Effects of a 6-months Partially Supervised Conditioning Program in CF (ACTIVATE-CF)
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Purpose
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 6-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 this intervention after 6 months of standardized care. Should this relatively simple program prove successful, this will be made available on a wider scale internationally.
| Condition | Intervention | Phase |
|---|---|---|
|
Cystic Fibrosis |
Behavioral: Exercise Intervention |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Effects of a 6-months Partially Supervised Conditioning Program in CF: an International Multi-centre, Randomized Controlled Trial |
- 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. [ Time Frame: baseline and 6 months ] [ Designated as safety issue: No ]
- Change in peak oxygen uptake (%predicted) [ Time Frame: baseline, 3 and 6 months ] [ Designated as safety issue: No ]
- Change in maximal aerobic power (%predicted) [ Time Frame: baseline, 3 and 6 months ] [ Designated as safety issue: No ]
- Change in measured steps per day [ Time Frame: baseline, 3 and 6 months ] [ Designated as safety issue: No ]
- Change in exercise steps per day [ Time Frame: baseline, 3 and 6 months ] [ Designated as safety issue: No ]
- Change in reported physical activity [ Time Frame: baseline, 3 and 6 months ] [ Designated as safety issue: No ]
- Change in forced expiratory volume in 1 second (FEV1; %predicted) [ Time Frame: 6 to 12 months ] [ Designated as safety issue: No ]
- Change in forced vital capacity (FVC; % predicted) [ Time Frame: baseline, 3 and 6 months ] [ Designated as safety issue: No ]
- Change in residual volume in percent of total lung capacity (RV/TLC; %) [ Time Frame: baseline, 3 and 6 months ] [ Designated as safety issue: No ]
- Time to first exacerbation [ Time Frame: baseline to 12 months ] [ Designated as safety issue: No ]
- Number of upper respiratory tract infections [ Time Frame: baseline to 6 months ] [ Designated as safety issue: No ]from diary
- Days on additional oral / intravenous antibiotics [ Time Frame: baseline to 6 months ] [ Designated as safety issue: No ]from questionnaire
- Change in body mass index (kg/m2) [ Time Frame: baseline and 6 months ] [ Designated as safety issue: No ]
- Change in muscle mass (kg) [ Time Frame: baseline and 6 months ] [ Designated as safety issue: No ]estimated from skinfold thickness
- Change in percent body fat [ Time Frame: baseline and 6 months ] [ Designated as safety issue: No ]estimated from skinfold thickness
- Change in Quality of Life scales [ Time Frame: baseline to 6 months and baseline to 12 months ] [ Designated as safety issue: No ]from the revised Cystic Fibrosis health-related quality of life Questionnaire (CFQ-R questionnaire)
- Change in depression, anxiety and stress scores [ Time Frame: baseline to 6 months and baseline to 12 months ] [ Designated as safety issue: No ]from Depression Anxiety Stress Scales
- Change in plasma glucose concentrations 1 and 2 hours after a standardized glucose load [ Time Frame: baseline and 6 months; 6 months and 12 months ] [ Designated as safety issue: No ]standardized oral glucose tolerance test only patients without diabetes mellitus
- Adverse events possibly or likely related to exercise [ Time Frame: baseline to 6 and to 12 months ] [ Designated as safety issue: Yes ]causality as judged by investigator
- Severe adverse events [ Time Frame: baseline to 6 and to 12 months ] [ Designated as safety issue: Yes ]
- Serious adverse events [ Time Frame: baseline to 6 and to 12 months ] [ Designated as safety issue: Yes ]
- Compliance with the exercise goal [ Time Frame: baseline to 6 and 12 months ] [ Designated as safety issue: No ]based on questionnaire and diary
| Estimated Enrollment: | 292 |
| Study Start Date: | July 2013 |
| Estimated Study Completion Date: | July 2015 |
| Estimated Primary Completion Date: | July 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Exercise Intervention
Add 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.
|
Behavioral: Exercise Intervention
Add 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.
|
|
No Intervention: Control
Keep activity level constant
|
Eligibility| Ages Eligible for Study: | 12 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
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
Contacts and Locations| Contact: Helge U Hebestreit, Prof. Dr. | +49 931 201 27728 | hebestreit@uni-wuerzburg.de |
| Germany | |
| Children´s Hospital of the University | |
| Würzburg, Bavaria, Germany, 97080 | |
More Information
Additional Information:
No publications provided
| Responsible Party: | Prof. Helge Hebestreit, Professor Dr. med., Wuerzburg University Hospital |
| ClinicalTrials.gov Identifier: | NCT01744561 History of Changes |
| Other Study ID Numbers: | ACT-CF-001 |
| Study First Received: | December 5, 2012 |
| Last Updated: | December 5, 2012 |
| Health Authority: | Germany: Ethics Commission |
Keywords provided by Wuerzburg University Hospital:
|
Exercise Motivation Feedback web-based diary pedometer |
Additional relevant MeSH terms:
|
Cystic Fibrosis Fibrosis Pancreatic Diseases Digestive System Diseases Lung Diseases |
Respiratory Tract Diseases Genetic Diseases, Inborn Infant, Newborn, Diseases Pathologic Processes |
ClinicalTrials.gov processed this record on June 17, 2013