Pilot Study of a Home-based Exercise Intervention to Treat Frailty in Lung Transplant Candidates View Homepage


Ontology type: schema:MedicalStudy     


Clinical Trial Info

YEARS

2015-2017

ABSTRACT

In this pilot project, 35 lung transplant candidates will be recruited to participate in a three month individualized home-based program focused on exercise and nutrition optimization. This pilot is designed to assess the feasibility of treating frailty before lung transplantation. Participants will complete a 1 day in-person assessment and training session that will include baseline frailty assessment, determination of exercise capacity, and a determination of nutritional status. Based on American Thoracic Society Guidelines and a diet evaluation by a registered dietician, information gathered during the assessment will be used to develop a tailored prescription for exercise and nutrition to be continued at home. Participants will also be taught self-management skills specific to control of dyspnea, fatigue, motivation, and support. Participants will receive training in protocol implementation at home by a coordinator trained in principles of behavior change, adult learning theory, and dyspnea control techniques. Subjects will be provided tablet computers with an app called Aidcube preloaded and taught how to interface with the app. Aidcube is a commercially available exercise platform designed for patients with lung and heart diseases. It was designed with the input of physicians, physical therapists, respiratory therapists, nutritionists who specialize in patients with lung and heart disease and adheres to professional society guidelines for exercise and rehabilitation in patients with lung disease. Subjects will then adhere to a individually tailored home exercise and nutrition program based on their exercise capacity. Aidcube allows clinicians (or in this case the PI and co-PI) the ability to design a customized program of exercises and diet plan through the "provider interface". The subjects interacts with the "patient interface" to complete their exercise program during the 8 week study intervention. This goal of this pilot project is to determine the feasibility of implementing a home-based exercise and nutrition program with patients with advanced lung disease awaiting lung transplantation. Information on Aidcube can be found at https://www.aidcube.com. The overarching aim of this pilot study is preparatory investigation to evaluate the feasibility of performing a home-based intervention to treat frailty in lung transplant candidates. Specific aims: - Establish a sampling time frame and recruitment techniques. - Assess willingness to participate - Assess adherence and compliance. - Identify logistical problems in the in-person and at-home components of the intervention - Determine the resources needed for a full-scale study. - Provide funding bodies evidence that research team is competent and knowledgeable. - Provide funding bodies that the study is feasible Detailed Description Lung transplantation aims to extend survival, reduce disability, and improve health-related quality of life for persons suffering from advanced lung diseases. Despite rigorous candidacy screening practices, improvements in surgical and medical management, and iterative advancements in organ allocation policies, nearly 20% of adults awaiting lung transplantation die or are removed from the waiting list due to disease progression prior to receiving a suitable donor offer1. After lung transplantation, nearly the same proportion of patients dies within the first post-operative year2. Notably, serious morbidity after transplantation is increasing, with resultant disability and associated decrements in health-related quality of life3,4. Although known risk factors for death are already incorporated into lung allocation in the United States (Lung Allocation Score [LAS]), persistently high mortality and increasing morbidity underscore the need to identify novel risk factors for poor outcomes in order to maximize the individual and societal benefit of lung transplantation5. Frailty- measured by simple, non-invasive clinic based instruments- is an independent risk factor for disability, perioperative complications, and mortality in older medical6-9 and surgical populations10-13. Conceptualized first in the field of geriatrics, frailty is defined as a generalized vulnerability to stressors resulting from an accumulation of physiologic deficits across multiple interrelated systems14. These deficits, in turn, deplete the body's physiologic reserves, resulting in a "state-of-risk" for disproportionate declines in health status following exposure to an additional stressor such as major surgery. Drawing from the geriatrics experience, frailty has become recognized more recently as a risk factor for poor outcomes in solid organ transplantation. Specifically, frailty has been found to be associated with delayed graft function and mortality in kidney transplant recipients and waitlist mortality in liver transplant candidates15-17. The evaluation of geriatric derived measures is particularly important in contemporary lung transplantation. Indeed, older patients are the fastest growing group of lung transplant candidates in the U.S18. Compared to 8% in 2004, patients aged 65 now account for 30% of annual new recipients, outnumbering those aged 50; those aged 60 account for over half of all new transplants19. This rapid trend has outpaced the evidence base, risk stratification tools, and society guidelines needed to identify which older candidates will do well after lung transplantation. Absent better information, transplant programs have resorted to either ad hoc and admittedly arbitrary chronological age cutoffs or "eyeball tests" of fitness for transplant. The investigators recently identified frailty as prevalent in lung transplant candidates and independently associated with delisting or death on the waitlist18. Very recently, studies in other populations suggest frailty may be reversible through targeted exercise and nutrition programs. While pulmonary rehabilitation programs may achieve similar goals, a substantial proportion of patients cannot access these programs due to geography or insurance limitations. The investigator's overarching hypothesis is that treating frailty with a home-based intervention before transplant may 1) reduce the risk of death or delisting for becoming too debilitated before transplant and 2) may reduce complications, disability, and possibly mortality after lung transplantation. This proposal seeks to generate critical pilot data needed to inform a larger intervention to treat frailty in lung transplant candidates. More... »

