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Trial registered on ANZCTR
Registration number
ACTRN12621001226897p
Ethics application status
Submitted, not yet approved
Date submitted
2/08/2021
Date registered
13/09/2021
Date last updated
13/09/2021
Date data sharing statement initially provided
13/09/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Testing a new ice vest that could help people experiencing Multiple Sclerosis exercise
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Scientific title
Effectiveness and acceptability of a novel cooling vest to assist people experiencing Multiple Sclerosis perform high-intensity exercise
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Secondary ID [1]
304936
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None
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Universal Trial Number (UTN)
U1111-1268-4326
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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:
Heat sensitivity in Multiple Sclerosis
323087
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Condition category
Condition code
Neurological
320661
320661
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0
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Multiple sclerosis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Two cooling vests with removable phase change cooling gel packs will be assessed separately including the UnderCool 2.0 (ThermApparel, Rochester, NY, USA) and the CryoVest Comfort (CryoInnov, Melesse, France). The vests will be individually fitted by the researcher and worn during 45 min of stationary cycling involving high-intensity intervals in a laboratory conditions of 22°C and 40% relative humidity. The exercise sessions will be supervised by an accredited physiotherapist or exercise scientist. The session is based on the 6th week/maintenance phase of the ‘MS Get A Head Start Program’ and includes;
•Warm-up: 2 min light-intensity, 2 min moderate-intensity, 1 min vigorous-intensity, 1 min rest (6 min total)
•Main set: 6 sets of 3 intervals (45 s high-intensity, 45 s rest) with 1 min rest between sets (33 min total)
•Cool-down: 6 min light-intensity (6 min total)
The intensities described above are established during a familiarisation session based on the Borg rating of perceived exertion scale.
The gel packs will be frozen according to manufacturer instructions and inserted into the vests immediately prior to commencing the exercise protocol. The UnderCool 2.0 weighs 0.6 kg with inserts and covers the abdomen and lower back. The CryoVest Comfort weighs 1.8 kg with inserts and covers the upper part of the torso from the collarbone to the upper abdomen and through to the mid-neck, posteriorly. In the control condition, no vest will be worn. Participants will wear standardised exercise clothing in all trials including a cotton t-shirt and polyester shorts. The cooling vests will be worn underneath the t-shirt. A control condition was chosen rather than a placebo (e.g. spraying the t-shirt with a liquid menthol solution), as the primary outcome measures of thermal and cardiovascular strain are objective measures that could not be influenced by a placebo effect.
Each participant will be subject to each intervention once in a randomised order involving a 2 h visit to the Research Centre each week for four weeks (familiarisation and then three experimental trials). Trials will be performed one-on-one or staggered in small groups of 2-3 people where possible and a checklist will be used to monitor attendance. The wash-out period between trials is one week.
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Intervention code [1]
321331
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Lifestyle
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Intervention code [2]
321476
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Treatment: Devices
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Comparator / control treatment
CryoVest Comfort and no vest (control). Apart from the vest/no vest component itself, all other aspects of the session will be identical.
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Control group
Active
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Outcomes
Primary outcome [1]
328659
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Gastrointestinal temperature with a temperature sensor pill ingested by participants prior to beginning each trial,
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Assessment method [1]
328659
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Timepoint [1]
328659
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At baseline and every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise
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Primary outcome [2]
328660
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Mean skin temperature with infrared temperature scanner
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Assessment method [2]
328660
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Timepoint [2]
328660
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At baseline and every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise
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Primary outcome [3]
328661
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total whole body sweat rate estimated from change in body mass measured by digital scales
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Assessment method [3]
328661
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Timepoint [3]
328661
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measures of body mass collected before and after exercise to make calculation
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Secondary outcome [1]
399854
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Heart rate with chest band heart rate monitor
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Assessment method [1]
399854
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Timepoint [1]
399854
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Every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise
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Secondary outcome [2]
399855
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thermal sensation with Young's thermal sensation scale
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Assessment method [2]
399855
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Timepoint [2]
399855
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At baseline and every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise. Measurements also taken at 2-, 4-, 6- and 8-hours post-exercise using Qualtrics Survey software
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Secondary outcome [3]
399856
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Rating of perceived exertion using Borgs CR10 scale
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Assessment method [3]
399856
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Timepoint [3]
399856
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Every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise
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Secondary outcome [4]
399858
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perceived pain using a custom 0-10 visual analogue scale where 0=none at all and 10=severe
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Assessment method [4]
399858
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Timepoint [4]
399858
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At baseline and every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise. Measurements also taken at 2-, 4-, 6- and 8-hours post-exercise using Qualtrics survey software.
