NCT03082404

Brief Summary

Chronic kidney disease is a renal injury and progressive and irreversible loss of kidney function and in its most advanced stage is called chronic renal failure. Although hemodialysis replace some kidney function, patients suffer some alterations characterized by "uremic syndrome" typically expressed by: motor neuropathy and/ or autonomic neuropathy, cardiac or musculoskeletal myopathies, peripheral vascular changes, among others. Thereby, the the adoption of physical exercise should be encouraged. However, it is known that the ability to exercise the subject in hemodialysis is low and they present weakness of the peripheral muscular system, including inspiratory muscles. The aim of this study is to assess the effects of inspiratory muscle training (IMT) on ventilatory muscle strength and functional capacity of patients with chronic kidney disease in hemodialysis. For this the following assessments will be performed before and after intervention: six-minute walk test to functional capacity; Kidney Disease and Quality of Life - Short Form questionnaire for quality of life; flow-mediated dilatation to endothelial function; sit-to-stand test for proximal strength of lower limbs. The subjects will be randomized into two groups, IMTG (inspiratory muscle training group) and CG (control group). The first will receive the IMT, for five weeks, three times a week, during hemodialysis session and the patients will be oriented to realize more three days at home. The control group only will be evaluated and re-evaluated. Expected results at the end of the protocol with IMT are: increased inspiratory muscle strength; longest distance covered on the six-minute walk test; improved quality of life; increased muscle strength of the lower limbs; improved endothelial function.

Trial Health

35
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
25

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Apr 2017

Shorter than P25 for not_applicable

Status
unknown

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

First Submitted

Initial submission to the registry

March 12, 2017

Completed
5 days until next milestone

First Posted

Study publicly available on registry

March 17, 2017

Completed
17 days until next milestone

Study Start

First participant enrolled

April 3, 2017

Completed
29 days until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 2, 2017

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

June 2, 2017

Completed
Last Updated

March 17, 2017

Status Verified

March 1, 2017

Enrollment Period

29 days

First QC Date

March 12, 2017

Last Update Submit

March 12, 2017

Conditions

Keywords

Chronic kidney diseaseInspiratory muscle training

Outcome Measures

Primary Outcomes (1)

  • Functional capacity

    Functional capacity will be assessed by the distance walked in six-minute walk test (6MWT)

    Five weeks

Secondary Outcomes (4)

  • Muscle strength of inspiratory muscle

    Five weeks

  • Proximal strength of lower limbs

    Five weeks

  • Endothelial function

    Five weeks

  • Quality of Life

    Five weeks

Study Arms (2)

Inspiratory muscle training group

EXPERIMENTAL

Six times a week (three supervised at hemodialysis unit and other three times at home), 5 series, 10 repetitions, two-minutes interval or according to the patient tolerance.

Other: Inspiratory muscle training

Control group

NO INTERVENTION

The patients in this group will be evaluated at baseline and reassessed after five weeks of follow-up.

Interventions

Inspiratory muscle training will be performed during the first hour of hemodialysis treatment and the protocol will consist of five series with 10 repetitions, each series with a two-minute interval of according to patient tolerance. The overload will be adjusted weekly, beginning with 50% of the maximum inspiratory pressure, during the first week, 60% of maximum inspiratory pressure in the second and third week and 70% of maximum inspiratory pressure in the fourth and fifth weeks. Maximum inspiratory pressure will be evaluated before the protocol period and adjusted weekly by manovacuometry.

Also known as: High intensity inspiratory muscle training
Inspiratory muscle training group

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients with chronic kidney disease on hemodialysis for more than 3 months;
  • Clearance of urea during hemodialysis (Kt/V ≥ 1.2).

You may not qualify if:

  • Cognitive impairment that prevents conducting evaluations, as well as inability to understand and sign the informed consent form;
  • Patients with recent sequel of stroke;
  • Disabling musculoskeletal disease;
  • Uncontrolled hypertension (Systolic blood pressure \> 230 mmHg and diastolic blood pressure \> 120 mmHg);
  • Grade IV heart failure (NYHA) or decompensated;
  • Uncontrolled diabetes (blood glucose \> 300 mg/dL);
  • Unstable angina;
  • Fever and/or infectious disease;
  • Recent acute myocardial infarction (two months);
  • Active smokers.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (1)

  • Dipp T, Macagnan FE, Schardong J, Fernandes RO, Lemos LC, Plentz RDM. Short period of high-intensity inspiratory muscle training improves inspiratory muscle strength in patients with chronic kidney disease on hemodialysis: a randomized controlled trial. Braz J Phys Ther. 2020 May-Jun;24(3):280-286. doi: 10.1016/j.bjpt.2019.04.003. Epub 2019 May 6.

MeSH Terms

Conditions

Renal Insufficiency, Chronic

Condition Hierarchy (Ancestors)

Renal InsufficiencyKidney DiseasesUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesChronic DiseaseDisease AttributesPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Rodrigo DM Plentz, PhD

    Federal University of Health Sciences of Porto Alegre

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Rodrigo DM Plentz, PhD

CONTACT

Rodrigo DM Plentz, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
PhD

Study Record Dates

First Submitted

March 12, 2017

First Posted

March 17, 2017

Study Start

April 3, 2017

Primary Completion

May 2, 2017

Study Completion

June 2, 2017

Last Updated

March 17, 2017

Record last verified: 2017-03

Data Sharing

IPD Sharing
Will not share