CClinicalTrials.gg
RecruitingNCT06141603Updated Dec 28, 2023

Comparison of Upper and Lower Limb Maximal Exercise Capacities and Muscle Oxygenation in Patients With ILD

An observational study in Interstitial Lung Disease, sponsored by Gazi University. Recruiting at 1 site in Turkey. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2023-12-28.

Sponsored by Gazi University · Observational

From the registry’s dates

  • Primary completion was expected by Dec 2024, 1 year 9 months ago, but the record still lists the study as recruiting.
  • Started Nov 2023; still recruiting 2 years 10 months later.
Study type
Observational
Model
Case-crossover
Time perspective
Prospective
Enrollment
30
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Interstitial lung diseases (ILD) are a complex group of diseases that cause significant morbidity and mortality, develop diffuse lung parenchyma and alveolar inflammation, as well as interstitial fibrosis, which refers to more than 200 diseases. Due to restrictive type ventilation disorder and impaired pulmonary gas exchange, pulmonary function has deteriorated in these patients and progressive shortness of breath, fatigue, cough and exercise intolerance are usually observed, which also affects the quality of life.

Read the detailed description

As a result of the chronic inflammatory process of the disease, structural and mechanical pulmonary disorders develop, which are cited as the causes of deterioration in cardiopulmonary functions. In these patients, there is a decrease in static and dynamic lung volumes and carbon monoxide diffusion capacity. As a result of this mechanism, the level of physical activity decreases due to increased shortness of breath during activity. In ILD, there is a decrease in peripheral November muscle strength of both the upper extremities and lower extremities. November it was stated that the weakness of the skeletal muscles of the lower extremities was more pronounced than the skeletal muscles of the upper extremities due to disuse in these patients, and the muscle strength of the upper extremities did not decrease significantly. However, it has been reported that upper limb exercise capacity is worse than lower limb exercise capacity. Arterial hypoxemia is shown as the main reason for the decrease in exercise performance, and peak oxygen consumption (VO2peak) decreased in these patients.

In healthy people, respiratory frequency, tidal volume (VT), minute ventilation and oxygen consumption increase during exercise. In interstitial lung patients, vital capacity decreases at rest, which leads to limitation of VT. Lung compliance decreases and respiratory workload increases. The respiratory workload, which increases even more during exercise, has a bad effect on ventricular function. This causes a lower oxygen pulse and pulse volume in patients during exercise than in healthy individuals.

The primary aim of the study: To compare the maximal exercise capacities and muscle oxygenation during cardiopulmonary exercise tests of upper and lower extremities in patients with interstitial lung disease.

The secondary aim of the study is to compare energy consumption and the perception of dyspnea and fatigue during tests in patients with interstitial lung disease.

The primary outcome will be upper and lower maximal exercise capacities (cardiopulmonary exercise tests) and muscle oxygenation during cardiopulmonary exercise tests (Near-infrared spectroscopy) device).

Secondary outcome will be energy consumption (multi sensor activity device), the perception of dyspnea (Modified Borg Scale (MBS)) and fatigue (MBS).

02

Conditions studied

  • Interstitial Lung Disease

Keywords

  • interstitial lung disease
  • muscle oxygenation
  • cardiopulmonary exercise testing
03

In context

Lung Diseases

3,303 studies on the registry are indexed under Lung Diseases; 355 are open to participants now.

This study's planned enrollment of 30 is below the median of 157 across 929 observational studies indexed under Lung Diseases.

Browse Lung Diseases studies →

Lead sponsor

Gazi University is the lead sponsor of 531 studies on the registry; 99 are open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

30 patients diagnosed with interstitial lung disease will be recruited.

Inclusion criteria

  • patients between the ages of 18-75 with interstitial lung disease

Exclusion criteria

Exclusion Criteria:

  • acute infection during the study
  • have an orthopedic or neurological disease that will affect their exercise capacity
  • acute exacerbation or any infection
  • have contraindications to the exercise test
  • an acute respiratory infection
  • had Coronavirus-19 (COVID-19) disease in the last 3 months
  • have undergone different treatments other than standard medical treatment
05

Study design

Observational model
Case-crossover
Time perspective
Prospective
Enrollment
30 participants (estimated)
Patient registry
No

Groups and cohorts

  • Lower Extremity Group

    The first test is the cardiopulmonary exercise test (CPET), which evaluates the maximal exercise capacity of the lower extremities and will be performed on a treadmill. During the test, the muscle oxygen of the individuals will be measured with a near-infrared spectrometer, and their energy consumption will be measured with a multisensory physical activity monitor.

