Physical Activity Clinical Trial
— PREPAOfficial title:
Prevention Study, on Loss of Autonomy and Physical Dependence, Based on Physical Exercises and Nutrition Counseling Applied to 70 Years Old and More People.
NCT number | NCT03667664 |
Other study ID # | 69HCL16_0324 |
Secondary ID | |
Status | Recruiting |
Phase | N/A |
First received | |
Last updated | |
Start date | July 10, 2018 |
Est. completion date | July 2023 |
According to several reports, the percentage of persons aged of more than 80 years is going
to be doubled for the 25 years, to reach 10 % of the population. This implies an adaptation
of practices of taken care for elderly people. Furthermore, the expectancy of life without
any disability at 65 years old is 10.4 years and remains much lower than the general
expectancy of life, which is of 24.4 years for women and 19.1 years for men.
Among predictive factors of loss of autonomy, the loss of mobility and muscular weakness are
major components (OR=3.28 up to 3 years). These two factors are the origins for disabilities
being responsible of falls, fractures, which lead to quality of life diminution, and increase
of mortality.
The only components easily employed in a preventive manner and which have proved their
efficacy are physical exercise and nutrition. But programs nowadays are still not implemented
into primary taken care.
A multimodal program including these two components for patients at risk of loss of mobility
is an imperative of public health.
Status | Recruiting |
Enrollment | 400 |
Est. completion date | July 2023 |
Est. primary completion date | July 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 70 Years and older |
Eligibility |
Inclusion Criteria: - Elder people aged of = 70 years - With at least two of the following signs : - Difficulty to stand up from a chair without using arms - Difficulty to climb a floor (10 steps) - Difficulty to move, slow walk - Difficulty to walk more than 400 meters without any stop - Walk activity less than 1h per week - Tiredness whilst doing moderate physical activities : home cleaning, shopping - A least two falls during last year - Unintentional loss of weight: loss of = 5 % in one month, = 10 % in 6 months, or BMI< 21kg/m2 - Short Physical Performance Battery (SPPB) score < 10 or Hand Grip < 16 kg for women and< 26 kg for men Exclusion Criteria: - Patient unable to express his participation refusal and under curators or unforced by the court of justice - Locomotor disability - expectancy of life being under 12 months |
Country | Name | City | State |
---|---|---|---|
France | Service de Médecine Gériatrique Groupement Hospitalier Sud | Pierre-Bénite |
Lead Sponsor | Collaborator |
---|---|
Hospices Civils de Lyon |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Physical functional status | Physical functional status will be evaluated by the Short Physical Performance Battery (SPPB) tests. This is composite measurement. SPPB tests is described as follows: 3 tests scored from 1 to 4, then summed up in a global score : Gait speed test (over 6 m), in meter/sec, Stand-up chair test (time in seconds to perform 5 up an go sitting from a chair), Balance test (time in seconds to be able to maintain 3 different positions of standing up on balance position). This global score enables to have a global overview of functional status of an elderly person. Global score is scored at a maximum of 12. Score between 0 to 6 is considered being at risk of loss of mobility. An increase of 1 point after three months of practical exercises will be considered significant. |
At three months | |
Secondary | Physical performance : Hand grip test | Hand grip test measures the strength of the hand gripping the device as strong as possible, and strength is measured in kg. | At three months | |
Secondary | Knee extension test | The strength of extension muscle starting from the knee is measured from appropriate device, in kg. | At three months | |
Secondary | Body repartition during crossing an obstacle | The percentage of body repartition is evaluated between the right side and the left side of the body, whilst crossing of an obstacle. | At inclusion | |
Secondary | Time needed for crossing an obstacle | Time needed to cross the obstacle is measured | At inclusion | |
Secondary | Sitting/standing up alternance | Time in seconds is recorded to measure necessary time from the sitting position up to standing position. | At inclusion | |
Secondary | Body mass measurement by impedancemetry | Composition of body mass is evaluated through bio-impedancemetry. It is used to determine the amount of water, fat and muscle. Measurements are made by simply placing electrodes on the body, and recording the resistance of biological tissues by sending a sinusoidal current of low intensity (about a milliampere) and high frequency (10-100 kHz) through these electrodes. | At three months | |
Secondary | Body mass measurement by Dual Energy X-Ray Absorptiometry | Composition of body mass is evaluated through Dual Energy X-Ray Absorptiometry. Dual-energy X-ray absorptiometry is a means of measuring total body composition with a high degree of accuracy. Two X-ray beams, with different energy levels, are aimed at the patient's bones. This technic uses a very small dose of ionizing radiation to produce pictures of the inside of the body. | At three months | |
Secondary | Nutrition | Evolution of Body Weight is measured in kg | At inclusion, three, six and twelve months | |
Secondary | Functionality | Katz scores ( ADL : Activities of daily living) This validated scale requires 3 evaluations spread over time. A score > 6 indicates an addiction. Useful for assessing the patient's state of functional autonomy and deciding on appropriate aids (meals at home, household helper, life support, legal protection). |
At inclusion, three and twelve months | |
Secondary | Functionality | Lawton scores (IADL - Instrumental Activities of Daily Living) | At inclusion, three and twelve months | |
Secondary | Echography of Muscles | Echography constitutes a method of choice in the evaluation of muscular structures. Ultrasound is used there as a screening tool for clinicians to assess/prevent physical decline during hospitalization. A good anatomical knowledge of the weakness sites, as well as knowledge of traumatic signs and symptoms is essential in order to deliver a precise report. Muscle architecture of lower and upper limbs will be collected with an echography. Pennation angle (PA), muscle thickness (MT), and fiber length (all measured in mm) and Skeletal Muscle Index Report (muscle mass of the 4 limbs squared to the waist) will be measured/calculated there. | At inclusion, three, six and twelve months | |
Secondary | Falls | Frequency of falls will be recorded at these different times, when these one will be considered as being traumatic falls, and/or conducting to hospitalizations or admissions in institutions. | At inclusion, 4 weeks, three, six, twelve months |
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