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Not yet recruitingNCT05871671Updated May 23, 2023

The Effects of Pulmonary Rehabilitation on Bone Mineral Density in Patients Diagnosed With Chronic Obstructive Pulmonary Disease

An interventional study of Pulmonary Rehabilitation and Control in Chronic Obstructive Pulmonary Disease, sponsored by University of Malta. Not yet recruiting. Per ClinicalTrials.gov, last updated 2023-05-23.

Sponsored by University of Malta · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Mar 2024, 2 years 8 months ago, but the record still lists the study as not yet recruiting.
Phase
Not applicable
Study type
Interventional
Enrollment
80
Allocation
Non-randomized
Sex
All
01

Study summary

Exercise has been reported to lead to improvements in Bone Mineral Density (BMD), however studies looking into the effects of exercise on BMD in Chronic Obstructive Pulmonary Disease (COPD) patients are still very limited. In view of this, the aims of such a study are to identify whether a 16-week Pulmonary Rehabilitation programme leads to improvements in BMD in patients with osteopenia and osteoporosis diagnosed with stable COPD, something which is warranted to reduce the risk of fractures and their related adverse consequences in these patients.

Read the detailed description

Patients suffering from Chronic Obstructive Pulmonary Disease (COPD) are reported to have a high prevalence rate and increased risk of osteopenia and osteoporosis especially due to the intake of corticosteroids, a factor which increases their risks of falls and likelihood of fractures. Considering the enormous impact of such fractures on COPD patients, prophylactic measures are warranted to prevent further loss of BMD to reduce their risk of fractures and their related adverse consequences. Exercise has been reported to lead to improvements in BMD. Evidence regarding the effects of such an intervention on BMD in COPD patients is still very limited. In view of this, the aims of such a study are to identify whether a 16-week Pulmonary Rehabilitation (PR) programme leads to improvements in BMD in patients with osteopenia and osteoporosis diagnosed with stable COPD.

A minimum of 80 patients shall be allocated to either the active group or the control group by the intermediary. The active group shall receive a PR Programme delivered twice weekly for a period of 16 weeks which shall be followed by a maintenance home exercise programme for a period of 36 weeks. The other group which shall consist of patients who do not wish to participate in Pulmonary Rehabilitation but show the wish to form part of this study, or participants who are on the waiting list to be enrolled into the Rehabilitation classes, shall act as a control for the study and therefore not undergo PR and the following maintenance home exercise programme until completion of the study.

As part of the assessment, at baseline (week 0), demographic and anthropometric details and individual patient factors known to affect bone metabolism including; age, gender, smoking status and any concurrent prescribed medications and supplements, shall be gathered directly from all participants. The patients' body weight and height and the Body Mass Index shall be then calculated. Each participant's last DEXA scan measurement shall be retrieved from the Picture Archiving and Communication System (PACS) through the intermediary. All participants shall also have their functional mobility level and fall risk assessed using the Timed "Up and Go" test (TUGT). Estimated 10-year probability of hip fractures and major osteoporotic fractures shall be predicted using WHO web-based fracture risk assessment (FRAX) tool. All participants shall also have their functional exercise capacity assessed using the Six-Minute Walk Test (6MWT).

At week 16 and at week 52 all patients shall be reassessed as baseline, except for the measurement of the bone mineral density which shall be taken using DEXA scan only at week 52 and shall be retrieved from the PACS through the intermediary for the active and control group subjects and shall be required per protocol.

02

Conditions studied

  • Chronic Obstructive Pulmonary Disease

Keywords

  • Pulmonary Rehabilitation, Exercise, Physical Activity, Chronic Obstructive Pulmonary Disease, Osteoporosis, Bone Mineral Density and Bone Mineral Status
03

In context

Pulmonary Disease, Chronic Obstructive

5,520 studies on the registry are indexed under Pulmonary Disease, Chronic Obstructive; 856 are open to participants now.

This study's planned enrollment of 80 is above the median of 62 across 3,839 interventional studies indexed under Pulmonary Disease, Chronic Obstructive.

