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Trial registered on ANZCTR
Registration number
ACTRN12616000429459p
Ethics application status
Not yet submitted
Date submitted
20/02/2016
Date registered
4/04/2016
Date last updated
4/04/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Respiratory muscle training to improve exercise capacity and quality of life in people with pulmonary arterial hypertension
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Scientific title
A mechanistic study of respiratory muscle training to improve exercise capacity and quality of life in people with pulmonary arterial hypertension
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Secondary ID [1]
288586
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None
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Universal Trial Number (UTN)
None
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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:
Pulmonary Hypertension
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Condition category
Condition code
Cardiovascular
297909
297909
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A randomised controlled study of respiratory muscle training for adults with pulmonary artery hypertension. The control group (Arm 1) will continue with usual/standard care. The training group (Arm 2) will undergo an 10 week respiratory muscle training program that includes 2 supervised sessions per week.
The respiratory muscle training group will be asked to attend hospital twice a week to undertake approximately 20 minutes of supervised training for 10 weeks. These sessions will be supervised by an Exercise Physiologist with expertise in respiratory muscle training. Training involves the participant breathing through a handheld device which provides resistance to their inhalation breaths. On one other day of the week participants will be asked to do 20 minutes of respiratory muscle training at home. Any costs incurred for travel to hospital will be reimbursed. Individuals in the control group will NOT participate in the Respiratory muscle training program.
Respiratory muscle training is performed using a threshold loading inspiratory muscle trainer (Threshold IMT; Respironics, Cedar Grove, NJ, USA). The participant will be seated and can lean forward and fix their arms on a chair or table if desired. The target inspiratory training load will initially be 30% of the maximum inspiratory pressure measured during assessment. The training will consist of:
1-minute warm-up at 50% of the target inspiratory training load
2 minutes of inspiratory muscle training at the target load followed by 1 minute rest
This 2-minute training plus 1-minute rest will be repeated seven times giving a total of 14 minutes of inspiratory muscle training and a total session time of 21 minutes. .
The training load will be increased based on maintaining the participant’s symptoms of perceived exertion at 3-4 (‘moderate’ to ‘somewhat heavy’) on the modified Borg 0-10 category-ratio rate of perceived exertion (RPE) scale. Participants will be asked to keep a diary to record their home training sessions to monitor adherence.
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Intervention code [1]
293981
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Rehabilitation
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Intervention code [2]
294074
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Treatment: Other
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Comparator / control treatment
Standard care that includes continuing medical therapy and usual levels of physical activity.
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Control group
Active
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Outcomes
Primary outcome [1]
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Peak oxygen uptake measured at cardiopulmonary exercise testing using a ramp protocol and open circuit spirometer.
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Assessment method [1]
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Timepoint [1]
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10 weeks
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Secondary outcome [1]
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6 minute walk distance.
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Assessment method [1]
321025
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Timepoint [1]
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10 weeks
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Secondary outcome [2]
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Quality of life (Sf-36)
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Assessment method [2]
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Timepoint [2]
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10 weeks
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Eligibility
Key inclusion criteria
Inclusion criteria are age greater than or equal to 18 years with either idiopathic or connective tissue disease related pulmonary arterial hypertension (mean arterial pressure of age greater than 25mmHg at rest assessed by right heart catherization) with NYHA Class II/III.
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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
Exclusion criteria are major intellectual instability, non-English speaking background, clinically unstable patients, lung volumes < 80% predicted, pregnancy and change in medication within 3 months of study commencement.
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
2/05/2016
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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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 Sydney
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Address [1]
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University of Sydney, NSW 2006
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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 Sydney
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Address
University of Sydney, NSW 2006
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Royal Prince Alfred Hospital
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Address [1]
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Missenden Rd Camperdown NSW 2050
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Country [1]
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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Royal Prince Alfred Hospital SLHD Ethics Committee
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Ethics committee address [1]
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Royal Prince Alfred Hospital Missenden Rd, Camperdown NSW Australia 2050
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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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21/04/2016
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Approval date [1]
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Ethics approval number [1]
294440
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Summary
Brief summary
We hypothesise that strengthening the respiratory muscles will improve exercise capacity and improve quality of life in people with pulmonary hypertension. This work plans to generate important information to help clinical specialists treat people suffering from pulmonary arterial hypertension. Currently, the best drug therapies available improve the distance a person can walk in 6 minutes by a mere 50m. Traditional types of exercise have been shown to have similar beneficial effects on exercise capacity, symptoms and quality of life but training needs to be carefully supervised because of safety issues making it impractical for many people. Respiratory muscle training places minimal stress on the cardiovascular system and thus could be safely performed in the home setting and may have important benefits in the setting of PAH.
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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 Rachael Cordina
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Address
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Department of Cardiology,
Royal Prince Alfred Hospital
Missenden Rd, Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 95156111
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Rachael Cordina
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Address
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Department of Cardiology,
Royal Prince Alfred Hospital
Missenden Rd, Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 95156111
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Rachael Cordina
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Address
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Department of Cardiology,
Royal Prince Alfred Hospital
Missenden Rd, Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 95156111
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Fax
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Email
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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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