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TerminatedNCT03291795Updated Jul 5, 2019

Prehabilitation Exercise Plus Perioperative Optimization of Senior Health

An interventional study of Exercise Intervention in Cognitive Decline, Age-Related Memory Disorders and Postoperative Complications, sponsored by Duke University. Terminated at 1 site in United States. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2019-07-05.

Sponsored by Duke University · Not applicable, Interventional, and Prevention

Why this study was terminated
feasibility challenges
Phase
Not applicable
Study type
Interventional
Enrollment
6
Allocation
Not applicable
Ages
60 Years and older
Sex
All
01

Study summary

The purpose of this study is the examine the feasibility of and estimate the efficacy of a preoperative exercise (i.e. prehabilitation) program in 40 up to sedentary older adults (i.e. age 60 and over) undergoing abdominal, urologic or gynecologic surgery under the Enhanced Recovery After Surgery (ERAS) protocol at Duke, using a variety of techniques to measure the possible effect of this intervention. Study patients will undergo a program of prehabilitation exercise for 6 days per week prescribed for them by an exercise physiologist, for up to 4 weeks prior to surgery. Study participants will undergo four types of assessments: Functional/Cognitive testing; Blood/cerebrospinal fluid (CSF) samples and Muscle biopsies; Brain Imaging; and Brain Activity Recording. Clinical Outcomes will also be obtained from the Duke electronic medical record system. The risks of the exercise intervention are generally mild, since moderate exercise in this patient population generally results in improved health outcomes. Data from these patients will be analyzed in comparison to propensity matched patients from the Duke Markers of Alzheimer's Disease and neurocognitive Outcomes after Perioperative Care (MADCO-PC) study who did not undergo this prehabilitation exercise intervention. Taken together, the results of this study will allow the investigators to estimate the possible effect of prehabilitation exercise on multiple domains of postoperative recovery (cognition, brain connectivity, biomarkers, brain activity, etc) and will provide important preliminary data.

Read the detailed description

The purpose of this study is the examine the feasibility of and estimate the efficacy of a preoperative exercise (i.e. prehabilitation) program in 40 up to sedentary older adults (i.e. age 60 and over) undergoing abdominal, urologic or gynecologic surgery under the Enhanced Recovery After Surgery (ERAS) protocol at Duke, using a variety of techniques to measure the possible effect of this intervention. Study patients will undergo a program of prehabilitation exercise for 6 days per week prescribed for them by an exercise physiologist, for up to 4 weeks prior to surgery. Study participants will undergo four types of assessments: Functional/Cognitive testing; Blood/CSF samples and Muscle biopsies; Brain Imaging; and Brain Activity Recording. Clinical Outcomes will also be obtained from the Duke electronic medical record system. The risks of the exercise intervention are generally mild, since moderate exercise in this patient population generally results in improved health outcomes. Data from these patients will be analyzed in comparison to propensity matched patients from the Duke Markers of Alzheimer's Disease and neurocognitive Outcomes after Perioperative Care (MADCO-PC) study who did not undergo this prehabilitation exercise intervention. Taken together, the results of this study will allow the investigators to estimate the possible effect of prehabilitation exercise on multiple domains of postoperative recovery (cognition, brain connectivity, biomarkers, brain activity, etc) and will provide important preliminary data and will help design future more definitive studies to test these hypotheses.

02

Conditions studied

  • Cognitive Decline
  • Age-Related Memory Disorders
  • Postoperative Complications
  • Age-Related Atrophy
  • Postoperative Cognitive Dysfunction
03

Who can participate

Ages eligible
60 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age 60 and above
  • Able to speak English.
  • seen, scheduled to be seen, or eligible to be seen in Preoperative Optimization of Senior Health (POSH) clinic prior to surgery
  • scheduled for general, gynecologic or urologic surgery under the Enhanced Recovery After Surgery (ERAS) protocol, or eligible for ERAS protocol
  • Lives within a \~1 hr drive of Duke
  • Sedentary (not currently following physical activity guidelines)
  • Ambulatory (assistive devices ok)
  • Able to give informed consent
  • Willing to perform prescribed exercises

Exclusion criteria

Exclusion Criteria:

  • Inmate of a correctional facility (i.e. prisoners).
  • Documented or suspected family or personal history of malignant hyperthermia.
  • Allergy or other contraindication to receiving isoflurane
  • Receiving systemic chemotherapy after the first cognitive testing session and before the 6 wk follow up cognitive testing sessions.
  • Major head trauma that occurs after the first cognitive testing session and before the 6 wk follow up cognitive testing sessions.
  • Anginal symptoms, known coronary artery disease (CAD), or high cardiovascular risk per American College of Cardiology (ACC)/ American Heart Association (AHA) guidelines
  • Taking anticoagulants that would preclude lumbar puncture per the American Society of Regional Anesthesia guidelines.
  • Diagnosed history of dementia.
  • Inability to ambulate independently.
  • Otherwise not appropriate for study participation in the judgement of the Principal Investigator, such as (but not limited to) because the patient does not have the cardiopulmonary capacity to complete the exercise regimen.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
6 participants (actual)

Study arms

  • Experimental
    Exercise Intervention

    Other: Exercise Intervention

Interventions

  • OtherExercise Intervention

    Study patients will undergo a program of prehabilitation exercise for 6 days per week prescribed for them by an exercise physiologist, for up to 4 weeks prior to surgery.

05

What researchers measure

Primary outcomes

  1. Feasibility of Preoperative exercise program

    The number of patients contacted versus the number of patients enrolled will be tracked to determine recruitment feasibility. Reasons for refusal will be assessed.

    Time frame: approximately 18 months

06

Study locations

1 site
  • Duke University Medical Center
    Durham, North Carolina 27710, United States
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03291795
Lead sponsor
Duke University
Collaborators
National Institute on Aging (NIA)
Responsible party
Sponsor
First posted
Sep 25, 2017
Start date
Aug 20, 2017
Primary completion
Jan 8, 2018
Completion
Jan 8, 2018
Last update
Jul 5, 2019

Study contacts

Miles Berger, MD, PhD
principal investigator · Duke University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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