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Chronic Obstructive Pulmonary DiseaseNCT02598830

The Granheim COPD Study - Vitamin D and Strength Training

A study testing Vitamin D3 in people with Chronic Obstructive Pulmonary Disease, run by Inland Norway University of Applied Sciences at 1 site in Norway.

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 study evaluates the effect of vitamin D supplementation on outcomes of 10 weeks progressive strength training in 100 ageing subjects (>45 years of age). Participants will be recruited into two similarly sized strata; one containing COPD patients and one containing healthy subjects of similar age. Read more about this study

Who is it for?
Ages 45 years and olderHealthy volunteers can take part
Conditions the study is for
Chronic Obstructive Pulmonary Disease
What is being tested?
Vitamin D3
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
97 participants
Where
1 siteNorway
Study dates
Nov 2015to Jun 2018
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 45 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Stable COPD at GOLD stage II or III, FEV1/FVC < 0.7 and FEV1 <80% and >30% of predicted
  • >45 years of age
  • >45 years of age

Who cannot join

  • Unstable cardiovascular disease
  • Chronic granulomatous
  • Known active malignant disease within last 5 years
  • Physically disabling muscloskeletal diseases
  • Peroral use of steroids within last 2 months
  • Serious psychiatric comorbidity
Show all 21Show fewer
  • Less than 4 weeks since last return t o habit ual condit ion from exacerbation
  • Failing to understand Norwegian literary or verbally
  • Medical record diagnosis of asthma
  • More than one bout of strength training per week during the last 6 months leading up to the project
  • Healthy control group
  • COPD
  • Unstable cardiovascular disease
  • Chronic granulomatous
  • Known active malignant disease within last 5 years
  • Physically disabling muscloskeletal diseases
  • Peroral use of steroids within last 2 months
  • Serious psychiatric comorbidity
  • Failing to understand Norwegian literary or verbally
  • Medical record diagnosis of asthma
  • More than one bout of strength training per week during the last 6 months leading up to the project

Trial locations and contacts

1 site in 1 country.

Norway1 site
  • Inland Norway University of Applied Sciences

    Lillehammer

Other trials in Norway

About this study

Official title: The Granheim COPD Study: Effects of Vitamin D3-supplementation on the Efficacy of Strength Training in COPD Patients and Healthy Controls - a Double-blinded RCT

This study evaluates the effect of vitamin D supplementation on outcomes of 10 weeks progressive strength training in 100 ageing subjects (>45 years of age). Participants will be recruited into two similarly sized strata; one containing COPD patients and one containing healthy subjects of similar age. In each stratum, half the participants will receive vitamin D supplementation and half the participants will receive placebo

Read the detailed description

Physical activity is a potent way of relieving some of the adverse morbidities associated with COPD, such as muscle atrophy and reduced muscle quality. It is thus problematic that 20-30% of patients fail to elicit positive adaptations to training. This oddity has been ascribed inherent muscular properties, with potential links to comorbidities such as vitamin D and testosterone deficiency and the nature of the training program. In the present project, a double-blinded RCT will be performed to disclose the functional and biological efficacy of vitamin D supplementation (with concomitant ingestion of 1000 mg Ca2+) on the outcomes of 10 wks strength training in 100 aging individuals with or without COPD. The strength training intervention will be preceded by 3 weeks of progressive introduction to training protocols.

50 COPD patients and 50 healthy subjects will be allocated into two strata and separately randomized into two equally sized supplementation groups; (1) vitamin D3 and (2) placebo. The planned 50:50 ratio between COPD patients and healthy individuals may change, depending on the access to COPD patients. All subjects will perform lower-limb strength-training protocols in a contralateral manner: (leg 1) high-resistance (10 RM) and (leg 2) low-resistance (30 RM). Such a one-limb-at-a-time protocol ensures training that is unconfined by the cardiorespiratory limitations inherent to these patients, and allow comparison of the two training modalities in a manner unconfined by individual variation in exercise adaptability. A pilot study investigating the possible central pulmonary capacity limitation to two-legged strength training exercise in COPD patients will be performed. In this pilot study, we will compare exercise performance involving large and small muscle mass. In addition, all subjects will perform a selection of bilateral upper body exercises (10 RM), ensuring adequate hormonal responses and compliance to the study. The study is likely to revitalize guidelines for rehabilitation of COPD patients, and to provide vital information regarding the role of vitamin D in adaptations to strength training.

