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Chronic Obstructive Pulmonary DiseaseNCT01945398

IMT in Ventilatory Muscle Metaboreflex in COPD

A study testing Inspiratory Muscle Training in people with Chronic Obstructive Pulmonary Disease, run by Federal University of Rio Grande do Sul at 1 site in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This research intends to evaluate if inspiratory muscle training (IMT) reduces inspiratory muscle metaboreflex through the decrease of calf vascular resistance and increase of calf blood flow in Chronic Obstructive Pulmonary Disease (COPD). Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Chronic Obstructive Pulmonary Disease
What is being tested?
Inspiratory Muscle Training
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
13 participants
Where
1 siteBrazil
Study dates
Jun 2013to Feb 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 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Selection of subjects will be made through the Hospital de Clinicas de Porto Alegre Pneumology Service's COPD ambulatory. The inclusion criteria consist of -patients with COPD with functional confirmation through spirometry as by previously defined criteria.
  • Those selected must be classified as GOLD II-IV, with moderate to severe expiratory flow obstruction.

Who cannot join

  • Patients will be considered ineligible for this study if they
  • develop COPD exacerbation 8 weeks prior to recruitment
  • if systemic corticosteroids are utilized (in the last three months)
  • if there is history of acute myocardial infarction (in the last three months)
  • if there is presence of neuromuscular disease
  • history of cardiovascular disease or active smoking (in the last 6 months)
  • clinical history of peripheral vascular disease and if age is equal or superior to 85 years

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Hospital de Clinicas de Porto Alegre

    Porto Alegre, Rio Grande do Sul, 90035-903

Other trials in Brazil

About this study

Official title: Effect of Inspiratory Muscle Training in the Ventilatory Muscle Metaboreflex in Chronic Obstructive Pulmonary Disease Patients.

This research intends to evaluate if inspiratory muscle training (IMT) reduces inspiratory muscle metaboreflex through the decrease of calf vascular resistance and increase of calf blood flow in Chronic Obstructive Pulmonary Disease (COPD).

Read the detailed description

Patients will be selected from the Hospital de Clinicas de Porto Alegre's COPD ambulatory, by convenience. Afterwards, patients will be submitted to pulmonary function test (spirometry) and cardiopulmonary exercise tests (incremental and submaximal), maximal inspiratory pressure evaluation and induction of the inspiratory muscle metaboreflex through venous occlusion plethysmography. Disease specific health related quality of life questionnaire (Saint George Respiratory Questionnaire) and daily life dyspnea questionnaire (Baseline Dyspnea Index and Transitional Dyspnea Index) will be administered at the first and last visit of each subject. Patients will undergo inspiratory muscle training for 30 minutes per day, 7 times a week, for 8 weeks, with Inspiratory Muscle Trainer device (PowerBreath Inc.). There will be a weekly follow up at the institution's Clinical Research Center, where maximal inspiratory pressure (PImax) and inspiratory training techniques will be reevaluated. After this period, tests of pulmonary function, questionnaires exercise tolerance and induction of the inspiratory muscle metaboreflex will be reevaluated.

Being tested
Inspiratory Muscle Training, SHAM
Keywords
Pulmonary Rehabilitation, Inspiratory Muscle Training, Inspiratory Muscle Strength, Vascular Resistance, Exercise, Chronic Obstructive Pulmonary Disease
Medical subject headings
Pulmonary Disease, Chronic Obstructive, Motor Activity

What participants receive

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

  • Inspiratory Muscle TrainingOther

    Patients will receive IMT for 30 min, 7 times per week, for 8 weeks using Inspiratory Muscle Trainer device (PowerBreath Inc.). During training, patients will be instructed to maintain diaphragmatic breathing, with a breathing rate at 15 to 20 breaths/min. Inspiratory load was set at 30% of maximal static inspiratory pressure, and weekly training loads were adjusted to maintain 30% of the PImax. Each week, six training sessions were performed at home and one training session was supervised at the hospital.