  • Upper Extremity Group

    In the second test, the maximal exercise capacity for the upper limb will again be evaluated by CPET and performed on the arm ergometer. The second test will be conducted 48 hours after the lower extremity exercise test. During the test in the second group, as in the first test, muscle oxygen will be measured with a near-infrared spectrometer, and energy expenditure with a multisensory physical activity monitor.

06

What researchers measure

Primary outcomes

  1. Peripheral Muscle Oxygenation

    Peripheral muscle oxygen will be measured by near-infrared spectrometry. The device probes will be placed on the upper and lower extremities for both tests. The device allows to display of the percentage of oxygen, the concentration of oxyhemoglobin, and deoxyhemoglobin, the difference between oxyhemoglobin and deoxyhemoglobin, and the total hemoglobin. These parameters will be evaluated in our study.

    Time frame: through study completion, an average of 1 year

Secondary outcomes

  1. Maximal Exercise Capacity

    Maximal Exercise capacity will be evaluated with Cardiopulmonary Exercise testing. The Cardiopulmonary Exercise Testing will be applied according to American Thoracic Society (ATS) and European Respiratory Society (ERS) criteria.

    Time frame: through study completion, an average of 1 year

  2. Energy Consumption During Tests

    Energy consumption will be evaluated with the Multi sensor activity monitor (SenseWear®, Inc Pittsburgh, ABD). The patient wear the multi sensor physical activity monitor over the triceps muscle of the non-dominant arm during CPETs. Energy consumption (joule / day) will be measured with the multi-sensor physical activity monitor. The measured parameter will be averaged and analyzed with the "SenseWear® 7.0 Software" program.

    Time frame: through study completion, an average of 1 year

  3. Physical Activity Level (Total energy expenditure)

    Physical activity will be evaluated with the Multi sensor activity monitor (SenseWear®, Inc Pittsburgh, ABD). The patient will wear the multisensor physical activity monitor over the triceps muscle of the non-dominant arm for 4 continuous days. The patient will be informed about removing the device while taking a bath. Total energy expenditure (joule / day) will be measured with the multi-sensor physical activity monitor. The parameters measured over two days will be averaged and analyzed with the "SenseWear® 7.0 Software" program.

    Time frame: through study completion, an average of 1 year

  4. Physical activity (Active energy expenditure (joule / day))

    Physical activity will be evaluated with the Multi sensor activity monitor (SenseWear®, Inc Pittsburgh, ABD). The patient will wear the multisensor physical activity monitor over the triceps muscle of the non-dominant arm for 4 continuous days. The patient will be informed about removing the device while taking a bath. Active energy expenditure (joule / day) will be measured with the multi-sensor physical activity monitor. The parameters measured over two days will be averaged and analyzed with the "SenseWear® 7.0 Software" program.

    Time frame: through study completion, an average of 1 year

  5. Physical activity (Physical activity time (min / day))

    Physical activity will be evaluated with the Multi sensor activity monitor (SenseWear®, Inc Pittsburgh, ABD). The patient will wear the multisensor physical activity monitor over the triceps muscle of the non-dominant arm for 4 continuous days. The patient will be informed about removing the device while taking a bath. Physical activity time (min / day)will be measured with the multi-sensor physical activity monitor. The parameters measured over two days will be averaged and analyzed with the "SenseWear® 7.0 Software" program.

    Time frame: through study completion, an average of 1 year

  6. Physical activity (Average metabolic equivalent (MET / day))

    Physical activity will be evaluated with the Multi sensor activity monitor (SenseWear®, Inc Pittsburgh, ABD). The patient will wear the multisensor physical activity monitor over the triceps muscle of the non-dominant arm for 4 continuous days. The patient will be informed about removing the device while taking a bath. Average metabolic equivalent (MET / day) will be measured with the multi-sensor physical activity monitor. The parameters measured over two days will be averaged and analyzed with the "SenseWear® 7.0 Software" program.

