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Heart FailureNCT01695421

The Effect of a Five Week Electrical Myostimulation Program in Chronic Diseases

A study testing Medium-frequency alternating current, Burst-modulated alternating current and Functional electrical stimulation in people with Heart Failure, run by University of Brasilia at 1 site in Brazil.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Patients afflicted with Chronic Heart Failure (HF) typically do not maintain stable cardiac function for the remainder of their life and consequently require continuous medical management and intermittent hospital admissions. Read more about this study

Who is it for?
Ages 21 to 80 years
Conditions the study is for
Heart Failure
What is being tested?
Medium-frequency alternating current, Burst-modulated alternating current and Functional electrical stimulation
Type of treatment
Surgery or procedure
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteBrazil
Study dates
Nov 2012to Jul 2015
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • (1) Male or female ≥ 21 and ≤ 80 years of age.
  • (2) Current HF symptoms consistent with NYHA class III-IV.
  • (3) On stable HF pharmacological therapy for at least one month prior to data collection.
  • (4) Left ventricular ejection fraction < 45% documented within 3 months of enrollment (obtained from subjects medical records).
  • (5) No planned elective surgery or pacemaker implantation at the time of study initiation.
  • (6) Hgb > 8.0 within 1 month of enrollment (obtained from subjects medical records).
  • (7) Willingness to provide written informed consent.

Who cannot join

  • (1) Inability to provide written informed consent.
  • (2) Inability to walk on a treadmill.
  • (3) Hemodynamically significant valvular heart disease.
  • (4) Unstable angina.
  • (5) Acute myocardial infarction within the previous 3 months.
  • (6) Obstructive hypertrophic cardiomyopathy.
Show all 15Show fewer
  • (7) HF known to be secondary to pericardial disease or uncorrected valvular disease.
  • (8) Chronic oxygen therapy.
  • (9) Participation in another clinical trial within the past 30 days.
  • (10) Participation in a regular exercise within the previous 6 months.
  • (11) Previous implantation of a cardiac pacemaker or defibrillator.
  • (12) Pregnancy.
  • (13) Resting systolic blood pressure > 200 mmHg.
  • (14) Failure to demonstrate the ability to operate the EMS unit.
  • (15) Failure to be compliant with at least 75% of the EMS training sessions.

Trial locations and contacts

1 site in 1 country.

Gerson Cipriano Junior, PhD contact

+556181907111

cipriano@unb.br

Brazil1 site, 1 recruiting
  • Brasilia University

    Brasília, Federal District, 72220-140

    Gerson Cipriano Junior, PhD, +556181907111, cipriano@unb.br

    Laura Maria T Neves, Master, +5581431769, lmtomazi@gmail.com

    Recruiting

Other trials in Brazil

About this study

Official title: Soft-hard Technologies to Assistance and Accessibility in Patients With Chronic Diseases: The Effect of a Five Week Electrical Myostimulation Program.

Patients afflicted with Chronic Heart Failure (HF) typically do not maintain stable cardiac function for the remainder of their life and consequently require continuous medical management and intermittent hospital admissions. Several investigations have demonstrated that electrical muscle stimulation (EMS) produces positive physiologic and psychological adaptations in patients with HF. However not all the EMS modalities were been evaluated on this population or not even were tested based on present recognized gold standard clinical parameters after a short period of treatment. The primary aims of the proposed study is to: Determine the effect of a five week home based of three EMS modalities on prognostics markers, perceived quality of life, muscle force and electrical activity in subjects diagnosed with HF.

Read the detailed description

Introduction: Chronic Heart Failure (HF) patients are a significant health care burden in many countries. Patients afflicted with HF typically do not maintain stable cardiac function for the remainder of their life and consequently require continuous medical management and intermittent hospital admissions. Several investigations have demonstrated that electrical muscle stimulation (EMS) produces positive physiologic and psychological adaptations in patients with HF. However not all the EMS modalities were been evaluated on this population or not even were tested based on present recognized gold standard clinical parameters after a short period of treatment. The impact of use of low frequency (FES) and medium-frequency currents (MAC and BMAC) as EMS on the VE/VCO2 and BNP has likewise not been investigated in patients with HF.

