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CompletedNCT03316157ENeRgyUpdated Mar 11, 2020

Exercise and Nutritional Rehabilitation in Patients With Cancer

An interventional study of ProSure and Physical Exercise in Cachexia; Cancer, Diet Modification and Physical Activity, sponsored by University of Edinburgh. Completed at 1 site in United Kingdom. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-03-11.

Sponsored by University of Edinburgh · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
45
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

In patients with incurable cancer, general deterioration in their ability to walk, exercise and care for themselves is often regarded as an inevitable consequence of this. In 2015, Hospice UK published a report advocating "Rehabilitative Palliative Care".

However there is limited robust evidence on which to base this approach. Reviews of the literature show limited study numbers but do suggest that rehabilitation may be feasible for advanced cancer patients. However key components were not clear and no recommendations could be given.

This trial is designed primarily to test the feasibility of a rehabilitation programme (exercise and nutritional supplementation) in advanced cancer patients. Feasibility will be the primary outcome measure including rates of recruitment and compliance. Secondary outcome measures include impact on physical function, nutritional status, quality of life for patients and their carers. We will also assess the health economic impact by assessing patient health facility use throughout the trial.

40 patients with advanced cancer living in the community will be recruited from two hospice palliative care teams in Edinburgh. These patients will be randomised in to either the treatment arm: the rehabilitation programme plus standard care, or the control arm: standard care alone. The treatment arm will consist of an 8 week rehabilitation programme, supervised at weekly clinics by a physiotherapist and dietician.

To minimise contamination the control group will be offered the treatment at the end of the 8 weeks (waiting list control).

Measurements will be made for both groups and compared at baseline (week 0), midpoint (week 5) and endpoint (week 9). Recommendations for a larger UK wide trial will be made from the findings of this study.

02

Conditions studied

  • Cachexia; Cancer
  • Diet Modification
  • Physical Activity
  • Advanced Cancer

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03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Diagnosis of advanced cancer (defined as metastatic or locally advanced cancer not amenable to curative treatment).
  2. Outpatient
  3. ≥18years
  4. Karnofsky score ≥ 60
  5. Prognosis greater than 3 months
  6. Able to complete trial based assessments
  7. Under care of community services at Marie Curie or St Columba's Hospices
  8. Ability to comply with trial protocol
  9. Ability to provide and have capacity to consent
  10. Agree to attend trial centre for trial related activity (St Columba's Hospice)

Exclusion criteria

Exclusion Criteria:

  1. Undergoing anti-cancer therapy (hormonal treatment or bisphosphonates permitted)
  2. Using enteral nutrition (NG or similar) or parenteral nutrition
  3. Co-enrolment in drug trials
  4. Inability to swallow
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
45 participants (actual)

Study arms

  • Experimental
    Rehabilitation

    Advanced cancer patients will receive an 8 week rehabilitation intervention consisting of physical exercise and nutritional supplementation, along with standard care

    Dietary Supplement: ProSure · Behavioral: Physical Exercise

  • No intervention
    Waiting list Control

    Standard care alone for the 8 week trial period, followed by participants being offered the rehabilitation programme

Interventions

  • Dietary supplementProSure

    Patients will take 2x 220mL nutritional supplements per day for 8 weeks and be given dietary advice to optimise their nutrition

  • BehavioralPhysical Exercise

    Patients will receive an individualised exercise regimen consisting of 60 minutes aerobic and 3x resistance elements per week

05

What researchers measure

Primary outcomes

  1. Feasibility of Rehabilitation programme

    Compliance with treatment and trial procedures

    Time frame: 8 weeks

Secondary outcomes

  1. Patient quality of life

    Measured by EORTC QLQ-C15-PAL questionnaire

    Time frame: 8 weeks

  2. Carer quality of life

    Measured by CQOLC questionnaire

    Time frame: 8 weeks

  3. Change in physical function

    Mean daily step count, measured by Physical Activity Meter over 5 days

    Time frame: 8 weeks

  4. Change in physical function

    Measured by two-minute walk test (metres/feet covered)

    Time frame: 8 weeks

  5. Change in physical function

    Measured by Karnofsky performance status (KPS) at baseline, mid and endpoint

    Time frame: 8 weeks

  6. Change in physical function

    Measured by timed up-and-go test (Seconds)

    Time frame: 8 weeks

  7. Change in physical function

    Measured by Life Space Assessment scores

    Time frame: 8 weeks

  8. Sleep quality

    Measured by physical activity meter at baseline and endpoint (Mean sleep hours, mean hours restless and hours awake)

    Time frame: 8 weeks

  9. Nutritional status

    Height and weight measured at baseline, mid and endpoint assessment (m, Kg and combined as kg/m2)

    Time frame: 8 weeks

  10. Nutritional status

    Measured by PG-SGA nutritional assessment (PG-SGA point score)

    Time frame: 8 weeks

  11. Contamination in the control group

    Measured by dietary intake using 24 hour recall (patient diary entries)

    Time frame: 8 weeks

  12. Contamination in the control group

    Measured by change in measures of physical function (see outcomes 4-8) in control group from baseline measurement to endpoint

    Time frame: 8 weeks

06

Study locations

1 site
  • University of Edinburgh
    Edinburgh, EH4 2XR, United Kingdom
07

Registry details

Key details

Study ID
NCT03316157
Lead sponsor
University of Edinburgh
Collaborators
Marie Curie Hospice, Belfast, Accord Clinical Research, NHS Lothian
Responsible party
Sponsor
First posted
Oct 20, 2017
Start date
Jan 30, 2018
Primary completion
Apr 24, 2019
Completion
Jul 3, 2019
Last update
Mar 11, 2020

Oversight

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