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Hoffmann AT, Mai A, Baum K, Schlegtendal A, Maier C, Stein J, Tokic M, Dillenhöfer S, Lücke T, Timmesfeld N, Brinkmann F. Move-PCD-a multi-center longitudinal randomized controlled superiority trial on the effect of a 6-month individualized supported physical activity (PA) program on quality of life (QoL) in children, adolescents, and adults with primary ciliary dyskinesia. Trials 2024; 25:539. [PMID: 39148115 PMCID: PMC11328395 DOI: 10.1186/s13063-024-08379-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 08/06/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Primary ciliary dyskinesia (PCD) is a rare genetical disease with malfunction of the motile cilia leading to impaired muco-ciliary clearance in the respiratory tract. There is no cure for PCD, only supportive therapy aimed at minimizing the progression of the disease and improving the patient's quality of life (QoL). Physical activity (PA) is one of these recommended supportive therapies for people with PCD (pwPCD). However, there is no scientific evidence to support this recommendation. In addition, regular medical advice to increase PA remains largely ineffective in pwPCD. METHODS To test the main hypothesis, that an individualized and supported PA program leads to a better QoL 6 months after randomization (QoL-PCD questionnaire) compared to usual recommendation in pwPCD, 158 pwPCD aged 7 to 55 years are to be included in this multi-center randomized controlled trial (RCT). After the screening visit, a 1:1 randomization stratified by age group and FEV1 will be performed. A QoL-PCD questionnaire, motor test, and lung function will be carried out at regular intervals in both groups. PA is recorded in both groups using activity trackers during the study period. The main aim of the trial is to estimate the difference in the change of QoL between the groups after 6 months. Therefore, our full analysis set consists of all randomized patients and analysis is performed using the intention-to-treat principle. Statistical software R ( http://www.r-project.org ) is used. Ethical approvement without any reservations: RUB Bochum Ethics Committee (No. 23-7938; December 4, 2023). Recruitment start: March 2024. DISCUSSION Limitations result from the rarity of PCD with its broad disease spectrum and the large age range. These are reduced by stratified randomization and the measurement of the individual change in QoL as primary endpoint. In our view, only a PA program tailored to individual needs with close contact to trainers offers the chance to meet personal needs of pwPCD and to establish PA as a pillar of therapy in the long term. The study protocol explains all procedures and methods of recruitment, implementation of the study visits and intervention, measures for patient and data safety, and for minimizing risks and bias. TRIAL REGISTRATION German Clinical Trials Register (DRKS) 00033030. Registered on December 7, 2023. Update 10 July 2024. STUDY PROTOCOL VERSION 10: Version 1.2; 12 June 2024.
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Affiliation(s)
- Anna Teresa Hoffmann
- University Clinic for Pediatrics and Adolescent Medicine, Ruhr University Bochum, Alexandrinenstr. 5, 44791, Bochum, Germany.