URL

https://clinicaltrials.gov/show/NCT03457545

Related SciGraph Publications

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/3048", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/3177", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/3053", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "type": "DefinedTerm"
      }
    ], 
    "description": "In this pilot project, 35 lung transplant candidates will be recruited to participate in a three month individualized home-based program focused on exercise and nutrition optimization. This pilot is designed to assess the feasibility of treating frailty before lung transplantation. Participants will complete a 1 day in-person assessment and training session that will include baseline frailty assessment, determination of exercise capacity, and a determination of nutritional status. Based on American Thoracic Society Guidelines and a diet evaluation by a registered dietician, information gathered during the assessment will be used to develop a tailored prescription for exercise and nutrition to be continued at home. Participants will also be taught self-management skills specific to control of dyspnea, fatigue, motivation, and support. Participants will receive training in protocol implementation at home by a coordinator trained in principles of behavior change, adult learning theory, and dyspnea control techniques. Subjects will be provided tablet computers with an app called Aidcube preloaded and taught how to interface with the app. Aidcube is a commercially available exercise platform designed for patients with lung and heart diseases. It was designed with the input of physicians, physical therapists, respiratory therapists, nutritionists who specialize in patients with lung and heart disease and adheres to professional society guidelines for exercise and rehabilitation in patients with lung disease. Subjects will then adhere to a individually tailored home exercise and nutrition program based on their exercise capacity. Aidcube allows clinicians (or in this case the PI and co-PI) the ability to design a customized program of exercises and diet plan through the \"provider interface\". The subjects interacts with the \"patient interface\" to complete their exercise program during the 8 week study intervention. This goal of this pilot project is to determine the feasibility of implementing a home-based exercise and nutrition program with patients with advanced lung disease awaiting lung transplantation. Information on Aidcube can be found at https://www.aidcube.com. The overarching aim of this pilot study is preparatory investigation to evaluate the feasibility of performing a home-based intervention to treat frailty in lung transplant candidates. Specific aims: - Establish a sampling time frame and recruitment techniques. - Assess willingness to participate - Assess adherence and compliance. - Identify logistical problems in the in-person and at-home components of the intervention - Determine the resources needed for a full-scale study. - Provide funding bodies evidence that research team is competent and knowledgeable. - Provide funding bodies that the study is feasible\n\nDetailed Description\nLung transplantation aims to extend survival, reduce disability, and improve health-related quality of life for persons suffering from advanced lung diseases. Despite rigorous candidacy screening practices, improvements in surgical and medical management, and iterative advancements in organ allocation policies, nearly 20% of adults awaiting lung transplantation die or are removed from the waiting list due to disease progression prior to receiving a suitable donor offer1. After lung transplantation, nearly the same proportion of patients dies within the first post-operative year2. Notably, serious morbidity after transplantation is increasing, with resultant disability and associated decrements in health-related quality of life3,4. Although known risk factors for death are already incorporated into lung allocation in the United States (Lung Allocation Score [LAS]), persistently high mortality and increasing morbidity underscore the need to identify novel risk factors for poor outcomes in order to maximize the individual and societal benefit of lung transplantation5. Frailty- measured by simple, non-invasive clinic based instruments- is an independent risk factor for disability, perioperative complications, and mortality in older medical6-9 and surgical populations10-13. Conceptualized first in the field of geriatrics, frailty is defined as a generalized vulnerability to stressors resulting from an accumulation of physiologic deficits across multiple interrelated systems14. These deficits, in turn, deplete the body's physiologic reserves, resulting in a \"state-of-risk\" for disproportionate declines in health status following exposure to an additional stressor such as major surgery. Drawing from the geriatrics