The exercise intervention group will be delivered with a telehealth platform using internet (Zoom HIPAA-Compliant video), an app, phone, and email/text support. Participants will be randomly allocated to either an exercise coaching program or a usual care arm. The exercise intervention arm will follow guidelines established by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) and complement best clinical practices established by the American Thoracic Society/European Respiratory Society (ATS/ERS). The usual care arm will be provided a handout on resources for engaging in physical activity.

Aim 1. Examine the feasibility of a home-based Tele-rehab intervention. Indicators of feasibility will include recruitment and adherence. Hypothesis 1: Based on previous trials, the investigators predict that \>50% of eligible participants will consent to the study. Hypothesis 2: Again, based on previous trials, \>70% of participants in the intervention arm will adhere to \>70% of their weekly prescribed exercise. Also, the investigators will assess reasons for; 1) eligible patients who don't enroll, 2) participants' non-adherence, and 3) non-completers.

Aim 2. Evaluate the impact of a home-based exercise program in adults with CF for improving clinical and patient-centered outcomes. Hypothesis 1: There will be a greater improvement in exercise capacity (measured by a modified shuttle test), a novel measure of lung function 129Xenon MRI (129Xe MRI), forced expiratory volume in 1 second (FEV1), and quality of life with participants in the intervention arm when compared to usual care. Hypothesis 2: Changes in exercise capacity and 129Xe MRI will be associated with exercise adherence, as noted in Aim 1.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
21
Inclusion Criteria
  • cystic fibrosis patients 18 years of age and older, confirmed diagnosis of CF (two CF mutations or sweat chloride > 60 mmol/L)
  • stable while either on/off Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulator therapy and no plan to start/discontinue CFTR modulator therapy
  • clearance from their CF physician to participate in exercise
  • have access to the internet
  • not involved in an exercise intervention in the previous 6 months, and not performing structured exercise > 150 minutes per week.
Exclusion Criteria
  • pregnancy
  • history of solid organ transplant
  • active treatment for mycobacterial infections
  • significant untreated hypoxemia, oxygen dependent at rest or with exercise
  • FEV1 < 40% of predicted or clinical evidence of cor pulmonale
  • untreated arterial hypertension (resting systolic blood pressure >140 mm Hg, diastolic blood pressure > 90 mmHg)
  • systolic blood pressure less than 90 mm Hg while standing
  • congestive heart failure
  • active treatment for Allergic Bronchopulmonary Aspergillosis (ABPA)
  • acute upper or lower respiratory infection or pulmonary exacerbation within 4 weeks prior to Day 1
  • changes in therapy (including antibiotics) for pulmonary disease within 4 weeks prior to Day 1
  • significant hemoptysis within 4 weeks prior to Day 1 (≥ 5 mL of blood in one coughing episode or > 30 mL of blood in a 24 hour period
  • ongoing participation in an investigational drug study within 60 days prior to Day 1

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
exercise coachingExerciseParticipants will receive weekly coaching intervention
Primary Outcome Measures
NameTimeMethod
cardiorespiratory fitness assessment- Modified shuttle Walk test result3 months

completion of a modified shuttle walk test at enrollment and study completion

Ventilation defect percentage (VDP) as detected by 129Xenon MRI3 months

Hyperpolarized 129Xe ventilation MRI will be performed to assess VDP at baseline (within 2 weeks of initiation of study) and after completion of the intervention/usual care-control period

Secondary Outcome Measures
NameTimeMethod
Exercise time3 months

assess weekly adherence to prescribed exercise as percent prescribed exercise time completed

forced expiratory volume in 1 second3 months

lung function will be assessed at enrollment and study completion

quality of life assessment. Scale 0-100 (high score indicates better quality of life)3 months

completion of the Cystic Fibrosis questionnaire-revised (CFQR)

Trial Locations

Locations (1)

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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