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CompletedNCT04486261HI-STIMUpdated Apr 10, 2024

High-intensity Strength Training in Myositis

An interventional study of High-intensity strength training in Myositis, Dermatomyositis and Polymyositis, sponsored by Rigshospitalet, Denmark. Completed at 1 site in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-04-10.

Sponsored by Rigshospitalet, Denmark · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
34
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study evaluates the effects of a high-intensity strength training in patients with myositis with the primary outcome being quality of life (SF-36). The study is designed as a parallel group randomised controlled trial with an intervention group and a control group.

Read the detailed description

Overall aim:

To investigate the effect of high-intensity strength training on quality of life, muscle strength, physical function, and disease activity in patients with myositis

Study design:

60 myositis patients will be included in a 16-week high-intensity strength training study. Patients will be randomly allocated into 2 groups (strength training and control) in a 1:1 ratio.

User involvement:

Myositis patients has been recruited to a patient advisory board. The advisory board's objective is to give patient-oriented project feedback, thus improving the overall research project.

Intervention:

Two training session per week for 16 weeks. Sessions consists of 3 sets of each exercise corresponding to 10 RM. Training progression will be accounted for and training loads will be evaluated weekly. The training protocol will be a full-body protocol, i.e. all major muscle groups will be engaged during each training session.

Outcomes:

The primary outcome is the Physical Component Summary Measure from the quality of life questionnaire (SF-36). Secondary outcomes include strength measures, functional tests, disease activity measures, questionnaires (e.g. International physical activity questionnaire), DEXA whole body scans, blood samples and muscle biopsies.

02

Conditions studied

  • Myositis
  • Dermatomyositis
  • Polymyositis
  • Immune-Mediated Necrotizing Myopathy
03

Who can participate

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

Inclusion criteria

  • Fulfilling the criteria for myositis by EULAR/ACR (Bottai et al., 2017; Lundberg et al., 2017)
  • ≤ 5 mg/day Prednisolone
  • Stable dosage of immunosuppressive treatment for at least 1 months prior to inclusion in the study
  • Myositis diagnosis at least 6 months prior to inclusion in the study

Exclusion criteria

Exclusion Criteria:

  • Patients with sporadic inclusion body myositis and overlap myositis (myositis combined with another autoimmune rheumatic diseases, except Sjögren's Syndrome)
  • Co-morbidity preventing resistance training (severe heart/lung-disease, uncontrolled hypertension (systolic > 160mmHg, diastolic > 100mmHg), severe knee/hip arthritis)
  • Alcohol- and/or drug abuse. Defined by the guidelines issued by The Danish Health Authority
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
34 participants (actual)

Study arms

  • Experimental
    High-intensity strength training

    16 weeks of high-intensity strength training two times per week. Participants will receive the usual care in accordance to myositis (various DMARDs, different from patient to patient) Interventions: Other: high-intensity strength training Drug: Usual care

    Other: High-intensity strength training

  • No intervention
    Control

    Participants receive the usual care in accordance to myositis (various DMARDs, different from patient to patient). Intervention: Drug: Usual care

Interventions

  • OtherHigh-intensity strength training

    The high-intensity strength training protocol will consist of 2 training sessions per week. The first two weeks will be familiarisation training, where each exercise will be performed in three sets of 10 repetitions at an intensity of 15 repetitions maximum (RM). At week three each session will consist of 3 sets of each exercise corresponding to 10 RM, which will be kept for the remaining part of training intervention. The weights for each exercise will be adjusted throughout the intervention period, so the training load will correspond to 10 RM for each exercise in the entire intervention period.

    Also known as: High-intensity resistance training

05

What researchers measure

Primary outcomes

  1. Quality of life (health survey (SF-36) subscale: Physical Component Summary)

    Quality of life will be evaluated with the short form (36) health survey (SF-36) subscale: Physical Component Summary. The scale ranges from 0 to 100 where 100 is the highest score.