Browse Pulmonary Disease, Chronic Obstructive studies →

Lead sponsor

University of Malta is the lead sponsor of 12 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Confirmed diagnosis of by Spirometry
  • Stable COPD confirmed by lack of an exacerbation within the 3 months preceeding the start of the study
  • Confirmed diagnosis of osteopenia or osteoporosis by DEXA scan which would have been carried out at some point in the previous 12 months
  • Due for a DEXA scan in the timeframe when the researcher shall be carrying out her data collection. This will ensure that no patients shall be receiving any exposures that were not part of their routine medical management
  • Optimal medical management
  • SpO2 >92% at rest
  • Motivated and committed
  • Suitable cognitive and communicative ability

Exclusion criteria

Exclusion Criteria:

  • Acute infection or exacerbation within the 3 months preceeding the start of the study
  • Lack of motivation and non-adherence
  • Unstable cardiovascular system

    • Myocardial Infarction within last 6 weeks
    • Uncontrolled hypertension
    • Unstable angina
    • Aortic stenosis
    • Acute Left Ventricular Failure
    • Uncontrolled cardiac arrhythmias
  • Unstable diabetes
  • Uncontrolled rheumatoid arthritis
  • Severe orthopaedic or neuromuscular conditions
  • Significant cognitive or psychiatric impairment which interfere with the PR programme
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

COPD

Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
Single (Investigator)
Enrollment
80 participants (estimated)

Study arms

  • Active comparator
    Control group

    The control group shall consist of a minimum of 40 patients with a confirmed diagnosis of COPD and osteoporosis or osteopenia. This group which shall consist of patients who do not wish to participate in Pulmonary Rehabilitation but show the wish to form part of this study, or participants who are on the waiting list to be enrolled into the Rehabilitation classes, shall act as a control for the study and therefore not undergo PR and the following maintenance home exercise programme until completion of the study. All patients were medically stable and referred by their caring respiratory consultant.

    Other: Control

  • Experimental
    Active group

    The active group shall consist of a minimum of 40 patients with a confirmed diagnosis of COPD and osteoporosis or osteopenia. All patients shall receive a 16-week twice weekly PR programme which shall be followed by a 36-week maintenance home exercise programme. All patients were medically stable and referred by their caring respiratory consultant.

    Behavioral: Pulmonary Rehabilitation

Interventions

  • BehavioralPulmonary Rehabilitation

    A 16-week PR programme shall be delivered twice weekly to the active group. This shall be followed by a 36-week maintenance home exercise programme which shall be monitored every 4 weeks via a phone call from the researcher herself for 36 weeks. The subjects shall self-document their adherence to the home exercise programme on a diary which shall be returned to the researcher at week 52.

    Also known as: Respiratory Rehabilitation

  • OtherControl

    The control group shall not receive the 16-week PR programme and the following 36-week maintenance home exercise programme until completion of the study.

06

What researchers measure

Primary outcomes

  1. The Changes in BMD

    BMD scores measured by DEXA Scan

    Time frame: Change in BMD scores from baseline to 52weeks

Secondary outcomes

  1. Timed "Up and Go" Test (TUGT)

    A test to measure the functional mobility level and risk for falls

    Time frame: Change in TUGT scores from baseline to 16 weeks and from 16weeks to 52weeks

  2. The fracture risk assessment (FRAX) tool

    A tool to estimate 10-year probability of hip fractures and major osteoporotic fractures

    Time frame: Change in FRAX tool scores from baseline to 16 weeks and from 16weeks to 52weeks

  3. 6 minute walk test (6MWT)

    A walk test to assess the functional exercise capacity

    Time frame: Change in 6MWT scores from baseline to 16 weeks and from 16weeks to 52weeks

  4. Demographics, Anthropometrics and Medical Data

    demographic and anthropometric details and individual patient factors known to affect bone metabolism including; age, gender, smoking status and any concurrent prescribed medications and supplements, shall be gathered directly from all participants. The patients' body weight and height and the Body Mass Index shall be then calculated.

    Time frame: Change in Demographics, Anthropometrics and Medical Data from baseline to 16weeks and from 16weeks to 52weeks

07

Study locations

No study locations are listed for this record.

08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 23, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT05871671
Lead sponsor
University of Malta
Responsible party
Melanie Axiak (Principal Investigator, University of Malta) — Principal investigator
First posted
May 23, 2023
Start date
May 2023 (estimated)
Primary completion
Mar 2024 (estimated)
Completion
Sep 2025 (estimated)
Last update
May 23, 2023

Study contacts

Melanie Axiak, BSc
Contact
melanie.axiak.14@um.edu.mt
79971016 ext. +356
Anabel Sciriha, PhD
Contact
anabel.sciriha@um.edu.mt
23401573 ext. +356
Melanie Axiak, BSc
principal investigator · University of Malta

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in May 2023. You cannot join it, but the record below documents what was studied.

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