NCT02614001

Brief Summary

Objectives: Little has been known the effectiveness of respiratory muscle training in patients with both stroke and heart failure. To investigate the feasibility and effectiveness of the inspiratory muscle training (IMT) in the respiratory muscle strength, cardiopulmonary function, exercise capacity, fatigue and quality of life in stroke patients with congestive heart failure. Design: A single-blind prospective randomized controlled study. Setting: A tertiary care medical center. Participant and method A total of twenty stroke patients with stable CHF, class I-III \[NYHA (New York Heart Association)\], aging between 20 to 85 year-old, will be eligible and randomly assigned into IMT and control group. Stroke will be confirmed by computerized tomography or magnetic resonance imaging. And CHF will be confirmed by a cardiologist. Both of groups will receive a conventional stroke rehabilitation program and diaphragmatic breathing training. The IMT groups will be trained daily, 30 minutes per day, at least 5 times a week, for 4 weeks; then readmitted to hospital 2 weeks later. For checking the compliance of IMT at home, patients will be monitored by making a phone call to them twice a week. Or patient will receive an out patient program about 10 weeks if they are not admitted to our hospital. Main outcome measurement: Each subject's baseline characteristics, and duration of the disease, neurological level (Brunnstrom's stage), functional level, spirometry; resting heart rate, blood pressure, resting oxyhemoglobin saturation (SpO2), lowest resting SpO2, maximal inspiratory pressure, maximal expiratory pressure, the resting oxyhemoglobin saturation (SpO2), lowest resting SpO2 and Borg's scale during a 6-minute walking test , handgrip strength, visual analog scale for severity of fatigue, fatigue assessment scale, Barthel scale will be assessed before and after program.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
48

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started May 2011

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 1, 2011

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2012

Completed
3.2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2015

Completed
5 months until next milestone

First Submitted

Initial submission to the registry

November 23, 2015

Completed
2 days until next milestone

First Posted

Study publicly available on registry

November 25, 2015

Completed
Last Updated

November 25, 2015

Status Verified

November 1, 2015

Enrollment Period

1 year

First QC Date

November 23, 2015

Last Update Submit

November 23, 2015

Conditions

Keywords

breathing training, congestive heart failure, stroke

Outcome Measures

Primary Outcomes (1)

  • MIP, MEP

    maximal inspiratory pressure, maximal expiratory pressure MIP was measured after maximal expiration with each subject seated and wearing a nose-clip, and MEP was measured after maximal inspiration. An experienced respiratory therapist who strongly urged the subjects to make maximum inspiratory and expiratory efforts at or near residual and total lung capacity, respectively, performed the measurements. Determinations were repeated until two technically satisfactory measurements were recorded, with the highest value used for calculations.

    10 weeks

Secondary Outcomes (3)

  • The Stages of Heart Failure. NYHA (New York Heart Association) Classification

    10 weeks

  • Pulmonary function tests

    10 weeks

  • six-minute walk work (6MWORK)

    10 weeks

Study Arms (2)

inspiratory muscle training, stroke rehabilitation

EXPERIMENTAL

Inspiratory muscle training with a pressure threshold device (Threshold® IMT HS730, RESPIRONICS Inc, Cedar Grove, NJ, USA) will be start at a resistance equal to 30% of their MIP or at a load which patient can tolerate, and then the loading will be gradually increased 2cm H2O per week or as symptom tolerated and according to the RPE scale. Each patient will receive regular post-stroke rehabilitation program.

Device: Threshold® IMT HS730, RESPIRONICS Inc, Cedar Grove, NJ, USAOther: post-stroke rehabilitation program

control group

OTHER

stroke rehabilitation.

Other: post-stroke rehabilitation program

Interventions

Patient will be trained daily, total 30 minutes or 15 minutes twice per day, at least 5 times a week, for 10 weeks

inspiratory muscle training, stroke rehabilitation
control groupinspiratory muscle training, stroke rehabilitation

Eligibility Criteria

Age20 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • stroke patients with stable CHF, NYHA(New York Heart Association) class I-III

You may not qualify if:

  • Patients who can't tightly place their lips over the mouthpiece or have air leakage during inhaling or exhaling through the threshold device, have COPD, a history of recent exacerbation, unstable angina, decompensated CHF, complicated arrhythmias, at risk or history of pneumothorax, large bullae on chest radiograph, marked osteoporosis together with a history of spontaneous rib fractures, a history of recent lung surgery (ie, within 12 months), or use of long-term oxygen therapy.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital.

Kaohsiung, Taiwan, 83305, Taiwan

Location

MeSH Terms

Conditions

DyspneaHeart FailureStroke

Condition Hierarchy (Ancestors)

Respiration DisordersRespiratory Tract DiseasesSigns and Symptoms, RespiratorySigns and SymptomsPathological Conditions, Signs and SymptomsHeart DiseasesCardiovascular DiseasesCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular Diseases

Study Officials

  • Liaw Mei-Yun, MD

    Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital.

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Department of physical medicine and rehabilitation

Study Record Dates

First Submitted

November 23, 2015

First Posted

November 25, 2015

Study Start

May 1, 2011

Primary Completion

May 1, 2012

Study Completion

July 1, 2015

Last Updated

November 25, 2015

Record last verified: 2015-11

Locations