    Time frame: through study completion, an average of 1 year

  7. Physical activity (Number of steps (steps / day))

    Physical activity will be evaluated with the Multi sensor activity monitor (SenseWear®, Inc Pittsburgh, ABD). The patient will wear the multisensor physical activity monitor over the triceps muscle of the non-dominant arm for 4 continuous days. The patient will be informed about removing the device while taking a bath. Number of steps (steps / day) will be measured with the multi-sensor physical activity monitor. The parameters measured over two days will be averaged and analyzed with the "SenseWear® 7.0 Software" program.

    Time frame: through study completion, an average of 1 year

  8. Physical activity (Time spent lying down (min / day) days))

    Physical activity will be evaluated with the Multi sensor activity monitor (SenseWear®, Inc Pittsburgh, ABD). The patient will wear the multisensor physical activity monitor over the triceps muscle of the non-dominant arm for 4 continuous days. The patient will be informed about removing the device while taking a bath. Time spent lying down (min / day) days) will be measured with the multi-sensor physical activity monitor. The parameters measured over two days will be averaged and analyzed with the "SenseWear® 7.0 Software" program.

    Time frame: through study completion, an average of 1 year

  9. Physical activity (Sleep time (min / day))

    Physical activity will be evaluated with the Multi sensor activity monitor (SenseWear®, Inc Pittsburgh, ABD). The patient will wear the multisensor physical activity monitor over the triceps muscle of the non-dominant arm for 4 continuous days. The patient will be informed about removing the device while taking a bath. Sleep time (min / day) will be measured with the multi-sensor physical activity monitor. The parameters measured over two days will be averaged and analyzed with the "SenseWear® 7.0 Software" program.

    Time frame: through study completion, an average of 1 year

  10. Peripheral Muscle Strength

    Isometric peripheral muscle strength will be measured with a portable hand dynamometer (JTECH Commander, USA). Measurements will be repeated on the shoulder abductors and knee extensors three times on the right and left.

    Time frame: through study completion, an average of 1 year

  11. Dyspnea

    Modified Borg Scale: The Modified Borg scale is a subjective scale that scores 0-10 for breathlessness and fatigue at rest and/or during activity. The lowest 0 points "not at all" the highest 10 points "very severe" means shortness of breath.

    Time frame: through study completion, an average of 1 year

  12. Fatigue

    Fatigue will be measured by the Turkish adaptation of the Fatigue Severity Scale. The Fatigue Severity Scale (FSS) is a scale that evaluates fatigue and consists of 9 questions. Scores can be taken from the scale in the range of 0 to 63 points. Each item is scored between 0 and 7 points. The total score is divided by 9 and if the average is less than 4, there is no fatigue, and if more than 4 points, it is considered that there is fatigue.

    Time frame: through study completion, an average of 1 year

07

Study locations

1 of 1 sites recruiting
  • Gazi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Cardiopulmonary Rehabilitation Unit
    Ankara, Çankaya 06490, Turkey
    Recruiting
08

