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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT03582982
Other study ID # 01903
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date May 16, 2018
Est. completion date February 1, 2020

Study information

Verified date November 2018
Source Washington D.C. Veterans Affairs Medical Center
Contact Jared M Gollie, PhD
Phone 202-745-8000
Email Jared.Gollie@va.gov
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Among Veterans, the prevalence of chronic kidney disease (CKD) is reported to be as high as 47.3% and a third higher than the general population. Muscle wasting and dysfunction have been identified as primary consequences of CKD. Disease-induced reductions in lean tissue adversely affect muscle fatigability. Consequently, muscle fatigability may serve as a potential limiting factor that contributes to activity limitations. However, there is a lack of evidence informing our understanding of muscle fatigability in patients with CKD. Dialysis treatment is a major factor contributing to the high financial costs of CKD care. Thus, in addition to potential health and quality of life benefits, treatments capable of maintaining kidney function or delaying the onset of dialysis treatment would provide substantial socio-economic benefit. Both lean body mass and muscle fatigability may be improved through strength training. Eccentric-overload (i.e. muscle lengthening) progressive resistance exercise (PRE) has been shown to be safe and effective for a variety of chronic conditions. Eccentric PRE using portable flywheel technology may provide a clinically viable treatment option to combat muscle impairments in CKD given the cost effectiveness and minimal space requirements for this mode of exercise.

The purpose of this study is to assess feasibility of the eccentric-overload PRE regimen for Veterans with CKD stage 3 & 4 predialysis using a prospective single-arm pre-test post-test intervention design. The primary aim of the project is to determine the effects of eccentric-overload PRE on muscle fatigability in Veterans with CKD Stages 3 & 4 predialysis. Feasibility of the regimen will be determined by the time needed to complete the 4-exercise regimen and the perceived exertion levels reported by the study participants.


Recruitment information / eligibility

Status Recruiting
Enrollment 20
Est. completion date February 1, 2020
Est. primary completion date February 1, 2019
Accepts healthy volunteers No
Gender All
Age group 18 Years to 84 Years
Eligibility Inclusion Criteria:

- ambulatory patients (with or without a gait aid)

- CKD stage 3 or 4

- patients receiving care at the DC VAMC Renal Service

- the ability to speak and read English

- orientation to person, place, and time

Exclusion Criteria:

- unable to speak English

- acute renal failure

- pregnant

- unable to follow study instructions

- any uncontrolled cardiovascular or musculoskeletal problems that would make participation in this study unsafe

Study Design


Intervention

Behavioral:
Eccentric overload exercise
12 weeks of 2x per week of the following eccentric exercises: squat, shoulder press, row, and bicep curl.

Locations

Country Name City State
United States Washington DC VA Medical Center Washington District of Columbia

Sponsors (1)

Lead Sponsor Collaborator
Washington D.C. Veterans Affairs Medical Center

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in Knee extensor isokinetic muscle fatigability index at 12 weeks Knee extensor muscle fatigability will be assessed using a protocol consisting of 30 repetitions or to failure, whichever comes first, at their maximum strength Baseline, Week 12
Primary Change in Muscle blood flow at 12 weeks Blood flow will be assessed using Doppler ultrasound Baseline, Week 12
Primary Change in Isokinetic and isometric peak knee extension force at 12 weeks Unilateral peak knee extension/flexion isokinetic force (at 180º/s and 60º/s) will be obtained across five continuous repetitions using a load cell Baseline, Week 6, Week 12
Primary Change in Short Physical Performance Battery at 12 weeks This composite score is made up of measures of balance, gait speed (15 ft), and timed chair stands (x5). Baseline, Week 12
Primary Change in Timed Up-and-Go at 12 weeks This test will begin the test with the subject fully sitting in a chair with arm rests, with the upright mobility portion of the test focused on an easily visible marked target 3 meters away from the chair Baseline, Week 12
Primary Change in Lean Body Mass, as estimated by diagnostic ultrasound at 12 weeks Sonographic estimates of LBM (aggregate muscle thickness, cm) will serve as a proxy measure for muscle tissue composition in this study Baseline, Week 6, Week 12
Primary Change in myosteatosis, as estimated by diagnostic ultrasound at 12 weeks Sonographic estimates of myosteatosis (grayscale, or GSL, values, 0-255) will serve as a proxy measure for muscle tissue composition in this study Baseline, Week 6, Week 12
Secondary Change in Grip strength at 12 weeks This measure will be obtained with a hand grip dynamometer using the mean value of 3 trials under standardized conditions. Baseline, Week 12
Secondary Change in Activities-Specific Balance Confidence (ABC) Scale at 12 weeks mobility questionnaire; range 0-100, with higher values indicating higher confidence Baseline, Week 12
Secondary Change in Short Form Health Survey (SF-36) Scale at 12 weeks general physical functioning questionnaire; each of eight sections range 0-100 with higher values indicating less disability. The eight sections include vitality, physical functioning, bodily pain, general health perceptions, physical role functioning, emotional role functioning, social role functioning, and mental health. Baseline, Week 12
Secondary Change in Falls Efficacy Scale (FES) at 12 weeks fall avoidance behavior questionnaire; range 10-100, with lower values indicating greater efficacy Baseline, Week 12
Secondary Change in weight at 12 weeks Weight (in lbs) using bioelectric scale Baseline, Week 6, Week 12
Secondary Change in height at 12 weeks Height (in inches) using stadiometer Baseline, Week 6, Week 12
Secondary Change in body water at 12 weeks Body water (%) using bioelectric scale Baseline, Week 6, Week 12
Secondary Change in Blood Pressure at 12 weeks After sitting quietly for 5 minutes, resting blood pressure will be recorded in triplicate Baseline, Week 12
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