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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT04617119
Other study ID # JALGHAITH
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date November 1, 2020
Est. completion date April 6, 2021

Study information

Verified date November 2020
Source Ministry of Health, Kuwait
Contact Jassim M Alghaith, PhD.
Phone (965)99558185
Email Alghaith328@gmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study aims to evaluate the effectiveness of respiratory muscle training with COVID-19 patient, who has underlying health conditions, in order to delay or prevent them from admitting to ICU.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 38
Est. completion date April 6, 2021
Est. primary completion date February 6, 2021
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 21 Years to 60 Years
Eligibility Inclusion Criteria: - Non- intubated patient diagnosed with moderate to severe pneumonia (confirmed by chest x-ray and officially reported) as secondary to COVID-19 with one more symptom such as: 1. Respiratory rate at = 20 breath.min-1. 2. Oxygen saturation (SatO2) = 90% at rest on room air. 3. Arterial partial pressure of oxygen (PaO2) = 80 mmHg at resting. 4. PaO2/FiO2 ratio or P/F (is the ratio between the arterial partial pressure of oxygen and the percentage of oxygen supplied) < 300mmHg. Exclusion Criteria: 1. Patient that has received upper abdominal or thoracic surgery recently (= 3 months). 2. Cancer patients. 3. Pregnant patients. 4. Patient mentally unstable. 5. Patient with unstable cardiovascular or neurological functions. 6. Patients refusing to participate in this clinical trial. 7. Patient less the 21 years old (According to Kuwaiti Law). 8. Patients who have a language barrier who cannot understand Arabic or English.

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Threshold IMT device
10 breaths X 3 sets, two times a day for 2 weeks. starting intensity 10 % of pre-measured maximal inspiratory pressure.
Other:
Conventional physical therapy
daily

Locations

Country Name City State
Kuwait Jaber Al-Ahmed Hospital Kuwait city

Sponsors (1)

Lead Sponsor Collaborator
DR. JASSIM ALGHAITH

Country where clinical trial is conducted

Kuwait, 

References & Publications (26)

Alderson LM, Joksaite SX, Kemp J, Main E, Watson T, Platt FM, Cortina-Borja M. Age-related gait standards for healthy children and young people: the GOS-ICH paediatric gait centiles. Arch Dis Child. 2019 Aug;104(8):755-760. doi: 10.1136/archdischild-2018-316311. Epub 2019 Mar 25. — View Citation

Almazeedi S, Al-Youha S, Jamal MH, Al-Haddad M, Al-Muhaini A, Al-Ghimlas F, Al-Sabah S. Characteristics, risk factors and outcomes among the first consecutive 1096 patients diagnosed with COVID-19 in Kuwait. EClinicalMedicine. 2020 Jul 4;24:100448. doi: 10.1016/j.eclinm.2020.100448. eCollection 2020 Jul. — View Citation

American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002 Aug 15;166(4):518-624. — View Citation

Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, Lee M. Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State. JAMA. 2020 Apr 28;323(16):1612-1614. doi: 10.1001/jama.2020.4326. — View Citation

Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, Greninger AL, Pipavath S, Wurfel MM, Evans L, Kritek PA, West TE, Luks A, Gerbino A, Dale CR, Goldman JD, O'Mahony S, Mikacenic C. Covid-19 in Critically Ill Patients in the Seattle Region - Case Series. N Engl J Med. 2020 May 21;382(21):2012-2022. doi: 10.1056/NEJMoa2004500. Epub 2020 Mar 30. — View Citation

Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med. 2020 Apr;8(4):e20. doi: 10.1016/S2213-2600(20)30117-X. Epub 2020 Mar 11. Erratum in: Lancet Respir Med. 2020 Apr;8(4):e26. — View Citation

Cai Q, Chen F, Wang T, Luo F, Liu X, Wu Q, He Q, Wang Z, Liu Y, Liu L, Chen J, Xu L. Obesity and COVID-19 Severity in a Designated Hospital in Shenzhen, China. Diabetes Care. 2020 Jul;43(7):1392-1398. doi: 10.2337/dc20-0576. Epub 2020 May 14. — View Citation

Cascella, M., et al., Features, evaluation and treatment coronavirus (COVID-19), in Statpearls [internet]. 2020, StatPearls Publishing.

Castro AA, Calil SR, Freitas SA, Oliveira AB, Porto EF. Chest physiotherapy effectiveness to reduce hospitalization and mechanical ventilation length of stay, pulmonary infection rate and mortality in ICU patients. Respir Med. 2013 Jan;107(1):68-74. doi: 10.1016/j.rmed.2012.09.016. Epub 2012 Oct 22. — View Citation

Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jeric K, Hróbjartsson A, Mann H, Dickersin K, Berlin JA, Doré CJ, Parulekar WR, Summerskill WS, Groves T, Schulz KF, Sox HC, Rockhold FW, Rennie D, Moher D. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013 Feb 5;158(3):200-7. doi: 10.7326/0003-4819-158-3-201302050-00583. — View Citation

Chiappa GR, Roseguini BT, Vieira PJ, Alves CN, Tavares A, Winkelmann ER, Ferlin EL, Stein R, Ribeiro JP. Inspiratory muscle training improves blood flow to resting and exercising limbs in patients with chronic heart failure. J Am Coll Cardiol. 2008 Apr 29;51(17):1663-71. doi: 10.1016/j.jacc.2007.12.045. — View Citation