References and documents

Publications

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  • Molgat-Seon Y, Schaeffer MR, Ryerson CJ, Guenette JA. Exercise Pathophysiology in Interstitial Lung Disease. Clin Chest Med. 2019 Jun;40(2):405-420. doi: 10.1016/j.ccm.2019.02.011. PubMed 31078218 ↗
  • Bourke SJ. Interstitial lung disease: progress and problems. Postgrad Med J. 2006 Aug;82(970):494-9. doi: 10.1136/pgmj.2006.046417. PubMed 16891438 ↗
  • Shen Q, Guo T, Song M, Guo W, Zhang Y, Duan W, Peng Y, Ni S, Ouyang X, Peng H. Pain is a common problem in patients with ILD. Respir Res. 2020 Nov 11;21(1):297. doi: 10.1186/s12931-020-01564-0. PubMed 33176795 ↗
  • Tomlinson OW, Markham L, Wollerton RL, Knight BA, Duckworth A, Gibbons MA, Scotton CJ, Williams CA. Validity and repeatability of cardiopulmonary exercise testing in interstitial lung disease. BMC Pulm Med. 2022 Dec 22;22(1):485. doi: 10.1186/s12890-022-02289-0. PubMed 36550475 ↗
  • Dowman LM, McDonald CF, Hill CJ, Lee AL, Barker K, Boote C, Glaspole I, Goh NSL, Southcott AM, Burge AT, Gillies R, Martin A, Holland AE. The evidence of benefits of exercise training in interstitial lung disease: a randomised controlled trial. Thorax. 2017 Jul;72(7):610-619. doi: 10.1136/thoraxjnl-2016-208638. Epub 2017 Feb 17. PubMed 28213592 ↗
  • Antoniou KM, Margaritopoulos GA, Tomassetti S, Bonella F, Costabel U, Poletti V. Interstitial lung disease. Eur Respir Rev. 2014 Mar 1;23(131):40-54. doi: 10.1183/09059180.00009113. PubMed 24591661 ↗
  • Baydur A. Pulmonary physiology in interstitial lung disease: recent developments in diagnostic and prognostic implications. Curr Opin Pulm Med. 1996 Sep;2(5):370-5. doi: 10.1097/00063198-199609000-00005. PubMed 9363170 ↗
  • Panagiotou M, Church AC, Johnson MK, Peacock AJ. Pulmonary vascular and cardiac impairment in interstitial lung disease. Eur Respir Rev. 2017 Jan 17;26(143):160053. doi: 10.1183/16000617.0053-2016. Print 2017 Jan. PubMed 28096284 ↗
  • Nishiyama O, Yamazaki R, Sano H, Iwanaga T, Higashimoto Y, Kume H, Tohda Y. Physical activity in daily life in patients with idiopathic pulmonary fibrosis. Respir Investig. 2018 Jan;56(1):57-63. doi: 10.1016/j.resinv.2017.09.004. Epub 2017 Oct 23. PubMed 29325683 ↗
  • Mendes P, Wickerson L, Helm D, Janaudis-Ferreira T, Brooks D, Singer LG, Mathur S. Skeletal muscle atrophy in advanced interstitial lung disease. Respirology. 2015 Aug;20(6):953-9. doi: 10.1111/resp.12571. Epub 2015 Jun 17. PubMed 26081374 ↗
  • Harris-Eze AO, Sridhar G, Clemens RE, Zintel TA, Gallagher CG, Marciniuk DD. Role of hypoxemia and pulmonary mechanics in exercise limitation in interstitial lung disease. Am J Respir Crit Care Med. 1996 Oct;154(4 Pt 1):994-1001. doi: 10.1164/ajrccm.154.4.8887597. PubMed 8887597 ↗
  • Bhambhani Y, Maikala R, Buckley S. Muscle oxygenation during incremental arm and leg exercise in men and women. Eur J Appl Physiol Occup Physiol. 1998 Oct;78(5):422-31. doi: 10.1007/s004210050441. PubMed 9809843 ↗
  • Molgat-Seon Y, Schaeffer MR, Ryerson CJ, Guenette JA. Cardiopulmonary Exercise Testing in Patients With Interstitial Lung Disease. Front Physiol. 2020 Jul 10;11:832. doi: 10.3389/fphys.2020.00832. eCollection 2020. PubMed 32754054 ↗
  • Orr JL, Williamson P, Anderson W, Ross R, McCafferty S, Fettes P. Cardiopulmonary exercise testing: arm crank vs cycle ergometry. Anaesthesia. 2013 May;68(5):497-501. doi: 10.1111/anae.12195. PubMed 23573845 ↗
  • Franssen FM, Wouters EF, Baarends EM, Akkermans MA, Schols AM. Arm mechanical efficiency and arm exercise capacity are relatively preserved in chronic obstructive pulmonary disease. Med Sci Sports Exerc. 2002 Oct;34(10):1570-6. doi: 10.1097/00005768-200210000-00007. PubMed 12370557 ↗
  • Lollgen H, Leyk D. Exercise Testing in Sports Medicine. Dtsch Arztebl Int. 2018 Jun 15;115(24):409-416. doi: 10.3238/arztebl.2018.0409. PubMed 29968559 ↗
  • Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J; ATS/ERS Task Force. General considerations for lung function testing. Eur Respir J. 2005 Jul;26(1):153-61. doi: 10.1183/09031936.05.00034505. No abstract available. PubMed 15994402 ↗
