Obesity Clinical Trial
Official title:
Comparison of 3 Exercise Training Modalities in Obese Patient With Sleep Apnea Syndrome Treated by Continue Positive Airway Pressure : a Randomized Controlled Study
The study was designed to test the following hypotheses:
In obese patients with OSAS, the benefit of the combination of exercise training + continuous
positive airway pressure (CPAP) will be higher than CPAP alone in term of functional
capacity, metabolic, inflammatory, cardiovascular and sleep parameters and quality of life.
In obese patients with OSAS, the benefit of training using ventilatory assistance (NIV)
during cycloergometer [cycloergometer with NIV] or respiratory muscles training (spirotiger)
in addition to cycloergometer [cycloergometer + spirotiger] will be higher than
cycloergometer training alone [cycloergometer] in term of functional and exercise capacities.
Dyspnea during walking test and respiratory muscle strength at baseline could influence the
response to combined exercise training such as [cycloergometer + NIV] or [cycloergometer +
spirotiger]
Background: Obesity and sleep apnea syndrome lead to metabolic troubles and increasing
cardiovascular risk. Furthermore, both diseases are associated with reduced exercise
tolerance. We hypothesized that exercise training could be complementary to nocturnal
ventilatory treatment in restoring metabolic disturbances, exercise tolerance and sleep
parameters in obese patients with SAS.
Objective: To evaluate the effect of training on exercise tolerance (walking distance and
dyspnea during walk)(main objective), systemic inflammation, vascular endothelial function,
insulin resistance, quality of sleep and quality of life in obese patients treated by CPAP
for OSAS (secondary objectives)
Methods: We proposed to conduct a controlled, randomized clinical trial comparing the
efficacy of 3 different modalities of training in obese patients with SAS. After a 6-week
control pre-inclusion period, patients are included in either [cycloergometer] vs.
[cycloergometer with ventilatory assistance] vs. [cycloergometer + respiratory muscle
exercises]. Before and after the control period, and both immediately and 9 month after
training, patients perform walking test, maximal incremental test on cycloergometer, blood
sampling and cardiovascular function, body composition, muscle function, quality of sleep and
quality of life assessments as well as spontaneous physical activity measurement. During the
5 years following inclusion in the training program, the number of cardiovascular event is
recorded every year.
An interim analysis will be carried out when 30 will have completed the third evaluation
session (after the training program). The Peto's method will be used to correct the p-values.
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