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Trial registered on ANZCTR
Registration number
ACTRN12612000745842
Ethics application status
Approved
Date submitted
10/07/2012
Date registered
13/07/2012
Date last updated
3/08/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Rehabilitation in Patients Hospitalised with An Acute Exacerbation of Chronic Obstructive Pulmonary Disease.
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Scientific title
Evaluation of exercise training versus usual care on exercise capacity, muscle strength and functional performance in patients hospitalised with an acute exacerbation of Chronic Obstructive Pulmonary Disease.
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Secondary ID [1]
280836
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Nil
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Universal Trial Number (UTN)
U1111-1132-4282
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Trial acronym
AECOPD: Acute Exacerbation of Chronic Obstructive Pulmonary Disease
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Exacerbation of Chronic Obstructive Pulmonary Disease (requires hospitalisation)
286903
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Condition category
Condition code
Physical Medicine / Rehabilitation
287219
287219
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0
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Physiotherapy
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Respiratory
287232
287232
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0
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Chronic obstructive pulmonary disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients allocated to the treatment group will receive two individual training sessions daily during the five weekdays, in which the morning session will be supervised, and the afternoon session will be unsupervised. The training sessions will comprise of walking and resistance exercises and will be carried out by a trained physiotherapist. The training will commence within 48 hours of admission until the patients are allowed to be discharged from the hospital. We expect each session (supervised or unsupervised) to take no longer than 30 minutes (inclusive of rests).
Resistance training includes sit to stand, half squats and step exercises. Initial prescription will be determined by one set of individualised number of repetition based on the baseline Sit-To-Stand-Test score. The exercise prescription will be increased by one set on every second day of training.
Walking training will be prescribed based on the baseline two-minute walk distance (2MWD) and progressed on every second day of training by increasing the distance walked during each session by 20%.
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Intervention code [1]
285250
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Rehabilitation
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Comparator / control treatment
Patients allocated to the control group will receive the usual medical and physiotherapy care given to patients admitted with an acute exacerbation of COPD according to the Malaysian Clinical Practice Guideline (CPG). It is expected that patients will receive usual care each weekday and the duration of the treatment will range between 15 to 30 minutes (depending on their individual needs).
In this guideline, a patient will be discharged if they meet all the criteria for discharge listed. Therefore, patients allocated to the control group will be involved in this study until they are allowed to be discharge from the hospital.
Patients allocated to the control group will receive usual care which includes:
Usual Medical care as described in the Malaysian COPD Clinical Practice Guidelines (CPG).
Usual Physiotherapy care may comprise airway clearance (if required), strategies to minimise dyspnoea (e.g. pursed lip breathing and positioning), and encouragement to mobilise in the ward.
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Control group
Active
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Outcomes
Primary outcome [1]
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Functional exercise capacity will be measured using the two-minute walk test (2MWT).
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Assessment method [1]
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Timepoint [1]
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Measurement at baseline and prior to discharge.
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Primary outcome [2]
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Peripheral muscle strength will be measured using a force gauge.
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Assessment method [2]
287510
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Timepoint [2]
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Measurement at baseline and prior to discharge.
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Primary outcome [3]
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Functional performance will be measured using the Sit-To-Stand-Test (STST)
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Assessment method [3]
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Timepoint [3]
287511
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Measurement at baseline and prior to discharge.
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Secondary outcome [1]
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Physical activity will be measured using a StepWatch Activity Monitor (SAM).
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Assessment method [1]
298289
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Timepoint [1]
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Measurement during the hospitalisation period
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Secondary outcome [2]
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Functional performance will be measured using the Timed-Up and Go (TUG) test.
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Assessment method [2]
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Timepoint [2]
298299
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Measurement at baseline and prior to discharge
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Eligibility
Key inclusion criteria
Patients who are admitted with an AECOPD.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(i) any contraindication to exercise as listed by the American College of Sports Medicine
(ii) hospitalisation within the previous 14 days
(iii) inability to understand or speak English or Malay
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation to intervention will be concealed by using sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computerised sequence generation will be used. The randomisation sequence will be stratified according to the hospital from which the patients were recruited (i.e. Hospital Selayang or Institute of Respiratory Medicine) and the patient’s baseline 2MWD.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Sample size calculation:
Assuming a between-group difference of 15% +/- 14% (alpha = 0.05, 1 - beta = 0.8), a sample size of 15 participants per group was needed (30 in total). This number was increased from 30 to 38 to allow for a 20% attrition rate
Data analyses:
Within- and between-group differences were analysed using a two-way repeated measures analysis of variance (two-way RM-ANOVA). Differences were expressed as mean difference (MD) and 95% confidence interval (CI). Analyses were undertaken according to an intention-to-treat basis.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/01/2013
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Actual
30/07/2013
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Date of last participant enrolment
Anticipated
27/01/2014
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Actual
4/08/2014
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Date of last data collection
Anticipated
31/01/2014
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Actual
8/08/2014
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Sample size
Target
38
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Accrual to date
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Final
38
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Recruitment outside Australia
Country [1]
4401
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Malaysia
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State/province [1]
4401
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Kuala Lumpur
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Funding & Sponsors
Funding source category [1]
285618
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Charities/Societies/Foundations
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Name [1]
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Malaysian Thoracic Society Research Grant
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Address [1]
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Malaysian Thoracic Society
Suite 2-3, Medical Academies of Malaysia,
210 Jalan Tun Razak,
50400 Kuala Lumpur
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Country [1]
285618
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Malaysia
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Primary sponsor type
University
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Name
School of Physiotherapy and Curtin Health Innovation Research Institute
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Address
Curtin University
Kent Street
Perth
Western Australia
6102
Australia
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Country
Australia
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Secondary sponsor category [1]
284450
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University
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Name [1]
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Faculty of Medicine, MARA University of Technology
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Address [1]
