COPD Clinical Trial
Official title:
Investigation of Clinical Tolerance, Cardio-respiratory Response and Muscle Fatigue During Electrostimulation
The study was designed to test the following hypothesis
Patients with high cardio-respiratory response to electrostimulation (ES), high perception
of pain during ES and high ES-induced muscle fatigue, have low tolerance to ES (more
difficulties to increase intensity during training).
Background: Muscle electrostimulation (ES) appears as a promising alternative to general
physical reconditioning in advanced COPD and its feasibility has been confirmed in this
population. However, patients are not equal in tolerance to ES. Certain patients are not
able to increase ES intensity during training, limiting its benefits. Furthermore, little is
known about the effect of one ES training session on cardio-respiratory response, muscle
fatigue and systemic inflammation in COPD patients.
Objective: To evaluate the tolerance to ES in COPD patients and to identify the
physiological parameters involved in ES tolerance.
Method: We propose to conduct a prospective study including 21 COPD patients of different
pulmonary severity (7 in each group of GOLD II, III and IV). Patients will be evaluated 3
times: at day 1, day 2 and day 9. In the first session, patients will be initiated to ES and
evaluated in walking distance. In the second session, patients will become autonomous with
ES and they will be evaluated in muscle strength and body composition. In the third session,
cardio-respiratory measurements will be performed during ES and patients will be evaluated
in muscle strength and systemic inflammation (blood sampling) before and after ES. Between
the 2d and the 3d sessions, patients will have to perform 5 ES sessions at home (from day 3
to day 8). Tolerance (symptoms assessed with visual analogical scale (VAS)) and intensity of
ES will be measured during each ES session.
Planning analysis: The main outcome will be the change in ES intensity between session 2 and
3 (delta intensity). The other end-points will be minute ventilation, heart rate, VO2 and
SaO2 during ES, but also change in ES tolerance (VAS) during ES at equal ES intensity, leg
muscle fatigue after ES, body composition and changes in plasmatic proteins after ES. Simple
and multiple regressions analysis will be done between delta intensity and
1/cardio-respiratory response during ES, 2/muscle fatigue after ES, 3/body composition,
4/perception of pain at session 2 (VAS), 5/changes in plasmatic proteins after ES.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Screening
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