Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| P30DK017047 | U.S. NIH Grant/Contract | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) | NIH |
People with diabetes are at risk for life altering complications, including diabetic foot ulcers. To heal a diabetic foot ulcer, people are often required to refrain from bearing weight on their affected limb for months. These long periods of non-weight bearing can result in severe physical deconditioning, putting these individuals at risk for further health decline. The goal of this pilot, randomized controlled trial is to evaluate the effects of a seated exercise program on clinically meaningful outcomes in people with diabetic foot ulcers. The long-term aim of this research is to improve overall health and quality of life in people with complications from diabetes.
People with diabetes are at risk for life-altering complications and comorbidities. One of the most serious complications is a diabetic foot ulcer, which significantly increases risk for limb amputation. To heal a diabetic foot ulcer, patients are often instructed to refrain from bearing weight on the affected limb. This non-weight bearing protocol results in extended periods of inactivity that can lead to severe physical deconditioning, including diminished strength, endurance, and flexibility. EnhanceFitness, a community exercise program designed for older adults, holds classes that can be adapted for people who are non-weight bearing due to a healing foot ulcer. These exercise classes focus specifically on strength training, aerobic fitness, and stretching - activities that can counteract progressive deconditioning in people with diabetic foot ulcer. Health benefits associated with exercise in people with diabetes are well-established. However, for those experiencing declines in health and physical function because of healing protocols for a diabetic foot ulcer, the potential benefits of exercise are not yet known. The proposed project aims to address this gap in diabetes research.
The long-term goal of this research is to improve the health and quality of life of people with complications from diabetes. The specific goal of this project is to evaluate the effect of a seated community exercise program, EnhanceFitness, on clinically-meaningful outcomes in people with diabetic foot ulcers. Study investigators will recruit people with diabetic foot ulcers from local wound care clinics and randomly assign them to two groups. The first group will engage in EnhanceFitness, an existing community fitness program appropriate for people with weight-bearing restrictions due to wound-healing protocols. The second group will receive the standard of care, which does not include exercise recommendations. To assess the effectiveness of the seated exercise program, the investigators will compare important health outcomes between people with diabetic foot ulcers participating in EnhanceFitness and a control group with diabetic foot ulcers. Specifically, the investigators will assess physical and physiological outcomes, including glycated hemoglobin (HbA1c), lower-extremity strength, and wound healing. The investigators will also measure psychosocial outcomes, such as depression, perceived physical function, overall health, and self-reported ability to continue with exercise. Further, the investigators will evaluate the feasibility of conducting research assessing the effects of seated exercise in people with foot ulcers. The data collected in this pilot research will be used to apply for large, extramural funding that aims to mitigate physical deconditioning in people with diabetic foot ulcers.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exercise | Experimental | EnhanceFitness exercise class, 1 hour, 3 times a week, duration of 12 weeks. |
|
| Control | No Intervention | Usual care. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EnhanceFitness community exercise program | Other | Level I EnhanceFitness class is a seated fitness class that includes warm up, aerobics, cool down, balance training, strength training, and stretching. |
| Measure | Description | Time Frame |
|---|---|---|
| Glycated Hemoglobin (HbA1c) at 12-week Session | Average blood glucose over a three-month period | 12 weeks post-intervention |
| Chair Stand Test (5x Sit-to-Stand) at 12-week Session | Measure of functional mobility and lower extremity strength. The 5x Sit-to-Stand test measures the total amount of time that it takes a individual to stand up and sit down in a chair five times. The individual is asked to stand up and sit down five times as quickly as they are able. The research staff started the stopwatch on "begin" and stopped timing after the individual had completed the fifth round of standing/sitting. Faster times are better, and scores are recorded in seconds. | 12 weeks post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| PROMIS-Global at 12-week Session | Patient-Reported Outcome Measurement Information System (PROMIS) Global 10-item short form. Results are reported as a T-score. PROMIS-Global is a self-reported questionnaire to assess global health. T-scores are calculated for 2 subscales- physical health and mental health. A higher T-score indicates better physical health and better mental health; a T-score of 50 indicates the general population mean with a standard deviation of 10. T-scores for physical health range from 16.2 to 67.7. T-scores for mental health range from 21.2 to 67.6. |
| Measure | Description | Time Frame |
|---|---|---|
| Recruitment | Feasibility measure- were overall recruitment targets reached? This feasibility measure will be assessed for the overall study and not for each participant. | At the completion of the 2-year study |
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Sara J Morgan, PhD | University of Washington | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Northwest Hospital | Seattle | Washington | 98133 | United States |
Participants were assigned to study group at the time that the baseline appointment was scheduled for logistical reasons (i.e., to facilitate the identification and enrollment in a community-based exercise course if the participant was allocated to the exercise group).