Purposes: The primary aims of the proposed study is to: Determine the effect of a five week home based EMS modalities (a) Functional electrical stimulation (FES), (b) medium-frequency alternating current (MAC) and (c) burst-modulated medium-frequency alternating current (BMAC) training program on the VE/VCO2 slope, Brain Natriuretic Peptide (BNP) level, peak VO2, VO2 at Ventilatory Threshold (VT), perceived quality of life, muscle force and electrical activity in subjects diagnosed with HF (NYHA III and IV). Examine changes in the previously outlined outcome measurements five weeks after cessation of the EMS ((a) FES, (b) MAC and (c) BMAC) training program.

Procedures: We will recruit 40 persons (10 for each EMS modalities and 10 control subjects) diagnosed with HF. A group of control subjects will participate using a sham current. The protocol can be conceptually divided into four sections in the following chronological sequence: (1) baseline assessment (body composition by a bone densitometer X-ray Dual energy X-Ray absortometry - DXA, Resting blood pressure and heart rate, complete blood count and BNP analysis); Living with Heart Failure Questionnaire (MLWHFQ); A physician-supervised maximal aerobic exercise test using a metabolic cart (Vmax, Viasys, USA) (VO2, VE/VCO2, VT); isokinetic peak torque (Biodex System III, Isokinetic Dynamometer, Biodex Medical, Inc., Shirley, NY) and electrical activity (Miotec, Brazil), (2) five week EMS training program (bilateral quadriceps and gastrocnemius for 5 days a week for 1 hour to each muscle group with FES, MAC and BMAC training program), (3) immediate post-training assessment within 5 days of completion of the EMS training program and a (4) final analysis five weeks after cessation of the EMS training program.

Conditions
Heart Failure
Being tested
Medium-frequency alternating current, Burst-modulated alternating current, Placebo, Functional electrical stimulation
Keywords
Transcutaneous Electric Nerve Stimulation, Oxygen Consumption, Heart Failure
Medical subject headings
Heart Failure

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Medium-frequency alternating currentProcedure or surgery

    Also called MAC

    The subjects will receive stimulation to quadriceps and gastrocnemius for 5 days a week for 1 hour during 5 weeks. Electrical stimulation will be delivered through channel one with one electrode placed over the vastus medialis and the second electrode placed medial and distal to the greater trochanter. The channel two will be place on the gastrocnemius with one electrode positioned over the muscle belly and the second over the musculotendinous junction. The stimulus will be on for 10 seconds followed by a 30 second relaxation period at the first two weeks. Subsequently, the EMS stimulus will be on for 15 seconds followed by a 30 second relaxation period. The intensity will be turned up to the maximal tolerable intensity as reported by the subject (10-100 mA) observing muscular contraction.

  • Burst-modulated alternating currentProcedure or surgery

    Also called BMAC

    The subjects will receive stimulation to quadriceps and gastrocnemius for 5 days a week for 1 hour during 5 weeks. Electrical stimulation will be delivered through channel one with one electrode placed over the vastus medialis and the second electrode placed medial and distal to the greater trochanter. The channel two will be place on the gastrocnemius with one electrode positioned over the muscle belly and the second over the musculotendinous junction. The stimulus will be on for 10 seconds followed by a 30 second relaxation period at the first two weeks. Subsequently, the EMS stimulus will be on for 15 seconds followed by a 30 second relaxation period. The intensity will be turned up to the maximal tolerable intensity as reported by the subject (10-100 mA) observing muscular contraction.

  • PlaceboProcedure or surgery

    The subjects will receive stimulation to quadriceps and gastrocnemius for 5 days a week for 1 hour during 5 weeks. Electrical stimulation will be delivered through channel one with one electrode placed over the vastus medialis and the second electrode placed medial and distal to the greater trochanter. The channel two will be place on the gastrocnemius with one electrode positioned over the muscle belly and the second over the musculotendinous junction. The stimulus will be on for 10 seconds followed by a 30 second relaxation period at the first two weeks. Subsequently, the EMS stimulus will be on for 15 seconds followed by a 30 second relaxation period. The intensity will be fixed on 5 mA.

