NCT04922840

Brief Summary

Inflammatory joint diseases (IJD) are autoimmune diseases with common symptoms of joint inflammation, pain, stiffness and fatigue. Compared to the general population, this large patient-group has an increased risk of cardiovascular disease (CVD) and CVD-related mortality. Patients with IJD call for improved CVD screening and risk management as well as access to evidence-based non-pharmacological treatment alternatives. Evidence supports high intensity training (HIIT) in mitigating risk of CVD and inflammation, but the evidence of these cardioprotective benefits is unclear in patients with IJD and the feasibility of HIIT protocols in daily clinical care needs to be addressed. Cardiorespiratory fitness (CRF) is an important physiological marker and highly correlated to risk of CVD. Despite strong recommendations, routine assessment of CRF is seldom performed in clinical care. The ExeHeart study will assess the potential cardioprotective and disease-modifying effect of HIIT in IJD in a randomized controlled trial. Furthermore, the ExeHeart-study will report on the validity of non-exercise measures of cardiorespiratory fitness (eCRF) measures for use in daily clinical care. Additionally, we will explore the feasibility of HIIT by addressing adherence and fidelity to the HIIT treatment protocol in a primary care setting

Trial Health

87
On Track

Trial Health Score

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

Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Aug 2021

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

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 15, 2021

Completed
27 days until next milestone

First Posted

Study publicly available on registry

June 11, 2021

Completed
2 months until next milestone

Study Start

First participant enrolled

August 9, 2021

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 20, 2022

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2023

Completed
Last Updated

March 13, 2023

Status Verified

March 1, 2023

Enrollment Period

1.4 years

First QC Date

May 15, 2021

Last Update Submit

March 10, 2023

Conditions

Keywords

ExerciseCardiovascular diseaseCardiovascular riskHigh-intensity trainingPhysiotherapyHigh-intensity exerciseInflammatory joint disease

Outcome Measures

Primary Outcomes (1)

  • Peak oxygen uptake - VO2peak ml/kg/min

    VO2peak, expressed in milliliters of oxygen per kilogram of body weight per minute (ml/kg/min). VO2peak will be measured by a Cardiopulmonary Exercise test (CPET) on a treadmill, using electrocardiogram (ECG), breath-by-breath gas analyzing system, blood pressure (BP) monitor, pulse oximetry, and Borg rating of perceived exertion

    3 months post baseline

Secondary Outcomes (170)

  • Peak oxygen uptake - VO2peak L/min

    3 months post baseline

  • Peak oxygen uptake - VO2peak ml/kg/min

    Baseline

  • Peak oxygen uptake - VO2peak ml/kg/min

    6 months post baseline

  • Peak oxygen uptake - VO2peak L/min

    Baseline

  • Peak oxygen uptake - VO2peak L/min

    6 months post baseline

  • +165 more secondary outcomes

Study Arms (2)

High-intensity exercise (HIIT)

EXPERIMENTAL

Usual care; CVD risk assessment, lifestyle advice (heart-healthy diet, regular exercise, weight management and non-smoking) and relevant medication. The 12-week intervention is carried out as individual or group sessions with maximal 4 patients, supervised by physiotherapists in primary health care. The HIIT group complete two weekly HIIT sessions and a third weekly session with exercise at moderate intensity. Exercise is tailored to each individual to provide the same relative exercise stress and to ensure progression. Target exercise intensity is tracked by a heart rate monitor. Individual exercise session are recorded in a training diary. Succeeding the intervention, a questionnaire will be distributed to patients in the HIIT group. Semi-structured interviews will target physiotherapists supervising HIIT and 5-7 patients in the HIIT group.

Behavioral: High-intensity exercise (HIIT)

Usual care

NO INTERVENTION

Control group participants receive the same treatment as usual care; CVD risk assessment including lifestyle advice (heart-healthy diet, regular exercise, weight management and non-smoking) and relevant medication. Control group participants are invited to a physiotherapist-led theoretical and practical HIIT session following study completion.