experience, frailty has become recognized more recently as a risk factor for poor outcomes in solid organ transplantation. Specifically, frailty has been found to be associated with delayed graft function and mortality in kidney transplant recipients and waitlist mortality in liver transplant candidates15-17. The evaluation of geriatric derived measures is particularly important in contemporary lung transplantation. Indeed, older patients are the fastest growing group of lung transplant candidates in the U.S18. Compared to 8% in 2004, patients aged 65 now account for 30% of annual new recipients, outnumbering those aged 50; those aged 60 account for over half of all new transplants19. This rapid trend has outpaced the evidence base, risk stratification tools, and society guidelines needed to identify which older candidates will do well after lung transplantation. Absent better information, transplant programs have resorted to either ad hoc and admittedly arbitrary chronological age cutoffs or \"eyeball tests\" of fitness for transplant. The investigators recently identified frailty as prevalent in lung transplant candidates and independently associated with delisting or death on the waitlist18. Very recently, studies in other populations suggest frailty may be reversible through targeted exercise and nutrition programs. While pulmonary rehabilitation programs may achieve similar goals, a substantial proportion of patients cannot access these programs due to geography or insurance limitations. The investigator's overarching hypothesis is that treating frailty with a home-based intervention before transplant may 1) reduce the risk of death or delisting for becoming too debilitated before transplant and 2) may reduce complications, disability, and possibly mortality after lung transplantation. This proposal seeks to generate critical pilot data needed to inform a larger intervention to treat frailty in lung transplant candidates.", 
    "endDate": "2017-12-01T00:00:00Z", 
    "id": "sg:clinicaltrial.NCT03457545", 
    "keywords": [
      "Pilot Project", 
      "home-based exercise", 
      "lung transplant", 
      "home", 
      "exercise", 
      "optimization", 
      "pilot", 
      "feasibility", 
      "frailty", 
      "lung transplantation", 
      "in-person", 
      "training session", 
      "assessment", 
      "determination", 
      "exercise capacity", 
      "nutritional status", 
      "american", 
      "guideline", 
      "diet", 
      "prescription", 
      "nutrition", 
      "self-management skill", 
      "control", 
      "dyspnea", 
      "fatigue", 
      "motivation", 
      "protocol implementation", 
      "coordinator", 
      "principle", 
      "behavior change", 
      "theory", 
      "control technique", 
      "tablet computer", 
      "APP", 
      "interface", 
      "patient", 
      "lung", 
      "heart disease", 
      "input", 
      "physician", 
      "physical therapist", 
      "respiratory therapist", 
      "Nutritionist", 
      "adheres", 
      "professional society", 
      "rehabilitation", 
      "lung disease", 
      "nutrition program", 
      "clinician", 
      "customized program", 
      "exercise program", 
      "study intervention", 
      "advanced lung disease", 
      "overarching aim", 
      "home-based intervention", 
      "Establish", 
      "sampling time", 
      "recruitment", 
      "willingness", 
      "adherence", 
      "compliance", 
      "logistical problem", 
      "at-home", 
      "intervention", 
      "Determine", 
      "Health Resource", 
      "full-scale study", 
      "funding body", 
      "research team", 
      "detailed description", 
      "transplantation", 
      "survival", 
      "disability", 
      "health-related quality", 
      "life", 
      "screening practice", 
      "improvement", 
      "medical management", 
      "advancement", 
      "allocation", 
      "adult", 
      "list", 
      "disease progression", 
      "suitable donor", 
      "same proportion", 
      "serious morbidity", 
      "decrement", 
      "known risk factor", 
      "death", 
      "United State", 
      "high mortality", 
      "morbidity", 
      "novel risk factor", 
      "poor outcome", 
      "societal benefit", 
      "clinic", 
      "independent risk factor", 
      "complication", 
      "mortality", 
      "Geriatrics", 
      "vulnerability", 
      "stressor", 
      "accumulation", 
      "deficit", 
      "body", 
      "reserve", 
      "state", 
      "health status", 
      "exposure", 
      "major surgery", 
      "risk factor", 
      "solid organ transplantation", 
      "delayed graft function", 
      "kidney transplant recipient", 
      "liver transplant", 
      "Evaluation Study as Topic", 
      "old patient", 
      "recipient", 
      "half", 
      "RAPID", 
      "evidence base", 
      "risk stratification", 
      "old", 
      "good information", 
