Blood Flow Restriction Exercise Study

NCT ID: NCT02868021

Last Updated: 2019-07-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-12

Study Completion Date

2018-08-01

Brief Summary

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This pilot study will investigate the effects of blood flow restriction (BFR) exercise for up to 4-6 weeks prior to total knee arthroplasty (TKA) surgery in older patients to measure clinical outcomes such as strength, lower extremity function, and pain.

Detailed Description

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The purpose of this study is to test the feasibility and efficacy of a low-resistance exercise protocol with blood flow restriction (BFR) using a tourniquet in the preoperative period of patients awaiting TKA. BFR exercise is a new exercise method that has not been studied in the perioperative period. The investigators will compare our intervention to a no-exercise group up to 4 - 6 weeks prior to surgery to determine if this type of exercise is feasible in the preoperative period and if BFR exercise will improve functional, physiological, and molecular outcomes when compared to patients without exercise.

Conditions

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Osteoarthritis, Knee

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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NO-EX group

Subjects allocated to the No Exercise (NO-EX) group will undergo: Strength testing, Short Physical Performance Battery (SPPB), Six-minute walk (SMW), Numerical pain scale, Self-assessed function and Six-minute walk (SMW) test. Intra-op muscle biopsies.

Group Type PLACEBO_COMPARATOR

Strength testing

Intervention Type DEVICE

Test the strength of subject's lower extremity muscles on the dynamometer system

Short Physical Performance Battery (SPPB)

Intervention Type BEHAVIORAL

The SPPB is a timed short distance walk, repeated chair stands, and balance test that measures lower extremity function.

Six-minute walk (SMW)

Intervention Type BEHAVIORAL

Subjects walk back and forth along a 100-ft hallway for six minutes after instructions to complete as many laps as possible.

Numerical pain scale

Intervention Type BEHAVIORAL

Measure pain using an 11-point numerical pain scale.

Self-assessed function

Intervention Type BEHAVIORAL

Using the Late Life Function and Disability Instrument.

Muscle biopsies

Intervention Type PROCEDURE

During the course of the surgery two small muscle biopsies from the quadriceps muscle of the operative leg will be collected.

EX-BFR group

Subjects allocated to the EX-BFR group will undergo baseline strength testing, Short Physical Performance Battery (SPPB), Numerical pain scale, Six-minute walk (SMW), Self-assessed function, and determination of 1 Repetition Maximum (1-RM). Blood flow restriction exercise, Borg Category Ratio 10 (Borg CR10) scale. Intra-op muscle biopsies.

Group Type EXPERIMENTAL

Strength testing

Intervention Type DEVICE

Test the strength of subject's lower extremity muscles on the dynamometer system

Short Physical Performance Battery (SPPB)

Intervention Type BEHAVIORAL

The SPPB is a timed short distance walk, repeated chair stands, and balance test that measures lower extremity function.

Six-minute walk (SMW)

Intervention Type BEHAVIORAL

Subjects walk back and forth along a 100-ft hallway for six minutes after instructions to complete as many laps as possible.

Numerical pain scale

Intervention Type BEHAVIORAL

Measure pain using an 11-point numerical pain scale.

Self-assessed function

Intervention Type BEHAVIORAL

Using the Late Life Function and Disability Instrument.

Muscle biopsies

Intervention Type PROCEDURE

During the course of the surgery two small muscle biopsies from the quadriceps muscle of the operative leg will be collected.

Determination of 1 Repetition Maximum (1-RM)

Intervention Type DEVICE

Following the warm-up, subjects will attempt to complete one repetition of the leg press exercise at progressively greater resistance until a full repetition can no longer be performed. The weight of the last complete unassisted repetition will be recorded as the 1-RM.

Blood flow restriction exercise

Intervention Type DEVICE

Perform lower-extremity exercises (leg press, leg extension, leg curl, and calf extension) at an intensity of 30% of 1-RM with external compression applied to the proximal thigh of each leg.