  • SHAMOther

    Patients will receive SHAM training for 30 min, 7 times per week, for 8 weeks using Inspiratory Muscle Trainer device (PowerBreath Inc.) without load. Patients will be instructed to maintain diaphragmatic breathing, with a breathing rate at 15 to 20 breaths/min. Each week, six training sessions were performed at home and one training session was supervised at the hospital.

Study groups in NCT01945398
Study groupRoleWhat they receive
Inspiratory Muscle Training (IMT)ExperimentalPatients from the inspiratory muscle training group will utilize a linear pressoric resistance equipment with an inspiratory charge of 30% of maximum inspiratory pressure (adjusted weekly), during 7 days of the week, session duration of 30 minutes, during 8 weeks.
Receives: Other: Inspiratory Muscle Training
Sham IMTPlacebo comparatorPatients in the placebo group will be submitted to inspiratory muscle training with the same equipment as the intervention group, however without a resistance generating spring.
Receives: Other: SHAM

What is being measured

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

  1. Calf blood flow

    Measured: 8 weeks

Secondary outcomes (5)
  1. Time to exercise tolerance (tlim)

    Exercise time during high intensity submaximal Cardiopulmonary exercise testing

    Measured: 8 weeks

  2. Maximum Inspiratory Pressure

    Measured: 8 weeks

  3. The St George's Respiratory Questionnaire

    Measured: 8 weeks

  4. Baseline Dyspnea Index/Transitional Dyspnea Index

    Measured: 8 weeks

  5. Calf vascular resistance

    Calf blood flow/mean arterial pressure

    Measured: 8 weeks

Timeline

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

  1. First posted18 Sep 2013 (estimated)
  2. Study startJun 2013
  3. Primary completionFeb 2015
  4. Study completionFeb 2015

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
13 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01945398
Sponsor's protocol ID
120489
Status last verified
Dec 2015
First submitted
15 Sep 2013
Last updated
3 Dec 2015
Results posted
No
Data monitoring committee
No

Publications

  • Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, Fukuchi Y, Jenkins C, Rodriguez-Roisin R, van Weel C, Zielinski J; Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2007 Sep 15;176(6):532-55. doi: 10.1164/rccm.200703-456SO. Epub 2007 May 16.

    PubMed 17507545
  • Aliverti A, Macklem PT. The major limitation to exercise performance in COPD is inadequate energy supply to the respiratory and locomotor muscles. J Appl Physiol (1985). 2008 Aug;105(2):749-51; discussion 755-7. doi: 10.1152/japplphysiol.90336.2008. Epub 2008 Mar 20. No abstract available.

    PubMed 18678622
  • Debigare R, Maltais F. The major limitation to exercise performance in COPD is lower limb muscle dysfunction. J Appl Physiol (1985). 2008 Aug;105(2):751-3; discussion 755-7. doi: 10.1152/japplphysiol.90336.2008a. No abstract available.

    PubMed 18678623
  • O'Donnell DE, Webb KA. The major limitation to exercise performance in COPD is dynamic hyperinflation. J Appl Physiol (1985). 2008 Aug;105(2):753-5; discussion 755-7. doi: 10.1152/japplphysiol.90336.2008b. No abstract available.

    PubMed 18678624
  • Neder JA, Jones PW, Nery LE, Whipp BJ. Determinants of the exercise endurance capacity in patients with chronic obstructive pulmonary disease. The power-duration relationship. Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):497-504. doi: 10.1164/ajrccm.162.2.9907122.

    PubMed 10934077
  • Puente-Maestu L, Garcia de Pedro J, Martinez-Abad Y, Ruiz de Ona JM, Llorente D, Cubillo JM. Dyspnea, ventilatory pattern, and changes in dynamic hyperinflation related to the intensity of constant work rate exercise in COPD. Chest. 2005 Aug;128(2):651-6. doi: 10.1378/chest.128.2.651.

