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StrokeNCT03798418

Sarcopenia and Risk of Falls in Patients With Major Chronic Diseases

A study testing elastic band strengthening exercise and diet counseling in people with Stroke and Osteoporosis, run by Changhua Christian Hospital at 1 site in Taiwan.

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

The objective of this study is to investigate the effects of therapeutic exercise and nutrition intervention for sarcopenia and risk of falls in patients with major chronic diseases. Read more about this study

Who is it for?
Any age
Conditions the study is for
Stroke, Osteoporosis, Chronic Kidney Diseases
What is being tested?
elastic band strengthening exercise and diet counseling
Could I receive a placebo?
No, everyone receives an active treatment
How many people
186 participants
Where
1 siteTaiwan
Study dates
1 Feb 2019to 30 Sep 2022
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 Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • 55-85 years old
  • 3-6 months after onset
  • walk independently for at least 10m

Who cannot join

  • lower limb Brunnstrom stage >5
  • combine other neuropathy diseases
  • significant deformity of lower limb include: Modified Ashworth scale(MAS) >3; contracture, fracture, chronic joint pain.
  • joint arthroplasty
  • unstable vital sign
  • can not cooperate study

Trial locations and contacts

1 site in 1 country.

Taiwan1 site
  • Changhua Christian Hospital

    Changhua, 500

Other trials in Taiwan

About this study

Official title: Sarcopenia and Risk of Falls in Patients With Major Chronic Diseases - Effects of Therapeutic Exercise and Nutrition Intervention

The objective of this study is to investigate the effects of therapeutic exercise and nutrition intervention for sarcopenia and risk of falls in patients with major chronic diseases. The outcomes will be analyzed regarding muscle strength, quality, and volume, etc., balance and gait, bone density, body composition, fall and quality of life after the intervention.

Read the detailed description

The main common chronic diseases in the elderly such as stroke, osteoporosis, chronic kidney disease and cancer, have been regarded as the fall high-risk patients. These patients are considered to be at risk for sarcopenia due to decreased exercise, nutritional status, and other reasons. Sarcopenia can be diagnosed and intervened effectively to delay the vicious cycle of health. Past studies have pointed out that in addition to drug intervention, treatment for sarcopenia must be accompanied by appropriate exercise and nutritional intervention (such as protein supplements, vitamin D) in order to achieve the best prevention and treatment.

Being tested
elastic band strengthening exercise, diet counseling
Keywords
Sarcopenia, stroke, osteoporosis, chronic kidney disease, cancer, balance and gait, fall
Medical subject headings
Stroke, Osteoporosis, Renal Insufficiency, Chronic, Neoplasms, Sarcopenia

What participants receive

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

  • elastic band strengthening exerciseBehavioural

    Also called thera-band strengthening exercise

    2-3days per week(150min per week)

  • diet counselingDietary supplement

    Also called nutrition counseling

    each patients in this group will receive4-5times diet counseling

Study groups in NCT03798418
Study groupRoleWhat they receive
exercise groupActive comparatorelastic band strengthening exercise
Receives: Behavioral: elastic band strengthening exercise
exercise combine diet counseling groupExperimentalelastic band strengthening exercise combined diet counseling.
Receives: Behavioral: elastic band strengthening exercise; Dietary Supplement: diet counseling

What is being measured

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

  1. Change of walking speed

    distance: 6m, patients can walk with foor orthosis and assistive devices

    Measured: baseline: before intervention; follow-up: 3 months after intervention

  2. Change of grip force

    Use a grip force meter (kg) to test both hands for test 3 times

    Measured: before intervention; follow-up: 3 months after intervention

  3. Change of postural sway displacement

    Use computerized dynography to measure the postural sway displacement (mm)

    Measured: before intervention; follow-up: 3 months after intervention

  4. Change of postural sway velocity

    Use computerized dynography to measure the postural sway velocity (mm/s)

    Measured: before intervention; follow-up: 3 months after intervention

  5. Change of postural sway area

    Use computerized dynography to measure the postural sway area (mm^2)

    Measured: before intervention; follow-up: 3 months after intervention

  6. Change of step time

    Use computerized dynography to measure spatial gait parameter: step time (ms)

    Measured: before intervention; follow-up: 3 months after intervention

  7. Change of stance time

    Use computerized dynography to measure spatial gait parameter: stance time (ms)

    Measured: before intervention; follow-up: 3 months after intervention

  8. Change of swing time

    Use computerized dynography to measure spatial gait parameter: swing time (ms)

    Measured: before intervention; follow-up: 3 months after intervention

  9. Change of single support time

    Use computerized dynography to measure spatial gait parameter: single support time (ms)

    Measured: before intervention; follow-up: 3 months after intervention

  10. Change of double support time

    Use computerized dynography to measure spatial gait parameter: double support time (ms)

    Measured: before intervention; follow-up: 3 months after intervention

  11. Change of step length

    Use computerized dynography to measure spatial gait parameter: step distance (mm)

    Measured: before intervention; follow-up: 3 months after intervention

  12. Change of stance length

    Use computerized dynography to measure spatial gait parameter: stance distance (mm)

    Measured: before intervention; follow-up: 3 months after intervention

  13. Change of muscle thickness

    Use ultrasound to assess muscles morphological parameter: thickness (mm). Target muscles include quadriceps, hamstring, anterior tibialis, gastrocnemius.