    Time frame: 16 weeks

Secondary outcomes

  1. Leg power

    Power rig

    Time frame: 16 weeks

  2. Handgrip strength

    Measured by a handheld dynamometer

    Time frame: 16 weeks

  3. Functional Index 3

    A test of muscle strength in a series of muscles, carried out by the physician or physiotherapist

    Time frame: 16 weeks

  4. 30 seconds chair rise

    Participants are instructed to stand up and sit down on a chair as many times as possible in 30 sec.

    Time frame: 16 weeks

  5. Timed up-and-go

    Participants are instructed to rise from a chair walk 3 m forward, pass a marking and return to the chair and sit down as fast as possible

    Time frame: 16 weeks

  6. 2-minute walk test

    A 2-min maximal walk test where the participant is encouraged to cover the greatest distance possible.

    Time frame: 16 weeks

  7. Balance

    Short physical performance battery - balance part

    Time frame: 16 weeks

  8. Whole-body, appendicular and lower-limb lean mass

    Measured by Dual-energy X-ray absorptiometry

    Time frame: 16 weeks

  9. Fat-free mass, body fat and total mass

    Measured by bioimpedance

    Time frame: 16 weeks

  10. Physician Global Activity

    Physician's overall assessment on a single 0-10 cm scale, where the higher score indicates higher disease activity

    Time frame: 16 weeks

  11. Patient Global Activity

    Patient's overall assessment on a single 0-10 cm scale, where the higher score indicates higher disease activity.

    Time frame: 16 weeks

  12. Extra-muscular Disease Activity

    An assessment tool used by the physician to evaluate disease activity in various organ systems via a scoring system and a 0-10 cm scale, where the higher score indicates higher disease activity.

    Time frame: 16 weeks

  13. Manual muscle test 8

    A test of muscle strength in a series of muscles, carried out by the physician

    Time frame: 16 weeks

  14. Health Assessment Questionnaire (HAQ)

    HAQ is a questionnaire to evaluate patient reported disability. It has 8 categories with a range of questions. Each question is scored from 0 to 3 where 0 is no disability and 3 is unable to do.

    Time frame: 16 weeks

  15. Physician Global assessment of disease damage

    Physician's overall assessment on a single 0-10 cm scale, where the higher score indicates higher disease damage.

    Time frame: 16 weeks

  16. Patient Global assessment of disease damage

    Patient's overall assessment on a single 0-10 cm scale, where the higher score indicates higher disease damage.

    Time frame: 16 weeks

  17. Medical history

    Questionnaire: Basic cardiovascular questionnaire concerning medical conditions, current medication, heart symptoms and smoking habits

    Time frame: 16 weeks

  18. Self-perceived physical activity levels

    International Physical Activity Questionnaire - long

    Time frame: 16 weeks

  19. Quality of life (health survey (SF-36) subscale: Mental component summary)

    Quality of life will be evaluated with the short form (36) health survey (SF-36) subscale: Mental Component Summary. The scale ranges from 0 to 100 where 100 is the highest score.

    Time frame: 16 weeks

  20. Body mass index (BMI)

    Weight will be measured by scale (kg). Height will be measured by measuring (m). BMI will be derived from weight and height (kg/m\^2)

    Time frame: 16 weeks

  21. Systolic and diastolic blood pressure

    Measured by blood pressure monitor

    Time frame: 16 weeks

  22. Blood samples (analysis of markers of af disease activity)

    Plasma analysis: lipid profile, HbA1c, troponins, NT-proBNP, creatine kinase

    Time frame: 16 weeks

  23. Electrocardiography (ECG)

    Standard 12-lead ECG at 25 mm/s is recorded and analyzed according to standard published criteria (48-50). According to the Minnesota coding the PQ-interval is measured and presence of 1st, 2nd (including Mobitz type 1 and 2), and 3rd degree of AV block are noted. Additional measures will include: P-wave duration (≥ 2.5 mm in any of leads II, III, aVF), QRS duration (≥ 120 ms in any of leads I, II, III, aVL, aVF), QTc duration (\> 450 ms), atrial fibrillation and flutter.

