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Partitioned Training of Patients With Idiopathic Pulmonary Fibrosis
Study Purpose
Idiopathic pulmonary fibrosis (IPF) is a lung disease that limits the ability to breathe
enough for a good workout. One way to improve the exercise training is to reduce the number
of muscles being trained together. By training one leg at a time, the patient does not have
to breathe as much allowing each leg a better workout. Our groundwork suggests it may work in
patients with IPF. This study will help decide whether one-legged exercise training is better
at improving a patient's exercise endurance compared to the usual way of exercising with both
legs at the same time.
Recruitment Criteria
Accepts Healthy Volunteers
Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms
No
Study Type
An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.
An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.
Searching Both is inclusive of interventional and observational studies.
Interventional
Eligible Ages
18 Years and Over
Gender
All
More Inclusion & Exclusion Criteria
Inclusion Criteria:
- confirmed idiopathic pulmonary fibrosis.
- Clinically stable.
- enrolled in pulmonary rehabilitation.
Exclusion Criteria:
- co-morbidities that might impair their ability to safely complete a pulmonary
rehabilitation program.
- complete a pulmonary rehabilitation program within the previous 6 months.
- experienced an exacerbation less than six weeks before participation
Trial Details
Trial ID:
This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.
Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.
Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.
Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.
Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.
N/A
Lead Sponsor
The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.
West Park Healthcare Centre
Principal Investigator
The person who is responsible for the scientific and technical direction of the entire clinical study.
Roger S Goldstein
Principal Investigator Affiliation
West Park Healthcare Centre
Agency Class
Category of organization(s) involved as sponsor (and collaborator) supporting the trial.
Other
Overall Status
Recruiting
Countries
Canada
Conditions
The disease, disorder, syndrome, illness, or injury that is being studied.
Lung; Disease, Interstitial, With Fibrosis
Additional Details
Dyspnea is a major clinical manifestation of idiopathic pulmonary fibrosis (IPF). It becomes
more severe and more limiting as the condition progresses. Many professional respiratory
societies recommend that the standard of care for IPF includes pulmonary rehabilitation (PR).
However, some patients with IPF are so limited by dyspnea that they are unable to tolerate
levels of aerobic exercise training sufficient to induce the physiological adaptations that
will improve functional and health related outcomes. Therefore, there is a need for exercise
training interventions that will enhance the muscle training stimulus above that currently
possible in individuals with a marked ventilatory limitation.
Partitioning large muscle exercise using one-legged high intensity training is more effective
than conventional aerobic training when applied to patients with central ventilatory or
cardiac limitation. Effective partitioned exercise enables an increased muscle load with less
ventilatory load. It increases the training stimulus to the muscles as they work at a high
intensity, relative to their current aerobic state, necessary to increase their capacity. As
long as the active muscle mass can create the same demands on the central exercise components
of the heart and circulation as does conventional two-legged exercise, this simple,
inexpensive novel approach, will stimulate leg muscles sufficiently to improve overall
cardiorespiratory fitness. For example, in those with chronic obstructive pulmonary disease,
one-legged training has been shown to provide a muscle specific stimulus sufficient to
improve whole body peak oxygen uptake during pulmonary rehabilitation. A preliminary acute
study of patients with IPF has demonstrated that during a laboratory simulation of an
exercise training session, partitioning aerobic exercise extended exercise tolerance.
Participants achieved double the work whilst exercising with one leg compared with two-legged
cycle exercise. Partitioned training may therefore be an effective approach to exercise
training in patients with IPF enrolled in PR.
The advent of pharmacological agents that stabilize the clinical course of IPF presents a
window of opportunity for exercise rehabilitation to further improve function. The aim of
this proposed study is to determine whether, within the setting of PR, partitioned aerobic
exercise training with a one-legged cycle training regime is more effective than the
conventional two-legged regimen in increasing exercise tolerance. The study hypothesis is
that partitioned aerobic exercise training, using a one-legged training regime is more
effective than conventional two-legged exercise training in increasing exercise tolerance
(measured by constant power endurance) and cardiorespiratory fitness as measured by maximal
oxygen uptake. The results will inform the best approach to produce clinically meaningful
improvements in dyspnea and health status for those with IPF.
Arms & Interventions
Arms
Experimental: intervention -1-leg cycle training
Primary aerobic training component one-legged, partitioned, cycle training. A progressive approach to combined intensity and duration will be taken. A cycle starting with intermittent high intensity one-legged exercise progressing to continuous duration of the target duration of 15 min for each leg and then restarting the cycle at a higher intensity.
Active Comparator: usual care - 2-leg cycle training
Primary aerobic training component conventional two-legged cycle training. A progressive approach to combined intensity and duration will be taken. A cycle starting with intermittent high intensity exercise progressing to continuous duration of 30 min and then restarting the cycle at a higher intensity.
Interventions
Other: - intervention -1-leg cycle training
partitioned aerobic exercise training
Other: - usual care - 2-leg cycle training
conventional aerobic exercise training
Contact a Trial Team
If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.
International Sites
West Park Healthcare Centre, Toronto, Ontario, Canada