Borg CR10 scale

Intervention Type BEHAVIORAL

Following each exercise session, participants will provide a rating of perceived exertion (RPE) for the session according to the Borg CR10 scale.

Interventions

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Strength testing

Test the strength of subject's lower extremity muscles on the dynamometer system

Intervention Type DEVICE

Short Physical Performance Battery (SPPB)

The SPPB is a timed short distance walk, repeated chair stands, and balance test that measures lower extremity function.

Intervention Type BEHAVIORAL

Six-minute walk (SMW)

Subjects walk back and forth along a 100-ft hallway for six minutes after instructions to complete as many laps as possible.

Intervention Type BEHAVIORAL

Numerical pain scale

Measure pain using an 11-point numerical pain scale.

Intervention Type BEHAVIORAL

Self-assessed function

Using the Late Life Function and Disability Instrument.

Intervention Type BEHAVIORAL

Muscle biopsies

During the course of the surgery two small muscle biopsies from the quadriceps muscle of the operative leg will be collected.

Intervention Type PROCEDURE

Determination of 1 Repetition Maximum (1-RM)

Following the warm-up, subjects will attempt to complete one repetition of the leg press exercise at progressively greater resistance until a full repetition can no longer be performed. The weight of the last complete unassisted repetition will be recorded as the 1-RM.

Intervention Type DEVICE

Blood flow restriction exercise

Perform lower-extremity exercises (leg press, leg extension, leg curl, and calf extension) at an intensity of 30% of 1-RM with external compression applied to the proximal thigh of each leg.

Intervention Type DEVICE

Borg CR10 scale

Following each exercise session, participants will provide a rating of perceived exertion (RPE) for the session according to the Borg CR10 scale.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* are scheduled for elective TKA for osteoarthritis
* are scheduled for unilateral joint replacement surgery only
* are able to give consent and follow instructions
* are willing to complete up to 15 study visits

Exclusion Criteria

* patients below the age of 55 years old
* patients over the age of 80 years old
* patients who live in a radius greater than 45 miles from the University of Florida (a feasible distance to allow for transportation to and from the clinical center for assessment visits)
* patients with impaired cognitive function and mental disease, (e.g. diagnosis of Alzheimer's disease)
* patients with paraplegia/extremity amputation
* patients with end stage renal disease requiring dialysis
* patients with uncontrolled diabetes and insulin-dependent diabetes
* patients with uncontrolled cardiovascular disease e.g. (Classes of Heart Failure (CHF) New York Heart Association (NYHA) class 3 or higher, BP \> 180/110 mmHg)
* patients with severe pulmonary disease requiring continuous oxygen therapy
* patients with active neoplasm
* patients with peripheral vascular disease or deep vein thrombosis (within the last 3 years)
* patients with structured exercise/Physical Therapy(PT)/Occupational Therapy (OT)/fitness program enrollment within 12 weeks prior to surgery and/or more than 2 hours per month on gym/fitness room exercises
* patients with BMI greater than 40 kg/m2
* patients with opioid use of more than 30 mg Morphine-equivalents per day
* patients with chronic oral steroid use
* patients with chronic anticoagulation (e.g. Plavix, Warfarin)
* patients with planned postoperative admission to a skilled nursing/inpatient rehab facility
* patients with ipsilateral joint disease involving hip, ankle or spine
* neurologic or other etiology of quadriceps wasting
* surgery within less than 4 weeks
* patients with comorbidities that the PI judges as not suitable for the study
* patients with a minimal mental status (MMSE) score below 24
Minimum Eligible Age

55 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Florida Clinical and Translational Science Institute (CTSI)

UNKNOWN

Sponsor Role collaborator

University of Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rene Przkora, MD

Role: PRINCIPAL_INVESTIGATOR

University of Florida

Locations

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United States, Florida UF Health

Gainesville, Florida, United States

Site Status

Countries

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United States

Other Identifiers

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IRB201601042

Identifier Type: -

Identifier Source: org_study_id

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