Interventions

12 week intervention: Two weekly sessions of 35-40 min exercise: 10 min warm-up, followed by 4x4 min at 90-95% peak heart rate (HRpeak) interspaced by 2-3 min active breaks at 60-70% HRpeak and a third weekly session with continuous exercise for a minimum of 40 min at moderate intensity.

High-intensity exercise (HIIT)

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age: 18-70
  • BMI: 18.5-40
  • Inflammatory joint disease verified by physician
  • Able to walk unaided and continuously for ≥ 15 min.
  • Norwegian or English speaking

You may not qualify if:

  • Sustained lower extremity injury ≤12 months, including surgery
  • Neurological disease
  • Absolute contraindication to maximal exercise test
  • Cognitive impairment
  • Participation in structured high-intensity exercise ≥ 1/week in the last 3 months

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Diakonhjemmet Hospital

Oslo, Norway

Location

Related Publications (3)

  • Norden KR, Semb AG, Dagfinrud H, Hisdal J, Sexton J, Fongen C, Bakke E, Odegard S, Skandsen J, Blanck T, Metsios GS, Tveter AT. Effect of high-intensity interval training in physiotherapy primary care for patients with inflammatory arthritis: the ExeHeart randomised controlled trial. RMD Open. 2024 Jan 18;10(1):e003440. doi: 10.1136/rmdopen-2023-003440.

  • Norden KR, Semb AG, Dagfinrud H, Hisdal J, Odegard S, Sexton J, Fongen C, Skandsen J, Blanck T, Metsios GS, Tveter AT. Associations between cardiovascular risk factors, disease activity and cardiorespiratory fitness in patients with inflammatory joint disease: a cross-sectional analysis. BMC Sports Sci Med Rehabil. 2023 Apr 21;15(1):63. doi: 10.1186/s13102-023-00678-4.

  • Norden KR, Dagfinrud H, Semb AG, Hisdal J, Viktil KK, Sexton J, Fongen C, Skandsen J, Blanck T, Metsios GS, Tveter AT. Effect of high-intensity exercise on cardiorespiratory fitness, cardiovascular disease risk and disease activity in patients with inflammatory joint disease: protocol for the ExeHeart randomised controlled trial. BMJ Open. 2022 Feb 17;12(2):e058634. doi: 10.1136/bmjopen-2021-058634.

Related Links

MeSH Terms

Conditions

SpondylarthritisArthritis, RheumatoidArthritis, PsoriaticMotor ActivityCardiovascular Diseases

Interventions

High-Intensity Interval Training

Condition Hierarchy (Ancestors)

SpondylitisSpinal DiseasesBone DiseasesMusculoskeletal DiseasesArthritisJoint DiseasesRheumatic DiseasesConnective Tissue DiseasesSkin and Connective Tissue DiseasesAutoimmune DiseasesImmune System DiseasesSpondylarthropathiesPsoriasisSkin Diseases, PapulosquamousSkin DiseasesBehavior

Intervention Hierarchy (Ancestors)

Physical Conditioning, HumanExerciseMotor ActivityMovementMusculoskeletal Physiological PhenomenaMusculoskeletal and Neural Physiological Phenomena

Study Officials

  • Anne Therese Tveter, PhD

    National Resource Center for Rehabilitation in Rheumatology

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
INVESTIGATOR
Masking Details
The trial is single-blinded with investigator (KRN) masked for group allocation to reduce risk of bias. Patients are not blinded to treatment exposure nor study hypothesis.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Participants will be allocated 1:1 according to a computer-generated randomization scheme, stratified by sex
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator, Assosiate Professor

Study Record Dates

First Submitted

May 15, 2021

First Posted

June 11, 2021

Study Start

August 9, 2021

Primary Completion

December 20, 2022

Study Completion

March 1, 2023

Last Updated

March 13, 2023

Record last verified: 2023-03

Data Sharing

IPD Sharing
Will not share

Data may be made available upon sound request to the principal investigator

Locations