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Trial registered on ANZCTR
Registration number
ACTRN12616000030471
Ethics application status
Approved
Date submitted
14/01/2016
Date registered
18/01/2016
Date last updated
6/02/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Investigation of changes to balance during walking with exertion in adults with chronic obstructive pulmonary disease
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Scientific title
Pilot study investigating changes in balance control during walking with exertion in adults with chronic obstructive pulmonary disease
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Secondary ID [1]
288315
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nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Postural balance
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Condition category
Condition code
Neurological
297477
297477
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0
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Other neurological disorders
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Respiratory
297517
297517
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0
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Chronic obstructive pulmonary disease
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Each participant will attend for two testing sessions one week apart (washout). Attendance of total duration two hours (ie one hour each session) with no follow up. At each session one of the two walking tests will be undertaken. Test order will be allocated randomly (computer generated by an independent researcher and numbers provided to research team in opaque envelopes). the two test are;
1. Shuttle Walk Test
A standardised externally paced incremental field walking task that provokes a symptom limited maximal performance
Used to assess functional capacity in people with chronic airways obstruction
One test is required for learning then a repeat test for assessment
The participant is required to walk between two cones in time to a set of auditory beeps played on a CD. Initially, the walking speed is very slow, but each minute the required walking speed progressively increases. The participant walks for as long as they can until they are either too breathless or can no longer keep up with the beeps at which time the test ends. The period of
A one-week washout period separates the two tests
2. 6 Minute Walk Test
This is a sub maximal test with normative data developed for community dwelling older adults
Used as a performance measure of gait endurance
Two tests within 30 minutes are required for validity
The object of this test is to walk as quickly as possible for six minutes between two markers so that the participant can cover as much ground as possible. The participant may slow down if necessary or stop. The participant may recommence walking again as soon as possible until the full 6 minute duration has elapsed
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Intervention code [1]
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Not applicable
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Comparator / control treatment
no control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Gait regularity: The GAITRite sensor mat and software will be utilised to capture:
Stride-time variability
Walking Velocity (distance and time analysis)
Step length variability
Step width variability
Double-support phase
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Assessment method [1]
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Timepoint [1]
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During the single assessment shuttle walk test as well as the two 6 minute walk tests.
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Primary outcome [2]
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Dynamic balance measured using Functional reach. It is a performance measure which identifies forwards reach ability in bilateral stance (self-generated perturbation) using continuous ratio data
This measure will be performed before and after each intervention to identify a change in dynamic balance after exertional walking
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Assessment method [2]
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Timepoint [2]
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Before and after the shuttle walk test and the two 6 minute walk tests (ie 6 time points)
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Secondary outcome [1]
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Level of exertion measured using both the modified Borg dyspnea scale and oxygen saturation levels, heart rate and respiratory rate by capnograph
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Assessment method [1]
319906
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Timepoint [1]
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Throughout the single assessment shuttle walk test as well as the two 6 minute walk tests
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Eligibility
Key inclusion criteria
1. People with a confirmed diagnosis of COPD (as determined by a lung function test)
2. Adults (18 years and over) able to provide informed consent to participate in the study
3. A current or recent participant of Pulmonary Rehabilitation at the UTAS, Launceston Campus
4. Able to ambulate independently on a flat even surface to complete the test safely
5. Living at home with or without oxygen supplementation
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Minimum age
18
Years
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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
1. People with end stage COPD that are requiring palliative management
2. People with a self-reported acute infective exacerbation in their symptoms
3. People that require a gait aid, a prosthetic limb, or physical assistance to walk
4. People with a significant neurological condition that affects their gait regularity
5. Women who are pregnant
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
To determine if gait regularity is affected by exertional walking:
Gait regularity will be analysed using linear regression modelling for within task and between task comparisons. If the residuals from linear modelling do not meet the requirements of linear regression then data will be analysed using logistic regression. A paired T test will be used to compare functional reach prior to and after each of the exertional tasks. Covariance accounting for baseline values will be undertaken.
To determine if dynamic balance is affected by exertional walking:
Functional reach will be measured before and after each exertional task and within task differences will be measured using paired t test
Correlation analysis will be undertaken to assess the relationship between changes to gait regularity and measures of exertion including oxygen saturation and heart rate.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
7/03/2016
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Actual
16/07/2016
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Date of last participant enrolment
Anticipated
7/03/2017
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Actual
19/01/2017
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Date of last data collection
Anticipated
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Actual
19/01/2017
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Sample size
Target
20
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Accrual to date
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Final
20
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Recruitment in Australia
Recruitment state(s)
TAS
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Tasmania
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Address [1]
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Newnham Drive, Newnham, Tasmania 7250
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Tasmania
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Address
Newnham Drive, Newnham, Tasmania 7250
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
291409
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294159
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Tasmanian Health and Medical Human Research Ethics Committee
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Ethics committee address [1]
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Private Bag 01 Hobart TAS 7001
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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06/11/2015
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Approval date [1]
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17/12/2015
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Ethics approval number [1]
294159
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H0015372
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Summary
Brief summary
A significant and well-established impact of Chronic Obstructive Pulmonary Disease (COPD) is poor balance and high rates of falling. People with COPD have well identified falls risk factors such as reduced balance, poor strength, and irregular walking patterns. However, further investigation into how balance changes during exertion is required in order to implement strategies for reducing the incidence of accidental falls in this population. The aim of the proposed study is to determine if adults with chronic obstructive pulmonary disease (COPD) have deterioration in their walking pattern (gait) regularity during walking with exertion, and have worse dynamic balance after exertional walking. This study examines changes in balance control (as measured by gait regularity and limits of stability) in adults with COPD during self-paced walking (6 Minute Walk Test) and externally paced walking with regular increases in pace (Shuttle Walking Test). Measures of exertion (Modified Borg Dyspnoea Scale, SPO2 and HR) will be recorded concurrent to each walking task. The study design is repeated measure crossover study in which twenty people with COPD will be recruited from the University Exercise Clinic. Participants with stable COPD will perform both a 6 Minute Walk Test and a Shuttle Walk Test one week apart in a randomised order with gait regularity and oxygen saturation recorded at one minute intervals. Both the walking tasks will be performed on a GAITRite sensor mat recording walking pattern and gait regularity. Before and after each walking task balance (Functional Reach) and perceived level of dyspnoea measures will be taken. Gait regularity will be analysed using linear regression modelling for within task and between task comparisons. If the residuals from linear modelling do not meet the requirements of linear regression then data will be analysed using logistic regression. A paired T test will be used to compare functional reach prior to and after each of the exertional tasks. Covariance accounting for baseline values will be undertaken.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Marie-Louise Bird
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Address
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The School of Health Science,
University of Tasmania,
Locked Bag 1322, Launceston, Tasmania, 7250,
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Country
62738
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Australia
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Phone
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+61 3 63245497
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Fax
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Email
62738
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[email protected]
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Contact person for public queries
Name
62739
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Marie-Louise Bird
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Address
62739
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The School of Health Science,
University of Tasmania,
Locked Bag 1322, Launceston, Tasmania, 7250,
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Country
62739
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Australia
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Phone
62739
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+61 3 63245497
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Fax
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Email
62739
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[email protected]
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Contact person for scientific queries
Name
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Marie-Louise Bird
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Address
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The School of Health Science,
University of Tasmania,
Locked Bag 1322, Launceston, Tasmania, 7250,
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Country
62740
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Australia
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Phone
62740
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+ 61 3 63245497
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Fax
62740
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Email
62740
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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
No additional documents have been identified.
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