    PubMed 16100150
  • Chiappa GR, Borghi-Silva A, Ferreira LF, Carrascosa C, Oliveira CC, Maia J, Gimenes AC, Queiroga F Jr, Berton D, Ferreira EM, Nery LE, Neder JA. Kinetics of muscle deoxygenation are accelerated at the onset of heavy-intensity exercise in patients with COPD: relationship to central cardiovascular dynamics. J Appl Physiol (1985). 2008 May;104(5):1341-50. doi: 10.1152/japplphysiol.01364.2007. Epub 2008 Mar 20.

    PubMed 18356477
  • Neder JA. The major limitation to exercise performance in COPD is inadequate energy supply to the respiratory and locomotor muscles vs. lower limb muscle dysfunction vs. dynamic hyperinflation. Interpretation of exercise intolerance in COPD requires an integrated, multisystemic approach. J Appl Physiol (1985). 2008 Aug;105(2):758-9. doi: 10.1152/japplphysiol.90336.2008e. No abstract available.

    PubMed 18678626
  • Nici L, Donner C, Wouters E, Zuwallack R, Ambrosino N, Bourbeau J, Carone M, Celli B, Engelen M, Fahy B, Garvey C, Goldstein R, Gosselink R, Lareau S, MacIntyre N, Maltais F, Morgan M, O'Donnell D, Prefault C, Reardon J, Rochester C, Schols A, Singh S, Troosters T; ATS/ERS Pulmonary Rehabilitation Writing Committee. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006 Jun 15;173(12):1390-413. doi: 10.1164/rccm.200508-1211ST. No abstract available.

    PubMed 16760357
  • Gayan-Ramirez G, Koulouris N, Roca J, Decramer M. Respiratory and skeletal muscles in chronic obstructive pulmonary disease. Eur Respir Mon 2006; 38: 201-223.

  • St Croix CM, Morgan BJ, Wetter TJ, Dempsey JA. Fatiguing inspiratory muscle work causes reflex sympathetic activation in humans. J Physiol. 2000 Dec 1;529 Pt 2(Pt 2):493-504. doi: 10.1111/j.1469-7793.2000.00493.x.

    PubMed 11101657
  • Harms CA, Babcock MA, McClaran SR, Pegelow DF, Nickele GA, Nelson WB, Dempsey JA. Respiratory muscle work compromises leg blood flow during maximal exercise. J Appl Physiol (1985). 1997 May;82(5):1573-83. doi: 10.1152/jappl.1997.82.5.1573.

    PubMed 9134907
  • Sheel AW, Derchak PA, Morgan BJ, Pegelow DF, Jacques AJ, Dempsey JA. Fatiguing inspiratory muscle work causes reflex reduction in resting leg blood flow in humans. J Physiol. 2001 Nov 15;537(Pt 1):277-89. doi: 10.1111/j.1469-7793.2001.0277k.x.

    PubMed 11711580
  • Dempsey JA, Romer L, Rodman J, Miller J, Smith C. Consequences of exercise-induced respiratory muscle work. Respir Physiol Neurobiol. 2006 Apr 28;151(2-3):242-50. doi: 10.1016/j.resp.2005.12.015.

    PubMed 16616716
  • Levison H, Cherniack RM. Ventilatory cost of exercise in chronic obstructive pulmonary disease. J Appl Physiol. 1968 Jul;25(1):21-7. doi: 10.1152/jappl.1968.25.1.21. No abstract available.

    PubMed 5661150

Questions about this trial

What is this clinical trial studying?

A study testing Inspiratory Muscle Training in people with Chronic Obstructive Pulmonary Disease, run by Federal University of Rio Grande do Sul 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 2 inclusion and 7 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: finished, as of the sponsor's last update on 3 Dec 2015. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Calf blood flow (time frame: 8 weeks). 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 NCT01945398, which also lists 34 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 3 Dec 2015.

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