Frailty SyndromeNCT04234087
Feasibility and Effectiveness of an Additional Resistance and Balance Training in Cardiac Rehabilitation of Older Patients After Valve Surgery or Intervention
A study testing Additional balance and resistance training in people with Frailty Syndrome and Quality of Life, run by Lithuanian University of Health Sciences at 1 site in Lithuania.
Trial summary
The aim of the study is to evaluate the short- and medium-term effectiveness of additional moderate dynamic resistance and balance training to the CR-program of old adults after valve surgery or intervention compared to usual care-CR. Read more about this study
- Who is it for?
- Ages 65 years and older
- Conditions the study is for
- Frailty Syndrome, Quality of Life, Valve Heart Disease
- What is being tested?
- Additional balance and resistance training
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 116 participants
- Where
- 1 siteLithuania
- Study dates
- 26 Feb 2018to 30 Jun 2020
- 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 65 years and older
- All sexes
- No healthy volunteers
- Older adult
Who may be able to join
- Patients after valve surgery and/or intervention
- Age 65 years and older
- Ability to start CR within 4 weeks after surgery,
- 6-minute walk distance (6-MWD) ≥100- ≤350 m (1)
- Patient's agreement to participate in the study.
Who cannot join
- Diseases in the musculoskeletal system or other organs complicating physical activity and exercise training;
- Exercise-limiting comorbidities (primarily orthopedic and neurological conditions that would exclude individuals from participating in CR according to study protocol), including chronic heart failure New York Heart Association Class IV, hemoglobin less than 9 g/dL, wound healing disturbance, cognitive or linguistic deficits.
Trial locations and contacts
1 site in 1 country.
Lithuania1 site
LUHS hospital Kaunas Clinics Rehabilitation hospital of Kulautuva
Kaunas, Kulautuva
About this study
The aim of the study is to evaluate the short- and medium-term effectiveness of additional moderate dynamic resistance and balance training to the CR-program of old adults after valve surgery or intervention compared to usual care-CR.
- Conditions
- Frailty Syndrome, Quality of Life, Valve Heart Disease
- Being tested
- Additional balance and resistance training
- Keywords
- Cardiac rehabilitation, Exercise training, Resistance training, Balance training, Physical capacity, Valve surgery, Valve intervention, Functional capacity
- Medical subject headings
- Frailty, Heart Valve Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Additional balance and resistance trainingOther
Additional exercise program with balance and resistance training three times per week. After completion participants are encouraged to continue exercise training at home according to recommendations and will receive control calls every two weeks.
| Study group | Role | What they receive |
|---|---|---|
| Control group | No intervention | The supervised exercise program included: continues endurance training on cycle ergometers (6 sessions a week). Every session included warm up (<50% target intensity 2 min, gradually increasing load 1-10 w/min up to target intensity within 5 - 10 min); exercise phase (100% of the target intensity (30-50% watts or 30-50% HRmax), starting with >5 minutes and gradually prolonged up to 30 min); cool down with gradual reduction of the load within 3 minutes); additional aerobic exercises performed sitting and/or standing (30 minutes, 5 days/week); respiratory muscle training (7 days/week, for 15 minutes) using ball trainer. |
| Intervention group | Other | Exercise program as for a control group together with additional resistance and balance training 3 sessions/week. The resistance training was started with low intensity (<30% 1-RM, RPE ≤ 11, 5-10 repetitions), increased gradually to moderate intensity (30-50% and up to 60% 1-RM, RPE 12-13, after 8-15 repetitions) with 3 sets and 3 minute rest between sets, if tolerated. The balance training included exercises to improve static as well as dynamic balance ability. It was performed on 2-3 days/week for 10-15 minutes. The complexity of the balance exercises was selected and incremented individually by changing the stand-position, the base on which the stands were performed and/or using unstable surfaces. If tolerated, the visual information was varied and/or additional tasks performed while balancing. After completion participants were encouraged to continue exercise training at home according to recommendations. Receives: Other: Additional balance and resistance training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Physical performance by Short Physical Perfromance Battery (SPPB)
The short physical performance battery (SPPB) is a group of measures that combines the results of the gait speed, chair stand and balance tests.The scores range from 0 (worst performance) to 12 (best performance).