      "Transplant", 
      "ad hoc", 
      "chronological age", 
      "eyeball", 
      "fitness", 
      "population", 
      "pulmonary rehabilitation", 
      "similar goal", 
      "substantial proportion", 
      "access", 
      "geography", 
      "limitation", 
      "overarching hypothesis", 
      "risk", 
      "pilot data"
    ], 
    "name": "Pilot Study of a Home-based Exercise Intervention to Treat Frailty in Lung Transplant Candidates", 
    "sameAs": [
      "https://app.dimensions.ai/details/clinical_trial/NCT03457545"
    ], 
    "sdDataset": "clinical_trials", 
    "sdDatePublished": "2019-03-07T15:27", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "file:///pack/app/us_ct_data_00026.json", 
    "sponsor": [
      {
        "id": "https://www.grid.ac/institutes/grid.266102.1", 
        "type": "Organization"
      }
    ], 
    "startDate": "2015-12-01T00:00:00Z", 
    "subjectOf": [
      {
        "id": "https://doi.org/10.1093/ageing/aft204", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1000431405"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/ajt.12584", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1009574882"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1741-7015-11-65", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1009639950", 
          "https://doi.org/10.1186/1741-7015-11-65"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1093/gerona/56.3.m158", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1013245649"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s10620-014-3086-6", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1016285225", 
          "https://doi.org/10.1007/s10620-014-3086-6"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s10620-014-3086-6", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1016285225", 
          "https://doi.org/10.1007/s10620-014-3086-6"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/archsurg.2011.1229", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1016552641"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.2014.469", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1016749027"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/ajt.12992", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1016987357"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1056/nejm199503023320902", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1018449194"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1164/rccm.201408-1562oc", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1018495830"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1164/rccm.201506-1150oc", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1018525959"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.2147/cia.s45300", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1018559521"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1093/gerona/56.3.m146", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1019653483"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1741-7015-9-83", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1025575279", 
          "https://doi.org/10.1186/1741-7015-9-83"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.jamcollsurg.2010.01.028", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1030832769"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1007/s00415-011-6241-4", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1031591252", 
          "https://doi.org/10.1007/s00415-011-6241-4"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.critrevonc.2009.11.002", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1037364728"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.healun.2014.08.004", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1040970689"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1016/j.jvs.2010.10.111", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1044028843"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/j.1600-6143.2006.01276.x", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1044616746"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1161/circulationaha.108.841437", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1047284751"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/ajt.12762", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1050753481"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1513/pats.200808-077go", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1051130225"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "type": "MedicalStudy", 
    "url": "https://clinicaltrials.gov/show/NCT03457545"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/clinicaltrial.NCT03457545'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/clinicaltrial.NCT03457545'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/clinicaltrial.NCT03457545'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/clinicaltrial.NCT03457545'