    Measured: before intervention; follow-up: 3 months after intervention

  14. Change of muscle fiber length

    Use ultrasound to assess muscles morphological parameter: fiber length (mm). Target muscles include quadriceps, hamstring, anterior tibialis, gastrocnemius.

    Measured: before intervention; follow-up: 3 months after intervention

  15. Change of muscle fiber orientation angle

    Use ultrasound to assess muscles morphological parameter: fiber orientation angle (degrees). Target muscles include quadriceps, hamstring, anterior tibialis, gastrocnemius.

    Measured: before intervention; follow-up: 3 months after intervention

  16. Change of muscle cross section area

    Use ultrasound to assess muscles morphological parameter: cross-sectional area (mm^2).

    Target muscles include quadriceps, hamstring, anterior tibialis, gastrocnemius.

    Measured: before intervention; follow-up: 3 months after intervention

  17. Change of physiological cost index (PCI)

    Heart rate (HR: beats/min) and walking speed (m/s) have been previously shown to be linearly related to oxygen uptake at sub-maximal exercise levels. Combination of these two parameters yields a single value in beats per meter, the physiological cost index (PCI). This is calculated as Working HR - Resting HR (beats/min) / Walking speed (m/s)

    Measured: before intervention; follow-up: 3 months after intervention

  18. Change of international Quality of Life Assessment Short Form -36 (SF-36)

    including 8 health concepts: (1) physical functioning, (2) role limitations because of physical health problems; (3) bodily pain, (4) social functioning, (5) general mental health (psychological distress and psychological wellbeing), (6) role limitations because of emotional problems, (7) vitality (energy/fatigue), (8) general health perceptions.

    Scoring: answers to each question are scored which are then summed and transformed to a 0 - 100 scale.

    The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability.

    Measured: before intervention; follow-up: 3 months after intervention

  19. Change of amplitude of Muscle activity

    use electromyography to measure the muscles activity in microvolts (uv) included quadriceps, hamstrings, tibialis anterior, gastrocnemius during subject walking in self-selected speed in 6 meters.

    Measured: before intervention; follow-up: 3 months after intervention

Secondary outcomes (14)
  1. Change of concentration of CRP (C-Reactive Protein)

    The concentration of CRP in the blood test. CRP is used mainly as a marker of inflammation.

    Measured: before intervention; follow-up: 3 months after intervention

  2. Change of concentration of ALB (Serum albumin)

    The concentration of ALB in the blood test. Albumin is the most important contributor to the maintenance of plasma colloid oncotic pressure; deficiency results in edema.

    Measured: before intervention; follow-up: 3 months after intervention

  3. Change of concentration of Glomerular Filtration Rate (GFR)

    The concentration of GFR in the blood test. The glomerular filtration rate is the best test to measure the patient's level of kidney function and determine the stage of kidney disease. It can calculate it from the results of the blood creatinine test.

    Measured: before intervention; follow-up: 3 months after intervention

  4. Change of concentration of Hemoglobin (Hb)

    The concentration of Hb in the blood test.

    Measured: Time Frame: before intervention; follow-up: 3 months after intervention

  5. Change of concentration of Glucose SPOT

    The concentration of Glucose SPOT in the blood test. TheSpot glucose measurement in epidermal interstitial fluid appears to be a promising alternative to capillary blood glucose estimation

    Measured: Time Frame: before intervention; follow-up: 3 months after intervention

  6. Change of concentration of Cholesterol

    The concentration of Cholesterol in the blood test.

    Measured: before intervention; follow-up: 3 months after intervention

  7. Change of concentration of Triglyceride

    The concentration of Triglyceride in the blood test.

    Measured: before intervention; follow-up: 3 months after intervention

  8. Change of concentration of Transferrin

    The concentration of Transferrin in the blood test.

    Measured: before intervention; follow-up: 3 months after intervention

  9. Change of Berg balance test (BBS)

    including 14 items which are scored on a 5 points scale (0-4). The degree of success in achieving each task is given a score of zero (unable) to four (independent), and the final measure is the sum of all of the scores.