Measured: Baseline
Physical performance by Short Physical Perfromance Battery (SPPB)
The short physical performance battery (SPPB) is a group of measures that combines the results of the gait speed, chair stand and balance tests.The scores range from 0 (worst performance) to 12 (best performance).
Measured: 20 days
Physical performance by Short Physical Perfromance Battery (SPPB)
The short physical performance battery (SPPB) is a group of measures that combines the results of the gait speed, chair stand and balance tests.The scores range from 0 (worst performance) to 12 (best performance).
Measured: Three months
Physical performance by 5 meters walking test (5MWT)
5MWT is a gate speed test measured by meters per second.
Measured: Baseline
Physical performance by 5 meters walking test (5MWT)
5MWT is a gate speed test measured by meters per second.
Measured: 20 days
Physical performance by 5 meters walking test (5MWT)
5MWT is a gate speed test measured by meters per second.
Measured: 3 months
Functional capacity by six minutes walking test (6MWT)
6MWT measured by meters
Measured: Baseline
Functional capacity by six minutes walking test (6MWT)
6MWT measured by meters
Measured: 20 days
Functional capacity by six minutes walking test (6MWT)
6MWT measured by meters
Measured: 3 months
Quality of life by questionnaire Short Form Survey SF-36
0-100%, the higher score, the better quality of life. The SF-36 measures eight scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) in units on the scale
Measured: Baseline
Quality of life by questionnaire Short Form Survey SF-36
0-100%, the higher score, the better quality of life. The SF-36 measures eight scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) in units on the scale
Measured: 20 days
Quality of life by questionnaire Short Form Survey SF-36
0-100%, the higher score, the better quality of life. The SF-36 measures eight scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) in units on the scale
Measured: 3 months
Quality of life by questionnaire Minnesota living with heart failure (Minesota HF)
Minesota HF questionnaire in units on the scale, 0-105, the the lower score, the better quality of life
Measured: Baseline
Quality of life by questionnaire Minnesota living with heart failure (Minesota HF)
Minesota HF questionnaire in units on the scale, 0-105, the the lower score, the better quality of life
Measured: 20 days
Quality of life by questionnaire Minnesota living with heart failure (Minesota HF)
Minesota HF questionnaire in units on the scale, 0-105, the the lower score, the better quality of life
Measured: 3 months
Quality of life by questionnaire EQ-5D
EQ-5D in units on the scale, 0-10, the higher score, the better quality of life
Measured: Baseline
Quality of life by questionnaire EQ-5D
EQ-5D in units on the scale, 0-10, the higher score, the better quality of life
Measured: 20 days
Quality of life by questionnaire EQ-5D
EQ-5D in units on the scale, 0-10, the higher score, the better quality of life
Measured: 3 months
Quality of life by questionnaire Quality of Life: Cardiac Index
Quality of Life: Cardiac Index in units on the scale, 15-33 the higher score, the better quality of life
Measured: Baseline
Quality of life by questionnaire Quality of Life: Cardiac Index
Quality of Life: Cardiac Index in units on the scale, 15-33 the higher score, the better quality of life
Measured: 20 days
Quality of life by questionnaire Quality of Life: Cardiac Index
Quality of Life: Cardiac Index in units on the scale, 15-33 the higher score, the better quality of life
Measured: 3 months
Secondary outcomes (18)
Frailty level by SPPB score
Frailty measured by SPPB score - 0-7 - frail, 8-9 - pre-frail, 10-12 robust.
Measured: baseline
Frailty level by SPPB score
Frailty measured by SPPB score - 0-7 - frail, 8-9 - pre-frail, 10-12 robust.
Measured: 20 days
Frailty level by SPPB score
Frailty measured by SPPB score - 0-7 - frail, 8-9 - pre-frail, 10-12 robust.
