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Trial registered on ANZCTR
Registration number
ACTRN12624000454572
Ethics application status
Approved
Date submitted
6/03/2024
Date registered
12/04/2024
Date last updated
2/10/2024
Date data sharing statement initially provided
12/04/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Development, feasibility, and efficacy of a co-designed exercise program for survivors of paediatric sarcoma
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Scientific title
Development, feasibility, and efficacy of a co-designed exercise program for survivors of paediatric sarcoma
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Secondary ID [1]
311627
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PFG_FULL_2023_004
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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:
Childhood sarcoma
333065
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Condition category
Condition code
Cancer
329750
329750
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0
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Sarcoma (also see 'Bone') - soft tissue
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Physical Medicine / Rehabilitation
329784
329784
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Brief name: Goal-directed therapeutic exercise program.
Participants will receive one weekly 30-60 minute individualised, goal-directed therapeutic exercise therapy program for 12 weeks, delivered face-to-face by a trained physiotherapist or exercise physiologist, with an accompanying home-based program to be completed three times per week.
Exercise intensity will be monitored using wearable sensors (ActiGraph GT3x+ and heart rate monitors) and/or perceived effort using the OMNI scale.
Participants will be assessed (via questionnaire and physical assessments) at the beginning, end-intervention (~12 weeks), and at a 6-month follow-up by a trained physiotherapist or exercise physiologist.
The exercise intervention will be tailored according to participant age, e.g., game-based activities for younger children, and may informally include peers or siblings to promote adherence to the home-based component. Peers or siblings will not be trained to assist with the exercise program.
The exercise intervention prescribed via goal-directed therapy, aligns with the principles of the International Classification and Functioning, Disability and Health framework (ICF), and will predominately be guided by the goals set by the participant. The program will adhere to established exercise prescription guidelines, comprising of physical activity and goal-directed task specific practice. At least half of the session will be dedicated to cardiorespiratory-focused and functional strength promoting activities i.e., running, ball games and locomotion play games, body weight exercises, bear crawls, and frog jumps. The remaining half is dedicated to goal-directed activities. Goals selected will be physical activity related and may include community recreation, occupational, sport or leisure goals. Specific examples of goal-directed activities will, therefore, vary and be individualised according to each participant’s age, goals, interests and functional capacity, presence of treatment-related side effects, and co-morbidities. The home-based program will replicate the essential elements of the supervised sessions in relation to activity type and will also reflect the resources at home.
Adherence to the intervention will be assessed by the physiotherapist or exercise physiologist who will complete a study logbook to record details about the exercises prescribed and the exercises completed.
The CI's will evaluate adherence to the program using attendance records and data from wearable sensors. Acceptability will be measured by questionnaire and structured interviews.
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Intervention code [1]
328090
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Rehabilitation
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Intervention code [2]
328105
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Lifestyle
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Intervention code [3]
328106
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Behaviour
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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]
337547
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Program Feasibility
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Assessment method [1]
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The Project Manager will monitor the rates of recruitment via the project REDCap database, A-priori cut-off values for program feasibility for recruitment is >= 25%
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Timepoint [1]
337547
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Baseline (T1) and , 12 weeks post-intervention commencement
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Primary outcome [2]
337562
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Program Feasibility
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Assessment method [2]
337562
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Sessions completed will be calculated as a percentage using the number of sessions completed (documented by the supervising therapist) x the number of sessions prescribed -1 x 100. A-prior cut-off values for program feasibility for session completion is >= 75%.
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Timepoint [2]
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12 weeks (T2) post-intervention commencement
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Primary outcome [3]
337883
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Program Feasibility
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Assessment method [3]
337883
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The Project Manager will monitor the attrition via the project REDCap database, A-priori cut-off values for program feasibility for attrition is >= 25%
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Timepoint [3]
337883
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Baseline (T1) and, 12 weeks (T2) post intervention commencement
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Secondary outcome [1]
432331
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Program Feasibility (Primary outcome measure).
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Assessment method [1]
432331
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Adherence will be documented during the supervised exercise sessions (by the supervising therapist), and participants’ self-reported adherence to home-based exercise. Adherence to the exercise program is defined as the proportion of minutes completed at the prescribed workload intensity relative to the prescribed number of minutes at that intensity. The a-prior cut-off value for program feasibility of exercise adherence is >= 75%.