    Time frame: 16 weeks

Other outcomes

  1. Muscle biopsies

    Muscle biopsies will be taken on a selected number of subjects from either the vastus lateralis or the tibialis anterior muscle, for the use in future analysis of i.e. muscle fibre size and distribution, myogenic stem cell activity, capillary density, muscle inflammation ect.

    Time frame: 16 weeks

  2. Physical activity level

    Will be measured by activity tracker (watch)

    Time frame: 16 weeks

06

Study locations

1 site
  • Rigshospitalet
    Copenhagen, 2100, Denmark
07

References and documents

Publications

  • Bottai M, Tjarnlund A, Santoni G, Werth VP, Pilkington C, de Visser M, Alfredsson L, Amato AA, Barohn RJ, Liang MH, Singh JA, Aggarwal R, Arnardottir S, Chinoy H, Cooper RG, Danko K, Dimachkie MM, Feldman BM, Garcia-De La Torre I, Gordon P, Hayashi T, Katz JD, Kohsaka H, Lachenbruch PA, Lang BA, Li Y, Oddis CV, Olesinka M, Reed AM, Rutkowska-Sak L, Sanner H, Selva-O'Callaghan A, Wook Song Y, Vencovsky J, Ytterberg SR, Miller FW, Rider LG, Lundberg IE; International Myositis Classification Criteria Project consortium, the Euromyositis register and the Juvenile Dermatomyositis Cohort Biomarker Study and Repository (JDRG) (UK and Ireland). EULAR/ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: a methodology report. RMD Open. 2017 Nov 14;3(2):e000507. doi: 10.1136/rmdopen-2017-000507. eCollection 2017. PubMed 29177080 ↗
  • Lundberg IE, Tjarnlund A, Bottai M, Werth VP, Pilkington C, de Visser M, Alfredsson L, Amato AA, Barohn RJ, Liang MH, Singh JA, Aggarwal R, Arnardottir S, Chinoy H, Cooper RG, Danko K, Dimachkie MM, Feldman BM, Garcia-De La Torre I, Gordon P, Hayashi T, Katz JD, Kohsaka H, Lachenbruch PA, Lang BA, Li Y, Oddis CV, Olesinska M, Reed AM, Rutkowska-Sak L, Sanner H, Selva-O'Callaghan A, Song YW, Vencovsky J, Ytterberg SR, Miller FW, Rider LG; International Myositis Classification Criteria Project Consortium, the Euromyositis Register, and the Juvenile Dermatomyositis Cohort Biomarker Study and Repository (UK and Ireland). 2017 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Adult and Juvenile Idiopathic Inflammatory Myopathies and Their Major Subgroups. Arthritis Rheumatol. 2017 Dec;69(12):2271-2282. doi: 10.1002/art.40320. Epub 2017 Oct 27. Erratum In: Arthritis Rheumatol. 2018 Sep;70(9):1532. doi: 10.1002/art.40691. PubMed 29106061 ↗
  • Jensen KY, Aagaard P, Schroder HD, Suetta C, Nielsen JL, Boyle E, Diederichsen LP. High-intensity strength training in patients with idiopathic inflammatory myopathies: a randomised controlled trial protocol. BMJ Open. 2021 Jun 25;11(6):e043793. doi: 10.1136/bmjopen-2020-043793. PubMed 34172544 ↗

Individual participant data

Plan to share: No — Due to GDPR-regulations IPD will not be available.

08

Registry details

Key details

Study ID
NCT04486261
Lead sponsor
Rigshospitalet, Denmark
Collaborators
University of Southern Denmark, Odense University Hospital
Responsible party
Louise Pyndt Diederichsen (Consultant Rheumatologist, Associate professor, Rigshospitalet, Denmark) — Principal investigator
First posted
Jul 24, 2020
Start date
Aug 30, 2021
Primary completion
Mar 1, 2022
Completion
Jan 1, 2023
Last update
Apr 10, 2024

Study contacts

Louise Pyndt Diederichsen, PhD
principal investigator · Rigshospitalet, Denmark

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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