 

This table displays all metadata directly associated to this object as RDF triples.

237 TRIPLES      16 PREDICATES      179 URIs      148 LITERALS      1 BLANK NODES

Subject Predicate Object
1 sg:clinicaltrial.NCT03457545 schema:about anzsrc-for:3048
2 anzsrc-for:3053
3 anzsrc-for:3177
4 schema:description In this pilot project, 35 lung transplant candidates will be recruited to participate in a three month individualized home-based program focused on exercise and nutrition optimization. This pilot is designed to assess the feasibility of treating frailty before lung transplantation. Participants will complete a 1 day in-person assessment and training session that will include baseline frailty assessment, determination of exercise capacity, and a determination of nutritional status. Based on American Thoracic Society Guidelines and a diet evaluation by a registered dietician, information gathered during the assessment will be used to develop a tailored prescription for exercise and nutrition to be continued at home. Participants will also be taught self-management skills specific to control of dyspnea, fatigue, motivation, and support. Participants will receive training in protocol implementation at home by a coordinator trained in principles of behavior change, adult learning theory, and dyspnea control techniques. Subjects will be provided tablet computers with an app called Aidcube preloaded and taught how to interface with the app. Aidcube is a commercially available exercise platform designed for patients with lung and heart diseases. It was designed with the input of physicians, physical therapists, respiratory therapists, nutritionists who specialize in patients with lung and heart disease and adheres to professional society guidelines for exercise and rehabilitation in patients with lung disease. Subjects will then adhere to a individually tailored home exercise and nutrition program based on their exercise capacity. Aidcube allows clinicians (or in this case the PI and co-PI) the ability to design a customized program of exercises and diet plan through the "provider interface". The subjects interacts with the "patient interface" to complete their exercise program during the 8 week study intervention. This goal of this pilot project is to determine the feasibility of implementing a home-based exercise and nutrition program with patients with advanced lung disease awaiting lung transplantation. Information on Aidcube can be found at https://www.aidcube.com. The overarching aim of this pilot study is preparatory investigation to evaluate the feasibility of performing a home-based intervention to treat frailty in lung transplant candidates. Specific aims: - Establish a sampling time frame and recruitment techniques. - Assess willingness to participate - Assess adherence and compliance. - Identify logistical problems in the in-person and at-home components of the intervention - Determine the resources needed for a full-scale study. - Provide funding bodies evidence that research team is competent and knowledgeable. - Provide funding bodies that the study is feasible Detailed Description Lung transplantation aims to extend survival, reduce disability, and improve health-related quality of life for persons suffering from advanced lung diseases. Despite rigorous candidacy screening practices, improvements in surgical and medical management, and iterative advancements in organ allocation policies, nearly 20% of adults awaiting lung transplantation die or are removed from the waiting list due to disease progression prior to receiving a suitable donor offer1. After lung transplantation, nearly the same proportion of patients dies within the first post-operative year2. Notably, serious morbidity