scholarly journals A Randomised Controlled Trial of Supervised Exercise Regimens and Their Impact on Walking Performance, Skeletal Muscle Mass and Calpain Activity in Patients With Intermittent Claudication

2014 ◽  
Vol 59 (3) ◽  
pp. 875
Author(s):  
C.L. Delaney ◽  
M.D. Miller ◽  
T.K. Chataway ◽  
J.I. Spark
Keyword(s):  
Skeletal Muscle ◽  
Randomised Controlled Trial ◽  
Intermittent Claudication ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Controlled Trial ◽  
Calpain Activity ◽  
Supervised Exercise ◽  
Walking Performance ◽  
Randomised Controlled

PS02.243: THE EFFECT OF PREHABILITATION ON SARCOPENIA DEVELOPMENT DURING NEOADJUVANT CHEMOTHERAPY FOR OESOPHAGOGASTRIC CANCER: A RANDOMISED CONTROLLED TRIAL

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 191-191
Author(s):  
Sophie Allen ◽  
Daniel White ◽  
Timothy Rockall ◽  
Shaun Preston ◽  
Javed Sultan
Keyword(s):  
Skeletal Muscle ◽  
Randomised Controlled Trial ◽  
Neoadjuvant Chemotherapy ◽  
Muscle Mass ◽  
Visceral Fat ◽  
Standard Care ◽  
Controlled Trial ◽  
Skeletal Muscle Index ◽  
Fat Loss ◽  
Randomised Controlled

Abstract Background Neoadjuvant chemotherapy (NAC) and surgery improves 5-year survival in patients with oesophagogastric (OG) cancer. NAC induces loss of skeletal muscle mass and function, leading to the development of sarcopenia (defined as > 5% skeletal muscle (SM) loss in patients with a BMI of > 20kg/m2). This is a poor prognostic indicator of outcome. We assess whether a prehabilitation programme (during NAC) results in a reduced rate of SM loss compared with ‘standard care’. Methods A single-centre, randomised controlled trial was conducted in patients undergoing NAC for OG cancer. Patients were assigned to a 15-week prehabilitation programme comprising twice weekly supervised aerobic and resistance training and a thrice weekly home exercise plan (Prehab), or standard care (Control). Patients underwent CT imaging at baseline (week 0) and following NAC (week 10). Analysis was performed using Tomovision SliceOmatic software, with a single slice at the third lumbar vertebra. Height provided the skeletal muscle index (SMI, cm2/m2). Hand grip strength (HGS) using an analogue dynamometer at weeks 0 and 10 supplied functional outcome. Results Since December 2016, 46 patients have been recruited, with a 15% drop-out rate (7/46). All patients received NAC. To date, complete dataset is available for 29 subjects (Prehab n = 16; Control n = 13). Groups were matched for baseline demographics, SMI and HGS (P = ns): Mean SMI 53.71 ± 10.15cm2/m2 and HGS 46 ± 11.13kg at baseline. There was a weak correlation between baseline HGS and SMI (0.58). No difference was observed in the rate of sarcopenia development during NAC (Prehab 68.75% (11/16) vs. Control 69.23% (9/13); P = 0.98), however there was a non-significant trend towards a smaller amount of skeletal muscle loss in Prehab subjects compared with Controls (-3.02 ± 3.22 cm2/m2 vs. -5.28 ± 3.00cm2/m2; P = 0.38). Similarly, NAC induced a trend towards lesser decline in mean HGS in the Prehab group versus Controls (-1.07 ± 1.28 kg vs. -2.08 ± 3.84kg; P = 0.25). A greater mean visceral fat loss was seen in the Prehab subjects compared with Controls (-16.04 vs -7.95; P = 0.02). Conclusion Interim analysis demonstrates a trend towards preservation of muscle mass and HGS, and significantly more visceral fat loss in patients receiving prehabilitation during NAC. Trial completion is warranted. The full dataset will be available by June 2018. Disclosure All authors have declared no conflicts of interest.

scholarly journals Evaluating differences in the clinical impact of a free online weight loss programme, a resource-intensive commercial weight loss programme and an active control condition: a parallel randomised controlled trial