284450
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Hospital Selayang
Lebuhraya Selayang-Kepong,
68100 Batu Caves, Selangor Darul Ehsan.
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Country [1]
284450
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Malaysia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
287615
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Human Research Ethics Committees of Malaysia Ministry of Health
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Ethics committee address [1]
287615
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Jawatankuasa Etika & Penyelidikan Perubatan (Medical Research & Ethics Committee), Kementerian Kesihatan Malaysia, INstitut Pengurusan Kesihatan, Jalan Rumah Sakit, Bangsar. 59000 Kuala Lumpur
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Ethics committee country [1]
287615
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Malaysia
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Date submitted for ethics approval [1]
287615
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16/10/2012
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Approval date [1]
287615
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19/12/2012
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Ethics approval number [1]
287615
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NMRR-12-971-12644
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Ethics committee name [2]
295630
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Human Research Ethics Committees of Universiti Teknologi MARA
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Ethics committee address [2]
295630
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Faculty of Meedicine, UiTM Sungai Buloh Campus, Jalan Hospital 47000 Sungai Buloh Selangor Darul Ehsan
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Ethics committee country [2]
295630
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Malaysia
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Date submitted for ethics approval [2]
295630
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18/02/2013
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Approval date [2]
295630
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09/04/2013
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Ethics approval number [2]
295630
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600-RMI (5/1/6)
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Ethics committee name [3]
295631
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Human Research Ethics Committees of Curtin University
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Ethics committee address [3]
295631
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Curtin University, Kent street, Bentley, 6102. Western Australia, Australia.
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Ethics committee country [3]
295631
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Australia
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Date submitted for ethics approval [3]
295631
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08/01/2013
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Approval date [3]
295631
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21/01/2013
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Ethics approval number [3]
295631
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HR 13/2013
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Summary
Brief summary
The present study aims at investigating the effects of a standardised exercise training program that comprises of walking and resistance exercises on exercise capacity, quadriceps muscle strength and functional performance in patients hospitalised with an AECOPD. Study hypotheses In patients with COPD who are hospitalised with an acute exacerbation of their disease, those who are allocated to the treatment group will show a significantly greater improvement in 2MWD, quadriceps muscle force, performance in the STST and TUG, and physical activity compared to the control group.
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Trial website
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Trial related presentations / publications
Tahirah F, Jenkins S, Othman SK, Ismail R, Ismail T & Hill K. A randomised controlled trial of individualised, progressed early exercise in patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease. European Respiratory Journal 2015; 46: Supplement 59, PA 743.
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Public notes
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Contacts
Principal investigator
Name
34425
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Mrs Fatim Tahirah Mirza
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Address
34425
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PO Box No 9,
Batu 10 Jalan Taiping,
34300 Bagan Serai,
Perak
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Country
34425
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Malaysia
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Phone
34425
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+6057215739
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Fax
34425
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Email
34425
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[email protected]
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Contact person for public queries
Name
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Fatim Tahirah Mirza
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Address
17672
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School of Physiotherapy and Curtin Health Innovation Research Institute
Curtin University
Kent Street
Perth
Western Australia
6102
Australia
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Country
17672
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Australia
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Phone
17672
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+61892669443
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Fax
17672
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+61892663699
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Email
17672
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[email protected]
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Contact person for scientific queries
Name
8600
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A/Prof Sue Jenkins
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Address
8600
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School of Physiotherapy and Curtin Health Innovation Research Institute
Curtin University
Kent Street
Perth
Western Australia
6102
Australia
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Country
8600
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Australia
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Phone
8600
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+61 8 9266 3639
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Fax
8600
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+61 8 9266 3699
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Email
8600
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Initiating exercise training early during the hospitalisation for an exacerbation of chronic obstructive pulmonary disease improves exercise capacity and quadriceps strength: A randomised controlled trial: Early exercise during COPD exacerbation.
2020
https://dx.doi.org/10.1016/j.yrmex.2020.100024
N.B. These documents automatically identified may not have been verified by the study sponsor.
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