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Timepoint [1]
432331
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Baseline (T1), 12 weeks (T2) and 6 months (T3) post intervention commencement.
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Secondary outcome [2]
432334
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Program acceptability (Primary outcome measure).
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Assessment method [2]
432334
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Program acceptability will be assessed using self-reported questionnaire: an online 8-item survey for the parents or caregivers (using REDCap) to measure acceptability and satisfaction of the experience with the program.
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Timepoint [2]
432334
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12 weeks (T2) post-intervention commencement
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Secondary outcome [3]
432335
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Program acceptability (Primary outcome measure).
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Assessment method [3]
432335
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Program acceptability will also be assessed through conducting structured interviews with thematic analysis to explore the child and parents' lived experience of participating in the 12-week therapeutic exercise program
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Timepoint [3]
432335
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12 weeks (T2) post-intervention commencement
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Secondary outcome [4]
433585
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Cardiorespiratory Fitness
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Assessment method [4]
433585
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Assessed using a continuous ramped exercise test on an electronically braked cycle ergometer to determine maximal aerobic capacity (VO2 peak).
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Timepoint [4]
433585
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Baseline (T1), 12 weeks (T2) and 6 months (T3) post intervention commencement.
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Secondary outcome [5]
433586
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Functional ability
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Assessment method [5]
433586
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Paediatric version of Toronto Extremity Salvage Score (pTESS) for the arm (pTESS-arm (29 items) or the pTESS-leg (32 items) depending on the site of their tumour.
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Timepoint [5]
433586
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Baseline (T1), 12 weeks (T2) and 6 months (T3) post intervention commencement.
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Secondary outcome [6]
433587
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Functional ability
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Assessment method [6]
433587
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Timed up and down stairs (TUDS) test
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Timepoint [6]
433587
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Baseline (T1), 12 weeks (T2) and 6 months (T3) post intervention commencement.
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Secondary outcome [7]
433588
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Functional ability
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Assessment method [7]
433588
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Timed up-and-go (TUG) test
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Timepoint [7]
433588
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Baseline (T1), 12 weeks (T2) and 6 months (T3) post intervention commencement.
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Secondary outcome [8]
433596
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Functional ability
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Assessment method [8]
433596
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6-minute walk test (6MWT).
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Timepoint [8]
433596
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Baseline (T1), 12 weeks (T2) and 6 months (T3) post intervention commencement.
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Secondary outcome [9]
433597
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Habitual physical activity
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Assessment method [9]
433597
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Physical activity will be measured using the ActiGraph GT3X+ accelerometer
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Timepoint [9]
433597
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Baseline (T1), 12 weeks (T2) and 6 months (T3) post intervention commencement.
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Eligibility
Key inclusion criteria
Eligibility criteria: (1) Children (8 to 18 years); (2) diagnosis of sarcoma that required surgical resection at least 12 months earlier, but no more than 5 years (60 months) prior to enrolment; (3) no chemotherapy or radiation therapy received in the last 6 months; (4) no evidence of progressive disease; and (5) medically able to complete an exercise program.
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Minimum age
8
Years
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Maximum age
18
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
Exclusion criteria:
(1) they have insufficient English to complete study assessments or participate in the exercise intervention;
(2) the study is not suitable as assessed by the clinical lead investigator;
(3) concurrent medical condition that would prohibit exercise testing or may jeopardise the ability of the patient to undergo the exercise intervention with reasonable safety. This includes but is not limited to unstable angina or arrhythmia, acute myocarditis, uncontrolled heart failure, lower extremity thrombus, uncontrolled asthma, severe mental impairment, or other inability to consent. These will be assessed on a case-by-case basis by the clinical lead investigator;
(4) the participant is unable to travel to the research facility to complete study assessments.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised 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
Single group
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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
Following established procedures for estimating the sample size requirements for pilot studies, the minimum sample size requirement was set to 15 participants. This calculation was based on detecting a hypothesised pre to post-change of at least 0.5 standard deviations (moderate effect size) in aerobic fitness, functional ability, and device measured physical activity, a power level of 0.80, and 2-tailed alpha level of 0.05. To offset a projected attrition rate of 25%, our sample size of 15 will be increased to 20 participants.