  • Johnson JD, Theurer WM. A stepwise approach to the interpretation of pulmonary function tests. Am Fam Physician. 2014 Mar 1;89(5):359-66. PubMed 24695507 ↗
  • Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Eur Respir J. 1993 Mar;6 Suppl 16:5-40. doi: 10.1183/09041950.005s1693. No abstract available. PubMed 24576915 ↗
  • Subudhi AW, Dimmen AC, Roach RC. Effects of acute hypoxia on cerebral and muscle oxygenation during incremental exercise. J Appl Physiol (1985). 2007 Jul;103(1):177-83. doi: 10.1152/japplphysiol.01460.2006. Epub 2007 Apr 12. PubMed 17431082 ↗
  • Lusina SJ, Warburton DE, Hatfield NG, Sheel AW. Muscle deoxygenation of upper-limb muscles during progressive arm-cranking exercise. Appl Physiol Nutr Metab. 2008 Apr;33(2):231-8. doi: 10.1139/h07-156. PubMed 18347677 ↗
  • Lee JA, Laurson KR. Validity of the SenseWear armband step count measure during controlled and free-living conditions. J Exerc Sci Fit. 2015 Jun;13(1):16-23. doi: 10.1016/j.jesf.2014.11.002. Epub 2015 Jan 29. PubMed 29541094 ↗
  • Patel SA, Benzo RP, Slivka WA, Sciurba FC. Activity monitoring and energy expenditure in COPD patients: a validation study. COPD. 2007 Jun;4(2):107-12. doi: 10.1080/15412550701246658. PubMed 17530503 ↗
  • Ross RM. ATS/ACCP statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003 May 15;167(10):1451; author reply 1451. doi: 10.1164/ajrccm.167.10.950. No abstract available. PubMed 12738602 ↗
  • Pane C, Salzano A, Trinchillo A, Del Prete C, Casali C, Marcotulli C, Defazio G, Guardasole V, Vastarella R, Giallauria F, Puorro G, Marsili A, De Michele G, Filla A, Cittadini A, Sacca F. Safety and feasibility of upper limb cardiopulmonary exercise test in Friedreich ataxia. Eur J Prev Cardiol. 2022 Mar 25;29(3):445-451. doi: 10.1093/eurjpc/zwaa134. PubMed 33624001 ↗
  • Andrews AW, Thomas MW, Bohannon RW. Normative values for isometric muscle force measurements obtained with hand-held dynamometers. Phys Ther. 1996 Mar;76(3):248-59. doi: 10.1093/ptj/76.3.248. PubMed 8602410 ↗
  • Bohannon RW. Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. 1997 Jan;78(1):26-32. doi: 10.1016/s0003-9993(97)90005-8. PubMed 9014953 ↗
  • Wilson RC, Jones PW. A comparison of the visual analogue scale and modified Borg scale for the measurement of dyspnoea during exercise. Clin Sci (Lond). 1989 Mar;76(3):277-82. doi: 10.1042/cs0760277. PubMed 2924519 ↗
  • Mahler DA, Rosiello RA, Harver A, Lentine T, McGovern JF, Daubenspeck JA. Comparison of clinical dyspnea ratings and psychophysical measurements of respiratory sensation in obstructive airway disease. Am Rev Respir Dis. 1987 Jun;135(6):1229-33. doi: 10.1164/arrd.1987.135.6.1229. PubMed 3592398 ↗
  • Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989 Oct;46(10):1121-3. doi: 10.1001/archneur.1989.00520460115022. PubMed 2803071 ↗
  • Gencay-Can A, Can SS. Validation of the Turkish version of the fatigue severity scale in patients with fibromyalgia. Rheumatol Int. 2012 Jan;32(1):27-31. doi: 10.1007/s00296-010-1558-3. Epub 2010 Jul 24. PubMed 20658235 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 28, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06141603
Lead sponsor
Gazi University
Responsible party
Meral Boşnak Güçlü (Study director, PT, PhD, Prof.Dr. Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Head of Cardiopulmonary Rehabilitation Clinic, Gazi University) — Principal investigator
First posted
Nov 21, 2023
Start date
Nov 25, 2023
Primary completion
Dec 28, 2024 (estimated)
Completion
Dec 30, 2024 (estimated)
Last update
Dec 28, 2023

Study contacts

Meral BOŞNAK GÜÇLÜ, Prof. Dr.
Contact
meralbosnak@gazi.edu.tr
03122162647
Beyza Nur ÖYMEZ, Pt.
Contact
beyzanuroymez@gmail.com
Beyza Nur ÖYMEZ, Pt.
principal investigator · Gazi University
Nilgün YILMAZ DEMİRCİ, Prof. Dr.
principal investigator · Gazi University
Meral BOŞNAK GÜÇLÜ, Prof. Dr.
study director · Gazi University

Oversight

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

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