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Secondary outcome [5]
399859
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perceived urinary urgency using a custom 0-10 visual analogue scale where 0=none at all and 10=severe
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Assessment method [5]
399859
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Timepoint [5]
399859
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At baseline and every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise. Measurements also taken at 2-, 4-, 6- and 8-hours post-exercise using Qualtrics survey software.
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Secondary outcome [6]
399860
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perceived concentration difficulty using a custom 0-10 visual analogue scale where 0=none at all and 10=severe
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Assessment method [6]
399860
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Timepoint [6]
399860
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At baseline and every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise. Measurements also taken at 2-, 4-, 6- and 8-hours post-exercise using Qualtrics survey software.
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Secondary outcome [7]
399861
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perceived fatigue using a custom 0-10 visual analogue scale where 0=none at all and 10=severe
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Assessment method [7]
399861
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Timepoint [7]
399861
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At baseline and every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise. Measurements also taken at 2-, 4-, 6- and 8-hours post-exercise using Qualtrics survey software.
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Secondary outcome [8]
399862
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vest concealability with a study specific single item question ("the vest was concealable") using a 1-7 Likert scale where 1=strongly disagree and 7=strongly agree.
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Assessment method [8]
399862
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Timepoint [8]
399862
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upon completion of all exercise trials
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Secondary outcome [9]
399863
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vest comfort with a study specific single item question ("the vest was comfortable") using a 1-7 Likert scale where 1=strongly disagree and 7=strongly agree.
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Assessment method [9]
399863
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Timepoint [9]
399863
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upon completion of all exercise trials
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Secondary outcome [10]
399864
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vest functionality with a study specific single item question ("the vest allowed me to move unrestricted") using a 1-7 Likert scale where 1=strongly disagree and 7=strongly agree.
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Assessment method [10]
399864
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Timepoint [10]
399864
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at end of all exercise trials
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Secondary outcome [11]
399865
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'intention to use vest in future' with a study specific single item question ("I would use the vest during exercise if I had one") using a 1-7 Likert scale where 1=strongly disagree and 7=strongly agree.
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Assessment method [11]
399865
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Timepoint [11]
399865
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at end of all exercise trials
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Secondary outcome [12]
399866
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thermal comfort with a study specific questionnaire of a 1-5 Likert scale where 1=comfortable and 5=extremely uncomfortable.
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Assessment method [12]
399866
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Timepoint [12]
399866
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At baseline and every 5 minutes throughout the trial. A mean will also be calculated for measures collected during exercise. Measurements also taken at 2-, 4-, 6- and 8-hours post-exercise using Qualtrics survey software.
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Eligibility
Key inclusion criteria
20 participants with a confirmed diagnosis of MS (including both relapsing remitting and primary progressive) will be recruited from within the ‘MS Get a Head Start’ exercise program in Coffs Harbour, NSW. Inclusion criteria are: aged between 18-64 years; report being 3-5.5 on the Expanded Disability Status Scale (EDSS); be at least 12 months from last relapse; completed at least 5-weeks of the ‘MS Get a Head Start Program’ including recumbent cycling; self-reported the presence of fatigue and heat-sensitivity as part of MS symptomology.
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Minimum age
18
Years
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Maximum age
64
Years
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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
Participants will be excluded if they are not cleared to perform high-intensity exercise as per the Exercise & Sports Science Australia Adult Pre-exercise Screening System and/or their general practitioner, or if they report any other condition that may affect thermoregulation (e.g. spinal cord injury, Parkinson disease). A need for analgesics or anti-inflammatory drugs within 72 hours of a trial will also be an exclusion criterion.
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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 involved contacting the holder of the allocation schedule who was "off-site"
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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 computer software
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
Counter-balanced
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The sample size was chosen based on a power calculation (G*Power 3.1.9.2) with an alpha of 0.05, an effect size of 0.25 and a power of 0.8. A conservative small effect size was chosen as cooling vests worn during exercise only have a small effect on the primary outcome variable of core body temperature.
