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Covid19NCT04898205

Cardiopulmonary Rehabilitation in COVID-19 Longhaulers

A study testing Treadmill Exercise, Concentrated Oxygen and Concentrated Air in people with Covid19 and Viral Syndrome, run by Noah Greenspan at 1 site in United States.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

This study will test the efficacy of treadmill exercise combined with supplemental oxygen during exercise and recovery for the treatment of persistent post-acute COVID-19 symptoms. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Covid19, Viral Syndrome
What is being tested?
Treadmill Exercise, Concentrated Oxygen and Concentrated Air
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
24 participants
Where
1 siteUnited States
Study dates
21 Jan 2021to 20 Jan 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 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Between the ages of 18-60
  • Contracted COVID-19 between February - July 2020
  • Has been clinician-diagnosed with COVID-19 based on PCR/antigen testing, antibody testing, or clinical symptoms
  • Is currently experiencing one or more of the following symptoms, which began only after contracting COVID-19 : dyspnea, cough, chest pain, tachycardia or other arrhythmias, hypertension, hypotension, blood pressure lability, oxygen desaturation, exercise/activity intolerance, fatigue, or dizziness.
  • Has been cleared by a physician for exercise and supplemental oxygen.
  • Has the capacity to provide written, informed consent
  • Able to complete questionnaires in English

Who cannot join

  • History of any of the following per the American College of Sports Medicine exercise testing guidelines (American College of Sports Medicine et al., 2018) to be determined during a screening consultation:
  • Acute myocardial infarction within the past two days
  • Ongoing unstable angina
  • Uncontrolled cardiac arrhythmias
  • Active endocarditis
  • Symptomatic severe aortic stenosis
Show all 12Show fewer
  • Decompensated heart failure
  • Active pulmonary embolism, pulmonary infarction, or deep venous thrombosis
  • Active myocarditis or pericarditis
  • Acute aortic dissection
  • Physical disability that precludes safe and adequate testing
  • Participants who demonstrate orthostatic intolerance or oxygen desaturation (<90%) during the exercise tolerance test will no longer be eligible for the study because it is not safe for them to exercise on a treadmill.

Trial locations and contacts

1 site in 1 country.

Noah Greenspan, DPT contact

(212) 249-0904

consult@covidpt.org

Julie Walsh-Messinger, Ph.D. contact

(937) 229-1380

udcovidstudy@udayton.edu

United States1 site, 1 recruiting
  • Post-COVID Rehabilitation and Recovery Clinic at H&D Physical Therapy

    New York, New York, 10017

    Noah Greenspan, DPT, 212-921-0214, consult@covidpt.org

    Julie Walsh-Messinger, PhD, (937) 229-1380, udcovidstudy@udayton.edu

    Recruiting

Other trials in United States

About this study

This study will test the efficacy of treadmill exercise combined with supplemental oxygen during exercise and recovery for the treatment of persistent post-acute COVID-19 symptoms. Participants will be pseudo-randomized (stratified by age) to one of four conditions for 8 treatment sessions: 1) treadmill exercise plus supplemental oxygen, 2) treadmill exercise plus air, 3) supplemental oxygen only, 4) air only. All participants will then cross-over and receive 16 additional sessions of treadmill exercise plus supplemental oxygen.

Read the detailed description

This study will test the efficacy of a COVID-19 specific cardiopulmonary rehabilitation protocol for treatment of persistent post-acute COVID symptoms and to study the impact of cardiopulmonary improvement on cognition, mental health, and function. Participants (N=36) with persistent post-acute COVID symptoms will undergo pre-treatment neurocognitive, orthostatic tolerance, and exercise tolerance tests before being pseudo-randomized (stratified by age and sex) to one of four conditions (all of which occur twice a week): 1) 8 sessions of treadmill exercise plus supplemental oxygen, 2) 8 sessions of treadmill exercise plus air, 3) 8 sessions of supplemental oxygen only, and 4) 8 sessions of air only. The pre-treatment testing will be repeated, after which all participants will receive 16 additional sessions of treadmill exercise plus supplemental oxygen, followed by post-treatment testing. All participants will complete baseline measures of physical and mental health, physical function, emotional wellbeing, and coping. A brief symptom measure will be collected daily and physical function, mental health, and emotional wellbeing will be assessed weekly.

Being tested
Treadmill Exercise, Concentrated Oxygen, Concentrated Air
Keywords
Post-COVID Syndrome, Post-acute COVID, Long COVID
Medical subject headings
COVID-19, Post-Acute COVID-19 Syndrome

What participants receive

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

  • Treadmill ExerciseOther

    Also called Supplemental oxygen (6 liters per minute)

    The cardiopulmonary rehabilitation protocol utilizes progressive treadmill exercise with alternating increases in intensity and incline with no more than 0.5 Met increase per session.