For outcome measures specific to COPD pasients, final analyses will be performed on data from the COPD population only. For other outcome measures, final analyses will be performed on data merged from COPD patients and healthy subjects. An important rationale behind implementing healthy control subjects is to increase the statistical power of outcome measures unrelated to COPD epidemiology, which are of general relevance to physiological adaptation to strength training. In a related set of analyses, we will perform between-groups comparisons, including multivariate analyses. We will also compare the efficacy of high- and low-resistance strength training in COPD patients and healthy control subjects. The two training modalities are expected to result in similar muscular adaptations.

In general, baseline vitamin D levels in blood, measured as 25(OH)D, is anticipated to be a determinant of the efficacy of the strength training intervention. In response to vitamin D3 supplementation, individuals with low baseline levels of 25(OH)D are expected to display more pronounced changes in biological active vitamin D, leading to more pronounced changes in functional and biological outcome measures in response to strength training. In contrast, supplementation may not lead to further elevation of blood 25(OH)D levels in individuals with high baseline levels, essentially meaning that vitamin D3 ingestion will be leveled out by or exceeded by the elimination of vitamin D derivatives. In these individuals, vitamin D3 ingestion will not have an additive effect on functional and biological outcome measures in response to strength training. To assess individual variation in vitamin D responses, data on functional and biological variables will be divided into quartiles based on baseline 25(OH)D-levels, whereupon comparisons will be made between low-end and high-end quartiles. Individual variation in responses to vitamin D supplementation and strength training will also be assessed using a mixed model approach.

Being tested
Vitamin D3, Placebo
Keywords
Cachexia, Vitamin D, Muscle, Strength training
Medical subject headings
Pulmonary Disease, Chronic Obstructive, Cachexia

What participants receive

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

  • Vitamin D3Dietary supplement

    Also called cholecalciferol

    Vitamin D3 dissolved in olive oil, encapsuled

  • PlaceboDietary supplement

    Olive oil, encapsuled

Study groups in NCT02598830
Study groupRoleWhat they receive
Vitamin D3+str.training, COPD & HealthyExperimentalVitamin D3 capsules for 30 weeks: * weeks 1-2: 10000 IU/day (equivalent to 250 ug), accompanied by 1000 mg Ca2+ * weeks 3-30: 2000 IU/day (equivalent to 50 ug), accompanied by 1000 mg Ca2+ Progressive unilateral strength training of the legs for 3+10 weeks (weeks 15-28); leg 1 = high-load training, leg 2 = low-load training, allocated to left and right foot in a randomized manner: * weeks 15-17, familiarization period * week 18, test period * weeks 19-28, intervention period * weeks 29-30, test period
Receives: Dietary Supplement: Vitamin D3
Placebo+str.training, COPD & HealthyPlacebo comparatorPlacebo capsules for 30 weeks (the number of capsules ingested each day match those of the vitamin D3 group) Progressive unilateral strength training of the legs for 3+10 weeks (weeks 15-28); leg 1 = high-load training, leg 2 = low-load training, allocated to left and right foot in a randomized manner: * weeks 15-17, familiarization period * week 18, test period * weeks 19-28, intervention period * weeks 29-30, test period
Receives: Dietary Supplement: Placebo

What is being measured

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

  1. Muscle size

    Muscle cell cross-sectional area measured in biopsies from m. vastus lateralis using immunohistochemistry

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  2. Muscle phenotype

    Muscle fiber type composition measured in biopsies from m. vastus lateralis using immunohistochemistry

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

Secondary outcomes (26)
  1. Lung function

    Lung function measured using spirometry

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  2. One-legged cycling

    Performance indicies measured during an incremental one-legged cycling test

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  3. Hormones in blood

    Levels of hormones in blood

    Measured: Changes over the course of the intervention (week 0 to 28)

  4. Cytokines in blood

    Levels of cytokines in blood

    Measured: Changes over the course of the intervention (week 0 to 28)

  5. Steroids in skeletal muscle

    Levels of steroids in m. vastus lateralis

    Measured: Changes over the course of the intervention (week 0 to 28)

  6. Androgen-converting enzymes in skeletal muscle

    Levels of androgen-converting enzymes in m. vastus lateralis

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  7. Gene expression in skeletal muscle

    RNA (e.g. messenger RNA, ribosomal RNA, microRNA, long non-coding RNA) abundances in m. vastus lateralis, measured both as single genes and at the level of the transcriptome

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  8. Gene expression in skeletal muscle