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Aidan Q. Innes ◽  
Greig Thomson ◽  
Mary Cotter ◽  
James A. King ◽  
Niels B. J. Vollaard ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomised Controlled Trial ◽  
Active Control ◽  
Body Mass ◽  
Controlled Trial ◽  
Free Access ◽  
Healthy Weight ◽  
Supervised Exercise ◽  
Weight Loss Programme ◽  
Randomised Controlled

Abstract Background Finding effective intervention strategies to combat rising obesity levels could significantly reduce the burden that obesity and associated non-communicable diseases places on both individuals and the National Health Service. Methods In this parallel randomised-controlled trial, 76 participants who are overweight or obese (50 female) were given free access to a fitness centre for the duration of the 12-week intervention and randomised to one of three interventions. The commercial intervention, the Healthy Weight Programme, (HWP, n = 25, 10/15 men/women) consisted of twelve 1-h nutrition coaching sessions with a nutritionist delivered as a mixture of group and 1 to 1 sessions. In addition, twice-weekly exercise sessions (24 in total) were delivered by personal trainers for 12 weeks. The NHS intervention (n = 25, 8/17 men/women) consisted of following an entirely self-managed 12-week online NHS resource. The GYM intervention (n = 26, 8/18 men/women) received no guidance or formal intervention. All participants were provided with a gym induction for safety and both the NHS and GYM participants were familiarised with ACSM physical activity guidelines by way of a hand-out. Results The overall follow-up rate was 83%. Body mass was significantly reduced at post-intervention in all groups (HWP: N = 18, − 5.17 ± 4.22 kg, NHS: N = 21–4.19 ± 5.49 kg; GYM: N = 24–1.17 ± 3.00 kg; p < 0.001) with greater reductions observed in HWP and NHS groups compared to GYM (p < 0.05). Out with body mass and BMI, there were no additional statistically significant time x intervention interaction effects. Conclusions This is the first study to evaluate the efficacy of both a free online NHS self-help weight-loss tool and a commercial weight loss programme that provides face-to-face nutritional support and supervised exercise. The findings suggest that both interventions are superior to an active control condition with regard to eliciting short-term weight-loss. Trial registration ISRCTN Registry - ISRCTN31489026. Prospectively registered: 27/07/16.

scholarly journals Motivating Structured walking Activity in people with Intermittent Claudication (MOSAIC): protocol for a randomised controlled trial of a physiotherapist-led, behavioural change intervention versus usual care in adults with intermittent claudication

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030002 ◽  
Author(s):  
Lindsay Bearne ◽  
Melissa Galea Holmes ◽  
Julie Bieles ◽  
Saskia Eddy ◽  
Graham Fisher ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Usual Care ◽  
Intermittent Claudication ◽  
Controlled Trial ◽  
Behavioural Change ◽  
Walking Distance ◽  
Walking Ability ◽  
Walking Activity ◽  
Walking Exercise ◽  
Randomised Controlled

IntroductionWalking exercise is a recommended but underused treatment for intermittent claudication caused by peripheral arterial disease (PAD). Addressing the factors that influence walking exercise may increase patient uptake of and adherence to recommended walking. The primary aim of this randomised controlled trial (RCT) is to evaluate the efficacy of a physiotherapist-led behavioural change intervention on walking ability in adults with intermittent claudication (MOtivating Structured walking Activity in people with Intermittent Claudication (MOSAIC)) in comparison with usual care.Methods and analysisThe MOSAIC trial is a two-arm, parallel-group, single-blind RCT. 192 adults will be recruited from six National Health Service Hospital Trusts. Inclusion criteria are: aged ≥50 years, PAD (Ankle Brachial Pressure Index ≤0.90, radiographic evidence or clinician report) and intermittent claudication (San Diego Claudication Questionnaire), being able and willing to participate and provide informed consent. The primary outcome is walking ability (6 min walking distance) at 3 months. Outcomes will be obtained at baseline, 3 and 6 months by an assessor blind to group allocation. Participants will be individually randomised (n=96/group, stratified by centre) to receive either MOSAIC or usual care by an independent randomisation service. Estimates of treatment effects will use an intention-to-treat framework implemented using multiple regression adjusted for baseline values and centre.Ethics and disseminationThis trial has full ethical approval (London—Bloomsbury Research Ethics Committee (17/LO/0568)). It will be disseminated via patient forums, peer-reviewed publications and conference presentations.Trial registration numberISRCTN14501418

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