For measures of body temperatures, sweat rate, heart rate, perceived exertion, thermal perception and heat related MS symptomology, a two-way repeated measures ANOVA (condition x time) will be used to determine if there is a statistically significant main or interaction effect. Where significant effects exist, paired-samples t-tests (with Holm-Bonferroni correction) will be used to determine significant differences between groups and time-points. For measures of vest acceptability, a Friedman test will be used to determine significant differences between distributions of the groups. Where significant differences in distributions exist, pairwise comparisons with Holm-Bonferroni correction (SPSS Statistics, 2012) will be conducted to determine significant differences between conditions. Cohen’s d effect size statistic will be calculated to determine the magnitude of any statistically significant differences and categorised as; 0.2 = small, 0.5 = medium and 0.8 = large effect.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/02/2022
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Actual
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Date of last participant enrolment
Anticipated
1/05/2022
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Actual
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Date of last data collection
Anticipated
30/06/2022
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Actual
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Sample size
Target
20
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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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Recruitment postcode(s) [1]
34844
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2450 - Coffs Harbour
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Funding & Sponsors
Funding source category [1]
309320
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University
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Name [1]
309320
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Southern Cross University
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Address [1]
309320
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1 Hogbin Dr, Coffs Harbour, NSW 2450
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Country [1]
309320
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Australia
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Primary sponsor type
Individual
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Name
Dr Christopher Stevens
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Address
1 Hogbin Dr, Coffs Harbour, NSW 2450
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Country
Australia
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Secondary sponsor category [1]
310289
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None
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Name [1]
310289
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Address [1]
310289
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Country [1]
310289
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
309144
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Southern Cross University Human Research Ethics Committee
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Ethics committee address [1]
309144
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1 Military Dr, Lismore, NSW, 2480
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Ethics committee country [1]
309144
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Australia
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Date submitted for ethics approval [1]
309144
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12/08/2021
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Approval date [1]
309144
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Ethics approval number [1]
309144
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Summary
Brief summary
To investigate the acute effect of the UnderCool 2.0 cooling vest during high-intensity exercise in a heat sensitive MS population on; i) body temperatures and sweating, ii) feelings of exertion and hotness, iii) MS symptoms that are aggravated by heat, and iv) Concealability, comfort and functionality. With a controlled, cross-over design, 20 participants diagnosed with MS will complete four high-intensity interval cycling sessions on separate days including familiarisation and three experimental trials with participants wearing either; i) an UnderCool 2.0 cooling vest, ii) a CryoVest Comfort cooling vest (current evidence-informed practice), or iii) no vest. The exercise sessions will be high-intensity interval cycling sessions of 45 minutes in controlled conditions (22°C, 40% relative humidity). Exercise intensities will be standardised across all trials. It is hypothesised that compared to control, during high-intensity exercise, the UnderCool 2.0 cooling vest will: 1) Attenuate the increase in gastrointestinal temperature, mean skin temperature, sweat rate and heart rate 2) Attenuate the increase in perceived exertion, thermal discomfort and thermal sensation, and 3) Reduce perceptions of fatigue, pain, difficulty concentrating and urinary urgency It is further hypothesised that compared to the CryoVest Comfort, during high-intensity exercise, the UnderCool 2.0 cooling vest will: 4) Improve perceptions of concealability, comfort, functionality and intention to use 5) Similarly attenuate the increase in gastrointestinal temperature, mean skin temperature, sweat rate and heart rate 6) Similarly attenuate the increase in perceived exertion, thermal discomfort and thermal sensation, and 7) Similarly reduce perceptions of fatigue, pain, difficulty concentrating and urinary urgency
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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
113142
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Dr Christopher Stevens
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Address
113142
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Southern Cross University, 1 Hogbin Dr, Coffs Harbour, NSW, 2450
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Country
113142
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Australia
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Phone
113142
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+61 2 6659 8036
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Fax
113142
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Email
113142
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[email protected]
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Contact person for public queries
Name
113143
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Christopher Stevens
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Address
113143
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Southern Cross University, 1 Hogbin Dr, Coffs Harbour, NSW, 2450
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Country
113143
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Australia
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Phone
113143
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+61 2 6659 8036
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Fax
113143
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Email
113143
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[email protected]
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Contact person for scientific queries
Name
113144
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Christopher Stevens
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Address
113144
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Southern Cross University, 1 Hogbin Dr, Coffs Harbour, NSW, 2450
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Country
113144
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Australia
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Phone
113144
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+61 2 6659 8036
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Fax
113144
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Email
113144
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Reduce risk of participant privacy invasion and to reduce the risk of poor secondary data analysis.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
12739
Ethical approval
[email protected]
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.
Download to PDF