The AccelERate Trial

NCT ID: NCT07218016

Last Updated: 2025-12-30

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

RECRUITING

Clinical Phase

NA

Total Enrollment

288 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-02

Study Completion Date

2028-12-31

Brief Summary

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The AccelERate study will evaluate the physical recovery of patients who have undergone Pelvic Organ Prolapse (POP) surgery. This will be evaluated via a self-reported recovery questionnaire completed daily. Participants will wear an accelerometer device on their non-dominant wrist and be given either routine or exercise-focused postoperative instructions. The primary outcome will be a comparison of the number of days needed to reach self-reported "mostly recovered" status between randomly assigned instruction groups.

Detailed Description

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The AccelERate Trial is a single-masked RCT to determine if a prescribed early exercise regimen during the postoperative period in women undergoing minimally invasive surgery (MIS) for POP is associated with quicker recovery compared to standard recommendations for postoperative activities. AccelERate will go beyond existing research and be the first to implement and quantitatively evaluate with accelerometer data a postoperative exercise regimen and its effects on recovery and pelvic floor symptoms. We will quantify postoperative activity as well as recovery using self-report, performance-based testing, and objective medical assessment. In this way, we will rigorously investigate the regimen's effect on postoperative recovery and pelvic floor outcomes. Given prior findings that women who resume physical activity early in the postoperative period report fewer pelvic floor symptoms than women restricted from activity, we hypothesize that an intervention designed to encourage physical activity in the postoperative period may even further improve recovery without impacting short- or long-term functional and anatomic outcomes. Thus, AccelERate has the potential to transform care for women with POP who will no longer be required to alter their lifestyle and the activities for which they are having surgery.

The intervention arm will be instructed to perform 30 minutes of medium-intensity exercise (vigorous enough to cause shortness of breath, but light enough to be able to maintain a conversation) starting on postoperative day 3 and continuing at least 5 times weekly for 6 weeks (modeled after recent surgical postoperative physical activity studies). The amount of physical activity is in line with the Center for Disease Control and Prevention (CDC) guidelines and has been utilized in previous postoperative exercise studies. Participants in the intervention group will be allowed to select their preferred physical activity, and the activity will be performed without supervision.

Participants in the control group will be given liberalized postoperative instructions with gradual resumption of activity. The decision to allow women to liberally resume activity following surgery was informed by previous postoperative activity recommendation studies in women undergoing prolapse surgery.

All participants will undergo a baseline surgical evaluation including a POP-Q exam and PFDI-20 and PFIQ-7, complete AAS and record their physical activity for one week. Baseline physical activity data will include objective, quantitative measurement of movement using the accelerometer during waking hours for seven days (not necessarily consecutive days), and 30-second sit to stand test (STS).

Following surgery on postoperative day 3, participants will resume wearing an accelerometer continuously during waking hours. Those randomized to prescriptive exercise arm will be instructed to complete 30 minutes of medium intensity exercise as recommended by CDC and log their activity and percent recovery. If participants cannot complete the exercises, they will be asked to explain why (pain, nausea, catheter in place, logistical constraints, time constraints). Participants will be queried every day via the mobile research app as to the recovery they feel they have achieved. When a participant records "mostly" or "completely" recovered on 2-consecutive occasions (allowing for skipped days), she will stop receiving alerts. The primary outcome will be number of days since surgery at which the participant first reports being mostly recovered, provided she confirms that status on the next consecutive occasion (allowing for skipped days).

Postoperative study data will be collected remotely from participants via the app until 12-weeks. Accelerometer data will be downloaded from the devices 2-, 6-, and 12-week visits. At 12 weeks and 1 year, participants will undergo an in-office evaluation (including examination) assessing anatomic and functional outcomes with a surgeon masked to study assignment. They will also complete the AAS, PFDI-20, PFIQ-7, Decisional Regret Scale, NRS and PGI-I. At the baseline, 12-week, and 1-year visits, research staff will collect the self-administered activity questionnaires. At all study visits, research staff will record any adverse events.