    RNA (e.g. messenger RNA, ribosomal RNA, microRNA, long non-coding RNA) abundances in m. vastus lateralis, measured both as single genes and at the level of the transcriptome

    Measured: Changes from before to after familiarization to strength training (week 15 to week 17)

  9. Protein abundances in skeletal muscle

    Levels of proteins and their modification status (e.g. phosphorylation) in m. vastus lateralis, measured at the level of single proteins and at the level of the proteome

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  10. Protein abundances in skeletal muscle

    Levels of proteins and their modification status (e.g. phosphorylation) in m. vastus lateralis, measured at the level of single proteins and at the level of the proteome

    Measured: Changes from before to after familiarization to strength training (week 15 to week 17)

  11. Vitamin D in blood

    Levels of vitamin D in blood

    Measured: Changes over the course of the intervention (week 0 to 28)

  12. Step test

    Performance and performance indicies measured during a 6 minutes step test

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  13. Pasient-reported outcome measures, generic

    Pasient-related outcome measures assessed using the generic survey SF-36

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  14. Pasient-reported outcome measures, COPD-specific

    COPD-specific pasient-reported outcome assessed using COPD assessment test

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  15. Body mass composition

    Body mass composition measured using Dual-energy X-ray absorptiometry (DXA)

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  16. Bilateral upper body maximal strength

    The ability of muscles of the upper body to exert maximal force during dynamic movements

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  17. Grip strength

    Isometric hand grip strength

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  18. Sit-to-stand test

    Performance and performance indicies measured during a sit-to-stand test

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  19. Unilateral lower body maximal muscle strength

    The ability of muscles of the lower body to exert maximal force during dynamic movements

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  20. Unilateral lower body muscle endurance

    The ability of muscles of the lower body to perform repeated dynamic contractions at a specified submaximal load to exhaustion

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  21. Bilateral upper body muscle endurance

    The ability of muscles of the upper body to perform repeated dynamic contractions at a specified submaximal load to exhaustion

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  22. Unilateral lower body isokinetic muscle strength

    The ability of muscles of the lower body to exert maximal force during isokinetic movements

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  23. Daily life activity level

    Daily life activity level measured using accelerometer

    Measured: Changes from before to after the intervention (week 0 to week 28)

  24. Muscle cell biological traits

    Muscle cell biological traits, including numbers of myonuclei, satelitte cells and capillaries, measured in biopsies from m. vastus lateralis using immunohistochemistry

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  25. Muscle mitochondrial quantities

    Mitochondrial quantities measured in biopsies from m. vastus lateralis

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

  26. Muscle mitochondrial functions

    Mitochondrial functions measured in biopsies from m. vastus lateralis

    Measured: Changes from before to after the strength training intervention (week 19 to week 28)

Timeline

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

  1. First posted6 Nov 2015 (estimated)
  2. Study startNov 2015
  3. Primary completionJun 2018
  4. Study completionJun 2018

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
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
97 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02598830
Sponsor's protocol ID
Trainsome 2014#004
Status last verified
Dec 2018
First submitted
5 Nov 2015
Last updated
12 Dec 2018
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes: De-identified data will be made available to the academic community through the general biobank "The Trainsome - effects of exercise and environment on human cells" (REK-2013/2045, Regional Comitees for Medical and Health Research Ethics South East). Data will be available on request and will be restricted to scientists and/or projects with a sound scientific purpose and rationale.

Publications

  • Molmen KS, Hammarstrom D, Falch GS, Grundtvig M, Koll L, Hanestadhaugen M, Khan Y, Ahmad R, Malerbakken B, Rodolen TJ, Lien R, Ronnestad BR, Raastad T, Ellefsen S. Chronic obstructive pulmonary disease does not impair responses to resistance training. J Transl Med. 2021 Jul 6;19(1):292. doi: 10.1186/s12967-021-02969-1.

    PubMed 34229714

Questions about this trial

What is this clinical trial studying?

A study testing Vitamin D3 in people with Chronic Obstructive Pulmonary Disease, run by Inland Norway University of Applied Sciences at 1 site in Norway.

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 3 inclusion and 21 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 12 Dec 2018. 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 Norway. 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?

Muscle size (time frame: Changes from before to after the strength training intervention (week 19 to week 28)). The study lists 2 primary outcomes in all. 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 NCT02598830, which also lists 1 linked publication.

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 12 Dec 2018.

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Clinical Trial NCT02598830 | AzTrials