  • Functional electrical stimulationProcedure or surgery

    The subjects will receive stimulation to quadriceps and gastrocnemius for 5 days a week for 1 hour during 5 weeks. Electrical stimulation will be delivered through channel one with one electrode placed over the vastus medialis and the second electrode placed medial and distal to the greater trochanter. The channel two will be place on the gastrocnemius with one electrode positioned over the muscle belly and the second over the musculotendinous junction. The stimulus will be on for 10 seconds followed by a 30 second relaxation period at the first two weeks. Subsequently, the EMS stimulus will be on for 15 seconds followed by a 30 second relaxation period. The intensity will be turned up to the maximal tolerable intensity as reported by the subject (10-100 mA) observing muscular contraction

Study groups in NCT01695421
Study groupRoleWhat they receive
Functional electrical stimulationExperimentalBurst modulated alternating rectified current with a 10 Hz carrier frequency, 400 microsecond pulse duration and 50 Hz bursts
Receives: Procedure: Functional electrical stimulation
Medium-frequency alternating currentExperimentalBurst modulated alternating current with a 2500 Hz carrier frequency, 400 microsecond pulse duration and 50 Hz bursts
Receives: Procedure: Medium-frequency alternating current
Burst-modulated alternating currentExperimentalBurst modulated alternating current with a 4000 Hz carrier frequency, 400 microsecond pulse duration and 50 Hz bursts.
Receives: Procedure: Burst-modulated alternating current
PlaceboPlacebo comparatorTraining with the intensity of 5 mA.
Receives: Procedure: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. VE/VCO2 slope

    Measured: Change from Baseline in VE/VCO2 slope at five and ten weeks post EMS.

Secondary outcomes (6)
  1. Peak VO2

    Measured: Change from Baseline in Peak VO2 at five and ten weeks post EMS.

  2. VO2 at Ventilatory Threshold

    Measured: Change from Baseline in VO2 at ventilatory threshold at five and ten weeks post EMS.

  3. Perceived quality of life

    Measured: Change from Baseline in perceived quality od life at five and ten weeks post EMS.

  4. Muscle force

    Measured: Change from Baseline in muscle force at five and ten weeks post EMS.

  5. Muscle electrical activity

    Measured: Change from Baseline in muscle electrical activity at five and ten weeks post EMS.

  6. Brain Natriuretic Peptide level

    Measured: Change from Baseline in Brain Natriuretic Peptide Level at five and ten weeks post EMS.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Sep 2012 (estimated)
  2. Study startNov 2012
  3. Primary completionJul 2013 (estimated)
  4. Study completionJul 2015 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01695421
Sponsor's protocol ID
CSF-01
Status last verified
Sep 2012
First submitted
19 Sep 2012
Last updated
10 Jun 2013
Results posted
No
Data monitoring committee
No

Publications

  • Myers J, Gademan M, Brunner K, Kottman W, Boesch C, Dubach P. Effects of high-intensity training on indices of ventilatory efficiency in chronic heart failure. J Cardiopulm Rehabil Prev. 2012 Jan-Feb;32(1):9-16. doi: 10.1097/HCR.0b013e3182343bdf.

    PubMed 22113369
  • Arena R, Myers J, Aslam SS, Varughese EB, Peberdy MA. Peak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparison. Am Heart J. 2004 Feb;147(2):354-60. doi: 10.1016/j.ahj.2003.07.014.

    PubMed 14760336
  • Mueller C, Scholer A, Laule-Kilian K, Martina B, Schindler C, Buser P, Pfisterer M, Perruchoud AP. Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med. 2004 Feb 12;350(7):647-54. doi: 10.1056/NEJMoa031681.

    PubMed 14960741
  • Vieira PJ, Chiappa AM, Cipriano G Jr, Umpierre D, Arena R, Chiappa GR. Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients. Respir Med. 2014 Apr;108(4):609-20. doi: 10.1016/j.rmed.2013.12.013. Epub 2014 Jan 2.

    PubMed 24418570

Questions about this trial

What is this clinical trial studying?

A study testing Medium-frequency alternating current, Burst-modulated alternating current and Functional electrical stimulation in people with Heart Failure, run by University of Brasilia at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 10 Jun 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Gerson Cipriano Junior, PhD (+556181907111, cipriano@unb.br), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

VE/VCO2 slope (time frame: Change from Baseline in VE/VCO2 slope at five and ten weeks post EMS.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01695421, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Jun 2013.

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