Conditions

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Pelvic Organ Prolapse Pelvic Organ Prolapse (POP) Pelvic Organ Prolapse Vaginal Surgery Pelvic Organ Prolapse, Patient Education

Keywords

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accelerometer Pelvic Organ Prolapse (POP) Post-operative Recovery recovery activities

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Standard of Care

Group Type NO_INTERVENTION

No interventions assigned to this group

Postoperative Exercise regimen

Group Type ACTIVE_COMPARATOR

Postoperative Exercise regimen

Intervention Type BEHAVIORAL

The intervention arm will be instructed to perform 30 minutes of medium intensity exercise (vigorous enough to cause shortness of breath, but light enough to be able to maintain a conversation) starting on postoperative day 3 and continuing at least 5 times weekly for 6 weeks. Participants in the intervention group will be allowed to select their preferred physical activity, and the activity will be performed without supervision. Participants in the control group will be given typical postoperative instructions with gradual resumption of activity.

Interventions

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Postoperative Exercise regimen

The intervention arm will be instructed to perform 30 minutes of medium intensity exercise (vigorous enough to cause shortness of breath, but light enough to be able to maintain a conversation) starting on postoperative day 3 and continuing at least 5 times weekly for 6 weeks. Participants in the intervention group will be allowed to select their preferred physical activity, and the activity will be performed without supervision. Participants in the control group will be given typical postoperative instructions with gradual resumption of activity.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Subject has provided written informed consent
* Ambulatory women undergoing laparoscopic, robotic, or vaginal reconstructive or obliterative surgery for apical prolapse
* POP-Q \>= Stage III
* Willing to participate in a postoperative exercise regimen
* Able to read and consent in English or Spanish
* Willing and able to wear an accelerometer prior to and after surgery (including agreeing to the terms of service), use an electronic data capture software, and record daily events
* Willing and able to install and use study-related smartphone app(s)
* Anticipated hospital discharge \<= postoperative day 1

Exclusion Criteria

* Inability or unwillingness to adhere to the exercise intervention
* Contraindication to medium-intensity exercise
* Comorbidities preventing physical activity
* Planned abdominal approach with laparotomy
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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RTI International

OTHER

Sponsor Role collaborator

University of California, San Diego

OTHER

Sponsor Role collaborator

University of Chicago

OTHER

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role collaborator

Women and Infants Hospital of Rhode Island

OTHER

Sponsor Role collaborator

University of Pennsylvania

OTHER

Sponsor Role collaborator

Kaiser Permanente

OTHER

Sponsor Role collaborator

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

NIH

Sponsor Role collaborator

NICHD Pelvic Floor Disorders Network

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Kaiser Permanente -- San Diego

San Diego, California, United States

Site Status RECRUITING

University of California - San Diego

San Diego, California, United States

Site Status RECRUITING

University of Chicago

Chicago, Illinois, United States

Site Status RECRUITING

Duke University, Duke Division of Urogynecology and Reconstructive Pelvic Surgery

Durham, North Carolina, United States

Site Status RECRUITING

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Brown/ Women and Infants Hospital of Rhode Island, Division of Urogynecology and Reconstructive Pelvic Surgery

Providence, Rhode Island, United States

Site Status RECRUITING

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status NOT_YET_RECRUITING

Countries

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United States

Facility Contacts

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Gisselle Zazueta-Damian

Role: primary

Kyle Herrala

Role: primary

Jinxuan (Rowena) Shi

Role: primary

Stephanie Yu

Role: primary

Zandra Kennedy

Role: primary

Madeline Malloy

Role: primary

Agnes Burris

Role: primary

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Related Links

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Other Identifiers

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UG1HD069013

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD054214

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD041267

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD054241

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD110057

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1HD069010

Identifier Type: NIH

Identifier Source: secondary_id

View Link

U24HD069031

Identifier Type: NIH

Identifier Source: secondary_id

View Link

PFDN-34P01_1

Identifier Type: -

Identifier Source: org_study_id