Measured: three months
Frailty level by 5MWT
Frailty measured by 5MWT - <0,6 m/s - frail, 0,7-0,99 m/s - pre-frail, 1,0 m/s and more - robust
Measured: baseline
Frailty level by 5MWT
Frailty measured by 5MWT - <0,6 m/s - frail, 0,7-0,99 m/s - pre-frail, 1,0 m/s and more - robust
Measured: 20 days
Frailty level by 5MWT
Frailty measured by 5MWT - <0,6 m/s - frail, 0,7-0,99 m/s - pre-frail, 1,0 m/s and more - robust
Measured: three months
Physical activity by International physical activity questionnaire (IPAQ)
IPAQ in units on the scale
Measured: 3 months
Physical activity by International physical activity questionnaire (IPAQ)
IPAQ in units on the scale
Measured: 20 days
Physical activity by International physical activity questionnaire (IPAQ)
IPAQ in units on the scale
Measured: Baseline
Cardiopulmonary exercise capacity by maximal oxygen consumption (peakVO2)
PeakVO2 measured with spiroergometry by millilitres of oxygen per kilogram of body mass per minute
Measured: Baseline
Cardiopulmonary exercise capacity by maximal load (maxWatt)
Maximal load measured with spiroergometry by maximal watts
Measured: Baseline
Cardiopulmonary exercise capacity by maximal oxygen consumption (peakVO2)
PeakVO2 measured with spiroergometry by millilitres of oxygen per kilogram of body mass per minute
Measured: 20 days
Cardiopulmonary exercise capacity by maximal oxygen consumption (peakVO2)
PeakVO2 measured with spiroergometry by millilitres of oxygen per kilogram of body mass per minute
Measured: 3 months
Cardiopulmonary exercise capacity by maximal load (maxWatt)
Maximal load measured with spiroergometry by maximal watts
Measured: 20 days
Cardiopulmonary exercise capacity by maximal load (maxWatt)
Maximal load measured with spiroergometry by maximal watts
Measured: 3 months
Muscular strength by one repetition maximum test (1RM)
1RM test for leg extension measured by kilograms
Measured: baseline
Muscular strength by one repetition maximum test (1RM)
1RM test for leg extension measured by kilograms
Measured: 20 days
Muscular strength by one repetition maximum test (1RM)
1RM test for leg extension measured by kilograms
Measured: 3 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Jan 2020
- Study start26 Feb 2018
- Primary completion1 Feb 2020
- Study completion30 Jun 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Frailty SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- None (open label)
- Enrolment
- 116 participants (actual)
Sponsor and investigators
- Lead sponsor
- Lithuanian University of Health Sciences
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Eglė Tamulevičiūtė-Prascienė, Lithuanian University of Health Sciences
- Investigators
- Raimondas Kubilius, Prof, Principal investigator, Lithuanian University of Health Sciences, Department of Rehabilitation
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04234087
- Sponsor's protocol ID
- LUHS001
- Status last verified
- Jul 2020
- First submitted
- 12 Jan 2020
- Last updated
- 16 Jul 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Tamuleviciute-Prasciene E, Beigiene A, Thompson MJ, Balne K, Kubilius R, Bjarnason-Wehrens B. The impact of additional resistance and balance training in exercise-based cardiac rehabilitation in older patients after valve surgery or intervention: randomized control trial. BMC Geriatr. 2021 Jan 7;21(1):23. doi: 10.1186/s12877-020-01964-3.
