Hot Flashes Clinical Trial
Official title:
WHAT - Effectiveness of Physical Activity for Treatment of Hot Flushes Among Postmenopausal Women. A Randomized Controlled Pragmatic Pilot Study
More than 60 % of women experience hot-flashes during postmenopausal and 20 % have serious
symptoms. Use of combined estrogen/progesterone therapy reduces hot-flashes effectively. In
2001, results from the randomized controlled WHI-study (Womens Health Initiative) showed
increased risk for breast cancer and hearth-disease among users of combined
estrogen/progesterone therapy. This reduced the use of combined estrogen/progesterone
therapy. Many women seek alternative treatment for hot-flashes. They are often told that
physical activity can reduce intensity and frequency of hot-flashes. The evidence for this
advice is sparse.
The primary hypothesis tested in the WHAT-study will be: Increased physical activity reduce
frequency and intensity of hot-flushes among sedentary postmenopausal women with bothersome
hot-flushes.
The WHAT-study is designed as a pragmatic randomized controlled clinical trial. To answer the
primary hypothesis we will need approximately 500 participants. The logistic in a pragmatic
trial of a complex intervention are complicated and we decided to first run a pilot study
with 50 participants as a feasibility study. The pilot gives us opportunity to gain
experience with possible problems like withdrawals and injuries.
The WHAT study is a pragmatic randomized controlled trial with two parallel arms. The
intervention is a 16 weeks individually tailored training programme with one hour physical
activity 2-3 times per week. Women randomized to the control group are asked to keep physical
activity at the same level as before the study.
Healthy postmenopausal women from Tromso will be recruited to the study by newspaper
advertisements and media coverage. Interested women are asked to make a call. A staff member
will ask about menopausal status, level of physical activity and diseases. Potential
participants will receive a diary by mail and will be asked to record frequency and severity
of hot-flashes, and duration of sleep at night for a period of 14 days. Women who return this
diary will be asked to sign the informed consent and complete a questionnaire, before the
fitness test. Baseline fitness is an important measure in this study. We will measure VO2-max
(maximal oxygen consumption) as a proxy for fitness. Whether you are randomized to
intervention or control group can influence the fitness test. The participants will therefore
be randomized after the fitness test.
Randomization: Unit of Applied Clinical Research, Institute of Cancer Research and Molecular
Medicine, Norwegian University of Science and Technology, Trondheim, Norway, will develop and
administrate a web-based randomization system for the WHAT pilot study. The data base will be
located at a server at the Medical Faculty at Norwegian University of Science and Technology
in Trondheim. The following staff are authorized to randomize people in WHAT pilot study:
Sameline Grimsgaard, Merethe Kumle, Sissel Andersen , Jorid Degerstrøm, Svein Arne Pettersen
In this pilot 50 women will be randomized either to intervention group (25 women) or control
group (25 women).
Elements in the intervention: A physiotherapist will based on interview and physical
examination make a plan for the 16 weeks physical activity programme for each participant.
The program will start with Pilates classes and low intensity aerobic training (2-4 weeks).
After this period, classes with moderate to high intensity aerobic training will be
introduced. The aim of the intervention is to increase aerobic capacity with 10 % from
baseline.
Both the intervention group and the control group will receive questionnaires at baseline, 4
weeks, 8 weeks, 12 weeks, 16 weeks, 6 months and 1 year after inclusion. We will run the test
for physical fitness at baseline and 16 weeks.
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