  • Concentrated OxygenOther

    Supplemental oxygen from a concentrator (6 liters per minute) will be provided via nasal cannula regardless of oxygen saturation.

  • Concentrated AirOther

    Room air will be delivered through an concentrator provided via nasal cannula.

Study groups in NCT04898205
Study groupRoleWhat they receive
Treadmill Exercise with Supplemental OxygenExperimentalParticipants will receive 24 sessions (2 x week for 12 weeks) of treadmill exercise combined with 6 liters per minute of supplemental oxygen via nasal cannula during exercise and 5-minutes of recovery. The first treadmill session will last 25% longer than the exercise tolerance test, but at a lower intensity, such that 80-100% of peak exercise intensity calculated from the exercise tolerance test MET is achieved within three sessions, after which time and intensity will be increased by no more than 0.5 METS, as tolerated based on symptoms and vitals. Heart rate, rhythm, and oxygen saturation will be continuously monitored, and blood pressure readings will be obtained every three to five minutes.
Receives: Other: Treadmill Exercise; Other: Concentrated Oxygen
Treadmill Exercise with AirSham comparatorParticipants will receive 8 sessions (2 x week for 4 weeks) of treadmill exercise combined with air delivered via nasal cannula during exercise and 5-minutes of recovery. They will then cross-over to 16 sessions of treadmill exercise combined with 6 liters per minute of supplemental oxygen via nasal cannula during exercise and 5-minutes of recovery. The first treadmill session will last 25% longer than the exercise tolerance test, but at a lower intensity, such that 80-100% of peak exercise intensity calculated from the exercise tolerance test MET is achieved within three sessions, after which time and intensity will be increased by no more than 0.5 METS, as tolerated based on symptoms and vitals. Heart rate, rhythm, and oxygen saturation will be continuously monitored, and blood pressure readings will be obtained every three to five minutes.
Receives: Other: Treadmill Exercise; Other: Concentrated Oxygen; Other: Concentrated Air
Supplemental Oxygen OnlySham comparatorParticipants will receive 8 treatment sessions (2 x week for 4 weeks) of 6 liters per minute of continuous oxygen via nasal cannula for 30 minutes at rest. Heart rate, rhythm, and oxygen saturation will be continuously monitored, and blood pressure readings will be obtained every three minutes. They will then cross-over to 16 sessions of treadmill exercise combined with 6 liters per minute of supplemental oxygen via nasal cannula during exercise and 5-minutes of recovery. The first treadmill session will last 25% longer than the exercise tolerance test, but at a lower intensity, such that 80-100% of peak exercise intensity calculated from the exercise tolerance test MET is achieved within three sessions, after which time and intensity will be increased by no more than 0.5 METS, as tolerated based on symptoms and vitals. Heart rate, rhythm, and oxygen saturation will be continuously monitored, and blood pressure readings will be obtained every three to five minutes.
Receives: Other: Treadmill Exercise; Other: Concentrated Oxygen
No InterventionPlacebo comparatorParticipants will receive 8 treatment sessions (2 x week for 4 weeks) of air via nasal cannula for 30 minutes at rest. Heart rate, rhythm, and oxygen saturation will be continuously monitored, and blood pressure readings will be obtained every three minutes. They will then cross-over to 16 sessions of treadmill exercise combined with 6 liters per minute of supplemental oxygen via nasal cannula during exercise and 5-minutes of recovery. The first treadmill session will last 25% longer than the exercise tolerance test, but at a lower intensity, such that 80-100% of peak exercise intensity calculated from the exercise tolerance test MET is achieved within three sessions, after which time and intensity will be increased by no more than 0.5 METS, as tolerated based on symptoms and vitals. Heart rate, rhythm, and oxygen saturation will be continuously monitored, and blood pressure readings will be obtained every three to five minutes.
Receives: Other: Treadmill Exercise; Other: Concentrated Oxygen; Other: Concentrated Air

What is being measured

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

  1. Heart rate and rhythm response to exercise and positional changes

    Heart rate and rhythm will be measured using 3-lead ECG telemetry

    Measured: Up to 24-weeks

  2. Blood pressure response to exercise and positional changes

    Blood pressure will be measured via manual cuff

    Measured: Up to 24-weeks

  3. Activity metabolic equivalent of task (MET) tolerated

    MET will be computed based upon peak exercise speed (MPH) and incline % gradation). Scores are expected to range from 1.8 to 12.1 (but can be higher is speed exceeds 3.9 MPH). Higher METs indicate more energy output.