after transplantation is increasing, with resultant disability and associated decrements in health-related quality of life3,4. Although known risk factors for death are already incorporated into lung allocation in the United States (Lung Allocation Score [LAS]), persistently high mortality and increasing morbidity underscore the need to identify novel risk factors for poor outcomes in order to maximize the individual and societal benefit of lung transplantation5. Frailty- measured by simple, non-invasive clinic based instruments- is an independent risk factor for disability, perioperative complications, and mortality in older medical6-9 and surgical populations10-13. Conceptualized first in the field of geriatrics, frailty is defined as a generalized vulnerability to stressors resulting from an accumulation of physiologic deficits across multiple interrelated systems14. These deficits, in turn, deplete the body's physiologic reserves, resulting in a "state-of-risk" for disproportionate declines in health status following exposure to an additional stressor such as major surgery. Drawing from the geriatrics experience, frailty has become recognized more recently as a risk factor for poor outcomes in solid organ transplantation. Specifically, frailty has been found to be associated with delayed graft function and mortality in kidney transplant recipients and waitlist mortality in liver transplant candidates15-17. The evaluation of geriatric derived measures is particularly important in contemporary lung transplantation. Indeed, older patients are the fastest growing group of lung transplant candidates in the U.S18. Compared to 8% in 2004, patients aged 65 now account for 30% of annual new recipients, outnumbering those aged 50; those aged 60 account for over half of all new transplants19. This rapid trend has outpaced the evidence base, risk stratification tools, and society guidelines needed to identify which older candidates will do well after lung transplantation. Absent better information, transplant programs have resorted to either ad hoc and admittedly arbitrary chronological age cutoffs or "eyeball tests" of fitness for transplant. The investigators recently identified frailty as prevalent in lung transplant candidates and independently associated with delisting or death on the waitlist18. Very recently, studies in other populations suggest frailty may be reversible through targeted exercise and nutrition programs. While pulmonary rehabilitation programs may achieve similar goals, a substantial proportion of patients cannot access these programs due to geography or insurance limitations. The investigator's overarching hypothesis is that treating frailty with a home-based intervention before transplant may 1) reduce the risk of death or delisting for becoming too debilitated before transplant and 2) may reduce complications, disability, and possibly mortality after lung transplantation. This proposal seeks to generate critical pilot data needed to inform a larger intervention to treat frailty in lung transplant candidates.
5 schema:endDate 2017-12-01T00:00:00Z
6 schema:keywords APP
7 Determine
8 Establish
9 Evaluation Study as Topic
10 Geriatrics
11 Health Resource
12 Nutritionist
13 Pilot Project
14 RAPID
15 Transplant
16 United State
17 access
18 accumulation
19 ad hoc
20 adherence
21 adheres
22 adult
23 advanced lung disease
24 advancement
25 allocation
26 american
27 assessment
28 at-home
29 behavior change
30 body
31 chronological age
32 clinic
33 clinician
34 compliance
35 complication
36 control
37 control technique
38 coordinator
39 customized program
40 death
41 decrement
42 deficit
43 delayed graft function
44 detailed description
45 determination
46 diet
47 disability
48 disease progression