Change in the primary outcomes will be tested for statistical significance immediately post-intervention and 6-month follow-up using general linear models (e.g., one-way repeated measures ANOVA) or generalised linear models, depending on the observed underlying distributions of the outcomes. Differences from baseline will be tested using a priori single degree of freedom contrasts.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/11/2024
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Actual
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Date of last participant enrolment
Anticipated
1/06/2025
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Actual
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Date of last data collection
Anticipated
30/12/2025
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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)
QLD
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Recruitment hospital [1]
26237
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Queensland Children's Hospital - South Brisbane
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Recruitment postcode(s) [1]
42205
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4101 - South Brisbane
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Funding & Sponsors
Funding source category [1]
315951
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Charities/Societies/Foundations
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Name [1]
315951
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Wereld Kanker Onderzoek Fonds (WKOF)
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Address [1]
315951
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Country [1]
315951
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Netherlands
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Funding source category [2]
316012
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Charities/Societies/Foundations
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Name [2]
316012
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World Cancer Research Fund International
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Address [2]
316012
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Country [2]
316012
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United Kingdom
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Primary sponsor type
University
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Name
The University of Queensland
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Address
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Country
Australia
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Secondary sponsor category [1]
318163
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None
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Name [1]
318163
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Address [1]
318163
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Country [1]
318163
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314779
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Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee
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Ethics committee address [1]
314779
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http://www.childrens.health.qld.gov.au/research/human-research-ethics-committee
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Ethics committee country [1]
314779
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Australia
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Date submitted for ethics approval [1]
314779
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20/11/2023
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Approval date [1]
314779
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06/02/2024
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Ethics approval number [1]
314779
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HREC/23/QCHQ/103918
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Summary
Brief summary
This study is determining if a novel co-designed therapeutic exercise program is feasible, acceptable, and potentially effective for survivors of paediatric sarcoma. Who is it for? You may be eligible for this study if you are aged between 8 - 18 years of age, diagnosed with sarcoma that required surgical resection at least 12 months earlier, but no more than 5 years prior to enrolment, not undergoing any cancer treatment, and medically able to complete the exercise program. Study details Participants will receive weekly face-to-face individualised goal-directed exercise program for 12 weeks, delivered by a physiotherapist or exercise physiologist. There will also be an accompanying home-based program three times per week. Treatment completion will be checked. Assessments of participant fitness, everyday functioning and activity levels will be at the beginning and end of the program (12-weeks), and at 6 months follow up. Test will include VO2 peak, six minute walk test, timed up and go, timed up and down stairs and pTESS] If the exercise program is shown to be feasible, acceptable, and efficacious, the program has strong potential for testing in larger studies involving more research centres and subsequent use in routine clinical practice. The study will be the first to explore the feasibility, acceptability and efficacy of therapeutic exercise to improve fitness, physical function and physical activity in survivors of childhood sarcoma; improvements in these outcomes could dramatically improve the quality of survivorship and play a major role in mitigating the significant risk of disabling secondary health conditions later in life
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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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Prof Stewart Trost
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Address
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The University of Queensland, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, at QLD Centre for Children’s Health Research (CCHR), Level 7. 62 Graham Street, South Brisbane, QLD 4101
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Country
132698
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Australia
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Phone
132698
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+61 0401368975
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Fax
132698
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Email
132698
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[email protected]
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Contact person for public queries
Name
132699
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Stewart Trost
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Address
132699
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The University of Queensland, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, at QLD Centre for Children’s Health Research (CCHR), Level 7. 62 Graham Street, South Brisbane, QLD 4101
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Country
132699
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Australia
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Phone
132699
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+61 0401368975
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Fax
132699
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Email
132699
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[email protected]
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Contact person for scientific queries
Name
132700
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Stewart Trost
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Address
132700
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The University of Queensland, School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, at QLD Centre for Children’s Health Research (CCHR), Level 7. 62 Graham Street, South Brisbane, QLD 4101
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Country
132700
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Australia
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Phone
132700
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+61 0401368975
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Fax
132700
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Email
132700
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Researchers will be able to contact the PI for access to data. De-identifiable individual participant data of primary and secondary outcomes will be shared. Data will be maintained in a csv.
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When will data be available (start and end dates)?
Immediately following the publication of the primary outcomes paper. There is no end date for the data to be available.
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Available to whom?
Case-by-case basis at the discretion of Primary Sponsor
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Available for what types of analyses?
Any purpose
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How or where can data be obtained?
Data will be made available by emailing the Principal Investigator at
[email protected]
. Access will be subject to approvals by the Principal Investigator.
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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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