    Measured: Up to 24-weeks

  4. Breathlessness

    Breathlessness will be assessed during peak exercise via self-report using the Borg Dyspnea scale. Scores can range from 0 to 20 and higher scores indicate more breathlessness

    Measured: Up to 24-weeks

  5. Rate of perceived exertion (RPE)

    RPE will be assessed during peak exercise via self-report using the Borg RPE scale. Scores can range from 0 to 20 and higher scores indicate more RPE.

    Measured: Up to 24-weeks

  6. Cognition (attention, short, delayed, and working memory, verbal fluency, and abstraction).

    Cognition will be assessed with the Repeatable Battery for the Assessment of Neuropsychological Status Update (RBANS-U) List Learning, List Recall, List Recognition, Story Memory, Story Recall, Semantic Fluency and Picture Naming subtests and the Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) Similarities and Digit Span subtests. All scores will be standard scores based on age norms.

    Measured: Up to 24-weeks

  7. Post-acute COVID symptoms (PACS)

    Frequency and severity of 38 PACS symptoms will be assessed daily via an online survey. Each symptom will be rated on a scale of 0 (not present) to 5 (severe).

    Measured: Up to 24-weeks

  8. Physical Function

    Physical function will be measured weekly via self-report with the Physical Function Short Form-36. Scores can range from 0 to 100 and higher scores indicate better function.

    Measured: Up to 24-weeks

Secondary outcomes (6)
  1. Depression

    Depression will be measured weekly with the Center for Epidemiological Studies Depression Scale - Revised (CESD-R). Scores range from 0 to 60 and higher scores indicate greater depression severity.

    Measured: Up to 24-weeks

  2. Generalized anxiety

    Generalized anxiety will be measured weekly using the Generalized Anxiety Disorder - 2 (GAD-2). Scores range from 0 to 6 and higher scores indicate greater anxiety severity.

    Measured: Up to 24-weeks

  3. State anxiety

    Anxiety will be measured weekly using the State Trait Anxiety Inventory (STAI) - State scale. Scale scores range from 20 to 80, with higher scores indicating greater state anxiety.

    Measured: Up to 24-weeks

  4. Trait anxiety

    Trait anxiety will be measured weekly using the State Trait Anxiety Inventory (STAI) - Trait scale. Scores can range from 20 to 80, with higher scores indicating greater trait anxiety.

    Measured: Up to 24-weeks

  5. Improvement in quality of life

    Quality of life will be measured weekly with the Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF). Raw scores range from 14 to 70 and will be converted to a percentage score based on the following formula:

    (raw total score -minimum score)/(maximum possible raw score -minimum score). Higher scores indicate greater life satisfaction.

    Measured: Up to 24-weeks

  6. Perception of cognitive function

    Perception of cognitive function will be assessed with the Neuro-QOL Cognitive function subscale which measures self-reported cognitive functioning over the past week, including perceptions of memory, executive functions, processing speed, and learning. Raw scores can range from 8 to 40, and will be converted to T-scores based on the administration manual norms. Higher scores indicated better perceived cognitive function.

    We have modified the baseline administration to also assess whether perceived cognitive function has changed since onset of acute COVID-19.

    Measured: Up to 24-weeks

Timeline

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

  1. First posted24 May 2021
  2. Study start21 Jan 2021
  3. Primary completion20 Jan 2022 (estimated)
  4. Study completion20 Jan 2022 (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
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
This study entails 24 treatment sessions. The first 8 sessions involve four experimental conditions: 1) exercise + oxygen (treatment), exercise + air (active control), oxygen only (active control), air only (placebo). Pre-treatment testing will then be repeated, after which all participants will crossover to 16 sessions of exercise + oxygen.
Masking
Single blind
Who is masked
Participant
Enrolment
24 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04898205
Sponsor's protocol ID
PLM UD 2021
Status last verified
May 2021
First submitted
17 May 2021
Last updated
25 May 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Upon conclusion of the study, we will share de-identified data upon request.

Questions about this trial

What is this clinical trial studying?

A study testing Treadmill Exercise, Concentrated Oxygen and Concentrated Air in people with Covid19 and Viral Syndrome, run by Noah Greenspan at 1 site in United States.

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 12 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 25 May 2021. 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 United States. 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 Noah Greenspan, DPT ((212) 249-0904, consult@covidpt.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Heart rate and rhythm response to exercise and positional changes (time frame: Up to 24-weeks). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 25 May 2021.

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