    The item scores are summed, minimum score =0, maximum score = 56

    Measured: before intervention; follow-up: 3 months after intervention

  10. Change of Fugl-Meyer Assessment (FMA)

    Items are scored on a 3-point ordinal scale (0 = cannot perform; 1 = performs partially; 2 = performs fully) Maximum Score = 226 points The 5 domains assessed include, Motor function (UE maximum score = 66; LE maximum score = 34), Sensory function (maximum score = 24), Balance (maximum score = 14), Joint range of motion (maximum score = 44), Joint pain (maximum score = 44)

    Measured: before intervention; follow-up: 3 months after intervention

  11. Change of Body Mass Index (BMI)

    (body weight) kg/(height) m*(height)m

    Measured: before intervention; follow-up: 3 months after intervention

  12. Change of Mini-mental state examination (MMSE)

    It is an 11-question measure that tests five areas of cognitive function:

    orientation, registration, attention and calculation, recall, and language. The maximum score is 30. A score of 23 or lower is indicative of cognitive impairment.

    Measured: before intervention; follow-up: 3 months after intervention

  13. Change of Modified Ashworth scale (MAS)

    measures resistance during passive soft-tissue stretching, the score is ranged from 0-4 0: No increase in muscle tone

    1. Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension 1+: Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM
    2. More marked increase in muscle tone through most of the ROM, but affected part(s) easily moved
    3. Considerable increase in muscle tone, passive movement difficult
    4. Affected part(s) rigid in flexion or extension

    Measured: before intervention; follow-up: 3 months after intervention

  14. Change of Muscle tone

    measure the muscle tone (kg/m) under muscle resting. Target muscles are quadricep, hamstring, anterior tibialis, gastrocnemius.

    Measured: before intervention; follow-up: 3 months after intervention

Timeline

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

  1. First posted10 Jan 2019
  2. Study start1 Feb 2019
  3. Primary completion30 Sep 2022
  4. Study completion30 Sep 2022

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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
186 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03798418
Sponsor's protocol ID
CCH-170208
Status last verified
Oct 2022
First submitted
28 Dec 2018
Last updated
1 Nov 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: only for research

Publications

  • Biolo G, Cederholm T, Muscaritoli M. Muscle contractile and metabolic dysfunction is a common feature of sarcopenia of aging and chronic diseases: from sarcopenic obesity to cachexia. Clin Nutr. 2014 Oct;33(5):737-48. doi: 10.1016/j.clnu.2014.03.007. Epub 2014 Mar 29.

    PubMed 24785098
  • Stapleton T, Ashburn A, Stack E. A pilot study of attention deficits, balance control and falls in the subacute stage following stroke. Clin Rehabil. 2001 Aug;15(4):437-44. doi: 10.1191/026921501678310243.

    PubMed 11518445
  • Hyndman D, Ashburn A, Stack E. Fall events among people with stroke living in the community: circumstances of falls and characteristics of fallers. Arch Phys Med Rehabil. 2002 Feb;83(2):165-70. doi: 10.1053/apmr.2002.28030.

    PubMed 11833018
  • Kutner NG, Zhang R, Huang Y, Wasse H. Falls among hemodialysis patients: potential opportunities for prevention? Clin Kidney J. 2014 Jun;7(3):257-63. doi: 10.1093/ckj/sfu034. Epub 2014 Apr 15.

    PubMed 25852886
  • Cook WL, Tomlinson G, Donaldson M, Markowitz SN, Naglie G, Sobolev B, Jassal SV. Falls and fall-related injuries in older dialysis patients. Clin J Am Soc Nephrol. 2006 Nov;1(6):1197-204. doi: 10.2215/CJN.01650506. Epub 2006 Aug 30.

    PubMed 17699348
  • Couch ME, Dittus K, Toth MJ, Willis MS, Guttridge DC, George JR, Barnes CA, Gourin CG, Der-Torossian H. Cancer cachexia update in head and neck cancer: Definitions and diagnostic features. Head Neck. 2015 Apr;37(4):594-604. doi: 10.1002/hed.23599. Epub 2014 Mar 25.

    PubMed 24415363
  • Liu CJ, Latham NK. Progressive resistance strength training for improving physical function in older adults. Cochrane Database Syst Rev. 2009 Jul 8;2009(3):CD002759. doi: 10.1002/14651858.CD002759.pub2.

    PubMed 19588334

Questions about this trial

What is this clinical trial studying?

A study testing elastic band strengthening exercise and diet counseling in people with Stroke and Osteoporosis, run by Changhua Christian Hospital at 1 site in Taiwan.

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 6 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 1 Nov 2022. 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 Taiwan. 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. 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?

Change of walking speed (time frame: baseline: before intervention; follow-up: 3 months after intervention). The study lists 19 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 NCT03798418, which also lists 7 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 1 Nov 2022.

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