49 dyspnea
50 evidence base
51 exercise
52 exercise capacity
53 exercise program
54 exposure
55 eyeball
56 fatigue
57 feasibility
58 fitness
59 frailty
60 full-scale study
61 funding body
62 geography
63 good information
64 guideline
65 half
66 health status
67 health-related quality
68 heart disease
69 high mortality
70 home
71 home-based exercise
72 home-based intervention
73 improvement
74 in-person
75 independent risk factor
76 input
77 interface
78 intervention
79 kidney transplant recipient
80 known risk factor
81 life
82 limitation
83 list
84 liver transplant
85 logistical problem
86 lung
87 lung disease
88 lung transplant
89 lung transplantation
90 major surgery
91 medical management
92 morbidity
93 mortality
94 motivation
95 novel risk factor
96 nutrition
97 nutrition program
98 nutritional status
99 old
100 old patient
101 optimization
102 overarching aim
103 overarching hypothesis
104 patient
105 physical therapist
106 physician
107 pilot
108 pilot data
109 poor outcome
110 population
111 prescription
112 principle
113 professional society
114 protocol implementation
115 pulmonary rehabilitation
116 recipient
117 recruitment
118 rehabilitation
119 research team
120 reserve
121 respiratory therapist
122 risk
123 risk factor
124 risk stratification
125 same proportion
126 sampling time
127 screening practice
128 self-management skill
129 serious morbidity
130 similar goal
131 societal benefit
132 solid organ transplantation
133 state
134 stressor
135 study intervention
136 substantial proportion
137 suitable donor
138 survival
139 tablet computer
140 theory
141 training session
142 transplantation
143 vulnerability
144 willingness
145 schema:name Pilot Study of a Home-based Exercise Intervention to Treat Frailty in Lung Transplant Candidates
146 schema:sameAs https://app.dimensions.ai/details/clinical_trial/NCT03457545
147 schema:sdDatePublished 2019-03-07T15:27
148 schema:sdLicense https://scigraph.springernature.com/explorer/license/
149 schema:sdPublisher N1f91c6d8fcb148ffaf17707368c0f64d
150 schema:sponsor https://www.grid.ac/institutes/grid.266102.1
151 schema:startDate 2015-12-01T00:00:00Z
152 schema:subjectOf sg:pub.10.1007/s00415-011-6241-4
153 sg:pub.10.1007/s10620-014-3086-6
154 sg:pub.10.1186/1741-7015-11-65
155 sg:pub.10.1186/1741-7015-9-83
156 https://doi.org/10.1001/archsurg.2011.1229
157 https://doi.org/10.1001/jama.2014.469
158 https://doi.org/10.1016/j.critrevonc.2009.11.002
159 https://doi.org/10.1016/j.healun.2014.08.004
160 https://doi.org/10.1016/j.jamcollsurg.2010.01.028
161 https://doi.org/10.1016/j.jvs.2010.10.111
162 https://doi.org/10.1056/nejm199503023320902
163 https://doi.org/10.1093/ageing/aft204
164 https://doi.org/10.1093/gerona/56.3.m146
165 https://doi.org/10.1093/gerona/56.3.m158
166 https://doi.org/10.1111/ajt.12584
167 https://doi.org/10.1111/ajt.12762
168 https://doi.org/10.1111/ajt.12992
169 https://doi.org/10.1111/j.1600-6143.2006.01276.x
170 https://doi.org/10.1161/circulationaha.108.841437
171 https://doi.org/10.1164/rccm.201408-1562oc
172 https://doi.org/10.1164/rccm.201506-1150oc
173 https://doi.org/10.1513/pats.200808-077go
174 https://doi.org/10.2147/cia.s45300
175 schema:url https://clinicaltrials.gov/show/NCT03457545
176 sgo:license sg:explorer/license/
177 sgo:sdDataset clinical_trials
178 rdf:type schema:MedicalStudy
179 N1f91c6d8fcb148ffaf17707368c0f64d schema:name Springer Nature - SN SciGraph project
180 rdf:type schema:Organization
181 anzsrc-for:3048 schema:inDefinedTermSet anzsrc-for:
182 rdf:type schema:DefinedTerm
183 anzsrc-for:3053 schema:inDefinedTermSet anzsrc-for:
184 rdf:type schema:DefinedTerm
185 anzsrc-for:3177 schema:inDefinedTermSet anzsrc-for:
186 rdf:type schema:DefinedTerm