PubMed 33413144
Study at a glance
From the registry record, last updated by the sponsor on 16 Jul 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Feasibility and Effectiveness of an Additional Resistance and Balance Training in Cardiac Rehabilitation of Older Patients After Valve Surgery or Intervention
- ClinicalTrials.gov ID
- NCT04234087
- Acronym / sponsor ID
- LUHS001
- Conditions
- Frailty Syndrome, Quality of Life, Valve Heart Disease
- Keywords
- Cardiac rehabilitation, Exercise training, Resistance training, Balance training, Physical capacity, Valve surgery, Valve intervention, Functional capacity
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 116 participants (actual)
- Lead sponsor
- Lithuanian University of Health SciencesUniversity, hospital or other
- Study start
- 26 Feb 2018 (actual)
- Primary completion
- 1 Feb 2020 (actual)
- Study completion
- 30 Jun 2020 (actual)
- First posted
- 21 Jan 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of the study is to evaluate the short- and medium-term effectiveness of additional moderate dynamic resistance and balance training to the CR-program of old adults after valve surgery or intervention compared to usual care-CR.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Control group | No intervention | –The supervised exercise program included: continues endurance training on cycle ergometers (6 sessions a week). Every session included warm up (<50% target intensity 2 min, gradually increasing load 1-10 w/min up to target intensity within 5 - 10 min); exercise phase (100% of the target intensity (30-50% watts or 30-50% HRmax), starting with >5 minutes and gradually prolonged up to 30 min); cool down with gradual reduction of the load within 3 minutes); additional aerobic exercises performed sitting and/or standing (30 minutes, 5 days/week); respiratory muscle training (7 days/week, for 15 minutes) using ball trainer. |
| Intervention group | Other | Other: Additional balance and resistance trainingExercise program as for a control group together with additional resistance and balance training 3 sessions/week. The resistance training was started with low intensity (<30% 1-RM, RPE ≤ 11, 5-10 repetitions), increased gradually to moderate intensity (30-50% and up to 60% 1-RM, RPE 12-13, after 8-15 repetitions) with 3 sets and 3 minute rest between sets, if tolerated. The balance training included exercises to improve static as well as dynamic balance ability. It was performed on 2-3 days/week for 10-15 minutes. The complexity of the balance exercises was selected and incremented individually by changing the stand-position, the base on which the stands were performed and/or using unstable surfaces. If tolerated, the visual information was varied and/or additional tasks performed while balancing. After completion participants were encouraged to continue exercise training at home according to recommendations. |
Who may qualify
- Ages
- 65 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Older adult
Key inclusion criteria (5 listed)
- Patients after valve surgery and/or intervention
- Age 65 years and older
- Ability to start CR within 4 weeks after surgery,
- 6-minute walk distance (6-MWD) ≥100- ≤350 m (1)
- Patient's agreement to participate in the study.
Key exclusion criteria (2 listed)
- Diseases in the musculoskeletal system or other organs complicating physical activity and exercise training;
- Exercise-limiting comorbidities (primarily orthopedic and neurological conditions that would exclude individuals from participating in CR according to study protocol), including chronic heart failure New York Heart Association Class IV, hemoglobin less than 9 g/dL, wound healing disturbance, cognitive or linguistic deficits.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Additional balance and resistance trainingAdditional exercise program with balance and resistance training three times per week. After completion participants are encouraged to continue exercise training at home according to recommendations and will receive control calls every two weeks. | Other | Intervention group |
Primary outcome
Physical performance by Short Physical Perfromance Battery (SPPB)
Time frame: Baseline
The short physical performance battery (SPPB) is a group of measures that combines the results of the gait speed, chair stand and balance tests.The scores range from 0 (worst performance) to 12 (best performance).
Physical performance by Short Physical Perfromance Battery (SPPB)
Time frame: 20 days
The short physical performance battery (SPPB) is a group of measures that combines the results of the gait speed, chair stand and balance tests.The scores range from 0 (worst performance) to 12 (best performance).
Physical performance by Short Physical Perfromance Battery (SPPB)
Time frame: Three months
The short physical performance battery (SPPB) is a group of measures that combines the results of the gait speed, chair stand and balance tests.The scores range from 0 (worst performance) to 12 (best performance).
Physical performance by 5 meters walking test (5MWT)
Time frame: Baseline
5MWT is a gate speed test measured by meters per second.
Physical performance by 5 meters walking test (5MWT)
Time frame: 20 days
5MWT is a gate speed test measured by meters per second.
Physical performance by 5 meters walking test (5MWT)
Time frame: 3 months
5MWT is a gate speed test measured by meters per second.
