Cystic Fibrosis Clinical Trial
Official title:
The 1-minute-sit-to-stand Test is Practical to Assess and Follow the Muscle Weakness in Cystic Fibrosis.
The investigators know that peripheral muscle weakness and exercise intolerance are prevalent
(56%) in cystic fibrosis (Trooster et al, 2009). Physical inactivity is likely to be an
important underlying factor. Those conditions are associated with a poor prognosis (Nixon et
al, 1992). The effect of intravenous antibiotherapy on peripheral muscle and physical
activity remains unclear.
The aim of the study is to evaluate the impact of intravenous antibiotherapy on peripheral
muscular strength in patients with cystic fibrosis (adults and children) who receive
intravenous antibiotherapy for an acute exacerbation or electively (decline in lung function
without exacerbation).
Background Peripheral muscle weakness and exercise intolerance are prevalent (56%) in cystic
fibrosis (Trooster et al, 2009). Physical inactivity is likely to be an important underlying
factor. Those conditions are associated with a poor prognosis (Nixon et al, 1992). The effect
of intravenous antibiotherapy on peripheral muscle and physical activity remains unclear.
Wieboldt et al showed that quadriceps strength at the hospital admission for an exacerbation
was lower than before and one month after hospitalisation while Burtin et al showed that
individual changes in quadriceps force were correlated with daily time spent activities of at
least moderate intensity (Wieboldt et al, 2012; Burtin et al, 2013). The effect of
intravenous antibiotherapy itself is poorly known in cystic fibrosis. Moreover, they did not
study the impact on muscular strength of hospitalisation versus home treatment. In contrast,
in COPD, it is well known that exacerbations are associated with a decline of muscle mass and
strength and that repeated exacerbations lead to a more rapid decrease in fat free mass
(Spruit et al, 2003; Jones et al, 2015; Joppa et al, 2016).
Hypothesis We think that exacerbations aggravate factors underlying muscle weakness as
physical inactivity, systemic inflammation and anabolic status. Moreover, hospitalisation
itself might be a reason of inactivity as patients spent all the day inside their room
compared to patients who follow their treatment at home and continue their usual life.
Aim The aim of our study is to evaluate the impact of an intravenous antibiotherapy on
peripheral muscular strength in patients with cystic fibrosis.
Methods We would compare patients (adults and children) who receive intravenous
antibiotherapy for an acute exacerbation, with patients who receive elective intravenous
antibiotherapy (decline in lung function without exacerbation). We will also compare
hospitalised patients who receive specific exercise training, with patients who follow their
antibiotherapy at home without specific exercise training. We will have a stable patients
group as control. To evaluate muscular strength we plan to measure quadriceps force at the
beginning of the cure and at the end with a functional test, the 1-minute Sit-to-Stand test
and a strength (isometric) test, with the Microfet2dynamometer. Those test are not invasive,
easy to realise and have already been used in other studies (Ozalevli, 2005). We will
quantify the physical activity level of the patients with an accelerometer that they will
carry during 72 hours, during the first week of the treatment.
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