Dimitriadis Z, Kapreli E, Konstantinidou I, Oldham J, Strimpakos N. Test/retest reliability of maximum mouth pressure measurements with the MicroRPM in healthy volunteers. Respir Care. 2011 Jun;56(6):776-82. doi: 10.4187/respcare.00783. Epub 2011 Feb 9. — View Citation

Edwards AM, Maguire GP, Graham D, Boland V, Richardson G. Four weeks of inspiratory muscle training improves self-paced walking performance in overweight and obese adults: a randomised controlled trial. J Obes. 2012;2012:918202. doi: 10.1155/2012/918202. Epub 2012 Jun 26. — View Citation

Ferraro FV, Gavin JP, Wainwright T, McConnell A. The effects of 8 weeks of inspiratory muscle training on the balance of healthy older adults: a randomized, double-blind, placebo-controlled study. Physiol Rep. 2019 May;7(9):e14076. doi: 10.14814/phy2.14076. — View Citation

Gosselink R, De Vos J, van den Heuvel SP, Segers J, Decramer M, Kwakkel G. Impact of inspiratory muscle training in patients with COPD: what is the evidence? Eur Respir J. 2011 Feb;37(2):416-25. doi: 10.1183/09031936.00031810. Review. — View Citation

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28. — View Citation

Honce R, Schultz-Cherry S. Impact of Obesity on Influenza A Virus Pathogenesis, Immune Response, and Evolution. Front Immunol. 2019 May 10;10:1071. doi: 10.3389/fimmu.2019.01071. eCollection 2019. Review. — View Citation

Jalan NS, Daftari SS, Retharekar SS, Rairikar SA, Shyam AM, Sancheti PK. Intra- and inter-rater reliability of maximum inspiratory pressure measured using a portable capsule-sensing pressure gauge device in healthy adults. Can J Respir Ther. 2015 Spring;51(2):39-42. Erratum in: Can J Respir Ther. 2015 Summer;51(3):72. — View Citation

Laveneziana P, Albuquerque A, Aliverti A, Babb T, Barreiro E, Dres M, Dubé BP, Fauroux B, Gea J, Guenette JA, Hudson AL, Kabitz HJ, Laghi F, Langer D, Luo YM, Neder JA, O'Donnell D, Polkey MI, Rabinovich RA, Rossi A, Series F, Similowski T, Spengler CM, Vogiatzis I, Verges S. ERS statement on respiratory muscle testing at rest and during exercise. Eur Respir J. 2019 Jun 13;53(6). pii: 1801214. doi: 10.1183/13993003.01214-2018. Print 2019 Jun. Review. — View Citation

Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020 Apr 14;323(14):1335. doi: 10.1001/jama.2020.4344. — View Citation

Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020 Apr 11;395(10231):1225-1228. doi: 10.1016/S0140-6736(20)30627-9. Epub 2020 Mar 13. Review. — View Citation

Sood A. Altered resting and exercise respiratory physiology in obesity. Clin Chest Med. 2009 Sep;30(3):445-54, vii. doi: 10.1016/j.ccm.2009.05.003. Review. — View Citation

Souza H, Rocha T, Pessoa M, Rattes C, Brandão D, Fregonezi G, Campos S, Aliverti A, Dornelas A. Effects of inspiratory muscle training in elderly women on respiratory muscle strength, diaphragm thickness and mobility. J Gerontol A Biol Sci Med Sci. 2014 Dec;69(12):1545-53. doi: 10.1093/gerona/glu182. — View Citation

WHO, CORONAVIRUS DISEASE (COVID-19) OUTBREAK: RIGHTS, ROLES AND RESPONSIBILITIES OF HEALTH WORKERS, INCLUDING KEY CONSIDERATIONS FOR OCCUPATIONAL SAFETY AND HEALTH 2020.

Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648. — View Citation

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3. Epub 2020 Mar 11. Erratum in: Lancet. 2020 Mar 28;395(10229):1038. Lancet. 2020 Mar 28;395(10229):1038. — View Citation

* Note: There are 26 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Changes in Respiratory muscle performance Changes in Respiratory muscle performance will be determined by using the Respiratory Pressure Meter device. Patient will perform full inspiration through this device for 1.5 seconds via the mouth (nose occluded). The reading of the negative peak pressure that is maintained for 1 second in the device is a maximal inspiration peak. Baseline, 1st week, 2nd week, one month
Secondary Blood pressure Blood pressure measured by electronic BP machine before and after session Daily from baseline to hospital discharge (2 weeks)
Secondary Heart rate measured by heart rate monitor before and after session Daily from baseline to hospital discharge (2 weeks)
Secondary Oxygen saturation Measured by pulse oximeter before and after session Daily from baseline to hospital discharge (2 weeks)
Secondary Oxygen supplementation Number of % of oxygen patient on it before and after session Daily from baseline to hospital discharge (2 weeks).
Secondary Oxygen flow rate measuring the number of time where the oxygen above or below 4L/min. Daily from baseline to hospital discharge (2 weeks)
Secondary Dyspnoea level By using Borg scale (rating of perceived exertion scale), Possible score range from 0 (nothing) to 10 ( Maximal exertion).
Before and after session.
Daily from baseline to hospital discharge (2 weeks)
Secondary Pain level By using visual analogue scale. Possible score range from 0 (no pain) to 10 (worst possible pain) Before and after session. Daily from baseline to hospital discharge (2 weeks)
Secondary Respiratory rate Measured by Respiratory rate monitor. Before and after session Daily from baseline to hospital discharge (2 weeks)
Secondary Threshold IMT device Recording number for breath and sets daily. Daily from baseline to 1 month from admission
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