187 sg:pub.10.1007/s00415-011-6241-4 schema:sameAs https://app.dimensions.ai/details/publication/pub.1031591252
188 https://doi.org/10.1007/s00415-011-6241-4
189 rdf:type schema:CreativeWork
190 sg:pub.10.1007/s10620-014-3086-6 schema:sameAs https://app.dimensions.ai/details/publication/pub.1016285225
191 https://doi.org/10.1007/s10620-014-3086-6
192 rdf:type schema:CreativeWork
193 sg:pub.10.1186/1741-7015-11-65 schema:sameAs https://app.dimensions.ai/details/publication/pub.1009639950
194 https://doi.org/10.1186/1741-7015-11-65
195 rdf:type schema:CreativeWork
196 sg:pub.10.1186/1741-7015-9-83 schema:sameAs https://app.dimensions.ai/details/publication/pub.1025575279
197 https://doi.org/10.1186/1741-7015-9-83
198 rdf:type schema:CreativeWork
199 https://doi.org/10.1001/archsurg.2011.1229 schema:sameAs https://app.dimensions.ai/details/publication/pub.1016552641
200 rdf:type schema:CreativeWork
201 https://doi.org/10.1001/jama.2014.469 schema:sameAs https://app.dimensions.ai/details/publication/pub.1016749027
202 rdf:type schema:CreativeWork
203 https://doi.org/10.1016/j.critrevonc.2009.11.002 schema:sameAs https://app.dimensions.ai/details/publication/pub.1037364728
204 rdf:type schema:CreativeWork
205 https://doi.org/10.1016/j.healun.2014.08.004 schema:sameAs https://app.dimensions.ai/details/publication/pub.1040970689
206 rdf:type schema:CreativeWork
207 https://doi.org/10.1016/j.jamcollsurg.2010.01.028 schema:sameAs https://app.dimensions.ai/details/publication/pub.1030832769
208 rdf:type schema:CreativeWork
209 https://doi.org/10.1016/j.jvs.2010.10.111 schema:sameAs https://app.dimensions.ai/details/publication/pub.1044028843
210 rdf:type schema:CreativeWork
211 https://doi.org/10.1056/nejm199503023320902 schema:sameAs https://app.dimensions.ai/details/publication/pub.1018449194
212 rdf:type schema:CreativeWork
213 https://doi.org/10.1093/ageing/aft204 schema:sameAs https://app.dimensions.ai/details/publication/pub.1000431405
214 rdf:type schema:CreativeWork
215 https://doi.org/10.1093/gerona/56.3.m146 schema:sameAs https://app.dimensions.ai/details/publication/pub.1019653483
216 rdf:type schema:CreativeWork
217 https://doi.org/10.1093/gerona/56.3.m158 schema:sameAs https://app.dimensions.ai/details/publication/pub.1013245649
218 rdf:type schema:CreativeWork
219 https://doi.org/10.1111/ajt.12584 schema:sameAs https://app.dimensions.ai/details/publication/pub.1009574882
220 rdf:type schema:CreativeWork
221 https://doi.org/10.1111/ajt.12762 schema:sameAs https://app.dimensions.ai/details/publication/pub.1050753481
222 rdf:type schema:CreativeWork
223 https://doi.org/10.1111/ajt.12992 schema:sameAs https://app.dimensions.ai/details/publication/pub.1016987357
224 rdf:type schema:CreativeWork
225 https://doi.org/10.1111/j.1600-6143.2006.01276.x schema:sameAs https://app.dimensions.ai/details/publication/pub.1044616746
226 rdf:type schema:CreativeWork
227 https://doi.org/10.1161/circulationaha.108.841437 schema:sameAs https://app.dimensions.ai/details/publication/pub.1047284751
228 rdf:type schema:CreativeWork
229 https://doi.org/10.1164/rccm.201408-1562oc schema:sameAs https://app.dimensions.ai/details/publication/pub.1018495830
230 rdf:type schema:CreativeWork
231 https://doi.org/10.1164/rccm.201506-1150oc schema:sameAs https://app.dimensions.ai/details/publication/pub.1018525959
232 rdf:type schema:CreativeWork
233 https://doi.org/10.1513/pats.200808-077go schema:sameAs https://app.dimensions.ai/details/publication/pub.1051130225
234 rdf:type schema:CreativeWork
235 https://doi.org/10.2147/cia.s45300 schema:sameAs https://app.dimensions.ai/details/publication/pub.1018559521
236 rdf:type schema:CreativeWork
237 https://www.grid.ac/institutes/grid.266102.1 schema:Organization
 




Preview window. Press ESC to close (or click here)


...