| | - Anna Mai
- Medical Informatics, Biometry and Epidemiology (AMIB), Ruhr University Bochum, 44780, Bochum, Germany
| | - Klaus Baum
- Trainingsinstitut Prof. Dr. Baum, Wilhelm-Schlombs-Allee 1, 50858, Cologne, Germany
| | - Anne Schlegtendal
- University Clinic for Pediatrics and Adolescent Medicine, Ruhr University Bochum, Alexandrinenstr. 5, 44791, Bochum, Germany
| | - Christoph Maier
- University Clinic for Pediatrics and Adolescent Medicine, Ruhr University Bochum, Alexandrinenstr. 5, 44791, Bochum, Germany
| | - Julien Stein
- Medical Informatics, Biometry and Epidemiology (AMIB), Ruhr University Bochum, 44780, Bochum, Germany
| | - Marianne Tokic
- Medical Informatics, Biometry and Epidemiology (AMIB), Ruhr University Bochum, 44780, Bochum, Germany
| | - Stefanie Dillenhöfer
- University Clinic for Pediatrics and Adolescent Medicine, Ruhr University Bochum, Alexandrinenstr. 5, 44791, Bochum, Germany
| | - Thomas Lücke
- University Clinic for Pediatrics and Adolescent Medicine, Ruhr University Bochum, Alexandrinenstr. 5, 44791, Bochum, Germany
| | - Nina Timmesfeld
- Medical Informatics, Biometry and Epidemiology (AMIB), Ruhr University Bochum, 44780, Bochum, Germany
| | - Folke Brinkmann
- University Clinic for Pediatrics and Adolescent Medicine, Ruhr University Bochum, Alexandrinenstr. 5, 44791, Bochum, Germany
- Section for Pediatric Pneumology and Allergology, University Clinic Schleswig Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
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Welsner M, Gruber W, Blosch C, Olivier M, Mellies U, Dillenhoefer S, Brinkmann F, Koerner-Rettberg C, Sutharsan S, Taube C, Stehling F. Impact of habitual physical activity and exercise capacity on quality of life in adolescents and adults with cystic fibrosis. Pediatr Pulmonol 2024. [PMID: 38214406 DOI: 10.1002/ppul.26855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/04/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND The influence of habitual physical activity and exercise capacity on health-related quality of life (HRQoL) in people with cystic fibrosis (pwCF) is poorly characterized. This study investigated the influence of habitual physical activity, exercise capacity, lung function, and body mass index (BMI) on HRQoL in adolescent and adult pwCF. METHOD Subjects were fitted with an accelerometer to determine habitual physical activity (steps/day), including time spent at different intensities, for up to 4 weeks. Then bicycle ergometry (maximal exercise capacity; Wpeak), lung function (percent predicted forced expiratory volume in 1 s, ppFEV1 ), BMI, and response to the Cystic Fibrosis Questionnaire-Revised (CFQ-R) were determined. RESULTS Sixty-five pwCF participated in the study. Physically active pwCF had significantly higher ppFEV1 (p < .001) and exercise capacity (p < .001) than inactive pwCF, and had significantly higher scores on the CFQ-R physical (p = .006), emotional (p = .015), role (p = .008), health (p = .006), and weight (p = .004) subscales. On multiple linear regression analysis, ppFEV1 and, to a lesser extent, exercise capacity, were the most important determinants of HRQoL in pwCF. Time spent in moderate-to-vigorous intensity physical activity did not influence any of the CFQ-R subscales, whereas time spent in vigorous-intensity influenced CFQ-R scores for role (p = .007), body (p = .001), health (p = .009), and weight (p = .01). CONCLUSION HRQoL in adolescent and adult pwCF was influenced by several factors. Avoiding sedentary behavior and spending time in vigorous-intensity levels positively influenced HRQoL, whereas the total number of steps per day played only a minor role in determining HRQoL. Both ppFEV1 and exercise capacity markedly influenced HRQoL.
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Affiliation(s)
- Matthias Welsner
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Adult Cystic Fibrosis Center, University of Duisburg-Essen, Essen, Germany
| | - Wolfgang Gruber
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Christopher Blosch
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
- Department of Pediatric Pulmonology, University Children's Hospital, Ruhr University, Bochum, Germany
| | - Margarete Olivier
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
| | - Uwe Mellies
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
| | - Stefanie Dillenhoefer
- Department of Pediatric Pulmonology, University Children's Hospital, Ruhr University, Bochum, Germany
| | - Folke Brinkmann
- Department of Pediatric Pulmonology, University Children's Hospital, Ruhr University, Bochum, Germany
| | - Cordula Koerner-Rettberg
- Department of Pediatric Pulmonology, University Children's Hospital, Ruhr University, Bochum, Germany
- Children's Hospital, Marienhospital Wesel, Wesel, Germany
| | - Sivagurunathan Sutharsan
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Adult Cystic Fibrosis Center, University of Duisburg-Essen, Essen, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Adult Cystic Fibrosis Center, University of Duisburg-Essen, Essen, Germany
| | - Florian Stehling
- Pediatric Pulmonology and Sleep Medicine, Cystic Fibrosis Center, Children's Hospital, University of Duisburg-Essen, Essen, Germany
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