Functional capacity by six minutes walking test (6MWT)
Time frame: Baseline
6MWT measured by meters
Functional capacity by six minutes walking test (6MWT)
Time frame: 20 days
6MWT measured by meters
Functional capacity by six minutes walking test (6MWT)
Time frame: 3 months
6MWT measured by meters
Quality of life by questionnaire Short Form Survey SF-36
Time frame: Baseline
0-100%, the higher score, the better quality of life. The SF-36 measures eight scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) in units on the scale
Quality of life by questionnaire Short Form Survey SF-36
Time frame: 20 days
0-100%, the higher score, the better quality of life. The SF-36 measures eight scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) in units on the scale
Quality of life by questionnaire Short Form Survey SF-36
Time frame: 3 months
0-100%, the higher score, the better quality of life. The SF-36 measures eight scales: physical functioning (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) in units on the scale
Quality of life by questionnaire Minnesota living with heart failure (Minesota HF)
Time frame: Baseline
Minesota HF questionnaire in units on the scale, 0-105, the the lower score, the better quality of life
Quality of life by questionnaire Minnesota living with heart failure (Minesota HF)
Time frame: 20 days
Minesota HF questionnaire in units on the scale, 0-105, the the lower score, the better quality of life
Quality of life by questionnaire Minnesota living with heart failure (Minesota HF)
Time frame: 3 months
Minesota HF questionnaire in units on the scale, 0-105, the the lower score, the better quality of life
Quality of life by questionnaire EQ-5D
Time frame: Baseline
EQ-5D in units on the scale, 0-10, the higher score, the better quality of life
Quality of life by questionnaire EQ-5D
Time frame: 20 days
EQ-5D in units on the scale, 0-10, the higher score, the better quality of life
Quality of life by questionnaire EQ-5D
Time frame: 3 months
EQ-5D in units on the scale, 0-10, the higher score, the better quality of life
Quality of life by questionnaire Quality of Life: Cardiac Index
Time frame: Baseline
Quality of Life: Cardiac Index in units on the scale, 15-33 the higher score, the better quality of life
Quality of life by questionnaire Quality of Life: Cardiac Index
Time frame: 20 days
Quality of Life: Cardiac Index in units on the scale, 15-33 the higher score, the better quality of life
Quality of life by questionnaire Quality of Life: Cardiac Index
Time frame: 3 months
Quality of Life: Cardiac Index in units on the scale, 15-33 the higher score, the better quality of life
18 secondary outcomes
Frailty level by SPPB score
Time frame: baseline
Frailty level by SPPB score
Time frame: 20 days
Frailty level by SPPB score
Time frame: three months
Frailty level by 5MWT
Time frame: baseline
Frailty level by 5MWT
Time frame: 20 days
Frailty level by 5MWT
Time frame: three months
Physical activity by International physical activity questionnaire (IPAQ)
Time frame: 3 months
Physical activity by International physical activity questionnaire (IPAQ)
Time frame: 20 days
Physical activity by International physical activity questionnaire (IPAQ)
Time frame: Baseline
Cardiopulmonary exercise capacity by maximal oxygen consumption (peakVO2)
Time frame: Baseline
Cardiopulmonary exercise capacity by maximal load (maxWatt)
Time frame: Baseline
Cardiopulmonary exercise capacity by maximal oxygen consumption (peakVO2)
Time frame: 20 days
Cardiopulmonary exercise capacity by maximal oxygen consumption (peakVO2)
Time frame: 3 months
Cardiopulmonary exercise capacity by maximal load (maxWatt)
Time frame: 20 days
Cardiopulmonary exercise capacity by maximal load (maxWatt)
Time frame: 3 months
Muscular strength by one repetition maximum test (1RM)
Time frame: baseline
Muscular strength by one repetition maximum test (1RM)
Time frame: 20 days
Muscular strength by one repetition maximum test (1RM)
Time frame: 3 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Jul 2020.
- Derived from this study: PubMed 33413144Tamuleviciute-Prasciene E, Beigiene A, Thompson MJ, Balne K, Kubilius R, Bjarnason-Wehrens B. The impact of additional resistance and balance training in exercise-based cardiac rehabilitation in older patients after valve surgery or intervention: randomized control trial. BMC Geriatr. 2021 Jan 7;21(1):23. doi: 10.1186/s12877-020-01964-3.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Raimondas Kubilius, Prof principal investigator
Lithuanian University of Health Sciences, Department of Rehabilitation
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Additional balance and resistance training in people with Frailty Syndrome and Quality of Life, run by Lithuanian University of Health Sciences at 1 site in Lithuania.
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 5 inclusion and 2 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 16 Jul 2020. 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 Lithuania. 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?
Physical performance by Short Physical Perfromance Battery (SPPB) (time frame: Baseline). The study lists 21 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 NCT04234087, 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 16 Jul 2020.