34 participants were allocated to treatment group, but only 24 attended a baseline session and consented to study participation.
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| FG000 | Exercise | EnhanceFitness exercise class, 1 hour, 3 times a week, duration of 12 weeks. EnhanceFitness community exercise program: Level I EnhanceFitness class is a seated fitness class that includes warm up, aerobics, cool down, balance training, strength training, and stretching. |
| FG001 | Control | Usual care. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Not provided
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Exercise | EnhanceFitness exercise class, 1 hour, 3 times a week, duration of 12 weeks. EnhanceFitness community exercise program: Level I EnhanceFitness class is a seated fitness class that includes warm up, aerobics, cool down, balance training, strength training, and stretching. |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Glycated Hemoglobin (HbA1c) at 12-week Session | Average blood glucose over a three-month period | Posted | Mean | Standard Deviation | percentage of HbA1c | 12 weeks post-intervention |
|
12 weeks (the duration of a participant's time in the study.
Not provided
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Exercise | EnhanceFitness exercise class, 1 hour, 3 times a week, duration of 12 weeks. EnhanceFitness community exercise program: Level I EnhanceFitness class is a seated fitness class that includes warm up, aerobics, cool down, balance training, strength training, and stretching. |
Not provided
Not provided
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Sara Morgan, PhD | University of Washington (affiliation) | 651-229-1719 | sjmorgan@uw.edu |
Not provided
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jul 7, 2022 | Jul 8, 2022 | Prot_SAP_000.pdf |
Not provided
| ID | Term |
|---|---|
| D017719 | Diabetic Foot |
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003925 | Diabetic Angiopathies |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016523 | Foot Ulcer |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
|
| 12 weeks post-intervention |
| PROMIS-Depression at 12 Weeks | Patient-Reported Outcome Measurement Information System (PROMIS) Depression 4-item short form. Results are reported as a T-score. PROMIS-Depression is a self-reported questionnaire to assess depression. A higher T-score indicates greater depression; a T-score of 50 indicates the general population mean with a standard deviation of 10. T-scores range from 41.0 to 79.4 for the 4-item short form. | 12 weeks post-intervention |
| PROMIS-Physical Function | Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function 11-item short form. Results are reported as a T-score. PROMIS-Physical Function is a self-reported questionnaire to assess physical function. A higher T-score indicates better physical function; a T-score of 50 indicates the general population mean with a standard deviation of 10. T-scores range from 11.9 to 57.9 for the 11-item short form. | 12 weeks post-intervention |
| Retention | Feasibility measure- did the participant attend all study data collection sessions? | Through the end of study participation, approximately 12 weeks |
| Adherence | Feasibility measure- % classes attended by participants in the intervention group | Through the end of study participation, approximately 12 weeks |
| EnhanceFitness Program Evaluation | Feasibility measure, satisfaction with exercise program for participants in the intervention group. This satisfaction measure was designed by EnhanceFitness. It included 5 items, each item was rated by participants as 1 (not at all satisfied) to 5 (very satisfied). Responses for the five questions were summed and divided by 5. Scores ranged from 1-5, with better scored indicating higher satisfaction. | 12-weeks post-intervention |
| Adverse Events | Feasibility measure- number of adverse events, if any, that occurred for each participant. | Through the end of study participation, approximately 12 weeks |
| Found to not meet inclusion criteria during baseline session data collection. |
|
| Control |
Usual care. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex/Gender, Customized | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Time since diabetes diagnosis (self-reported) | Mean | Standard Deviation | years |
|
| Body mass index | Mean | Standard Deviation | kg/m^2 |
|
| Units | Counts |
|---|
| Participants |
|
|
|
| Primary | Chair Stand Test (5x Sit-to-Stand) at 12-week Session | Measure of functional mobility and lower extremity strength. The 5x Sit-to-Stand test measures the total amount of time that it takes a individual to stand up and sit down in a chair five times. The individual is asked to stand up and sit down five times as quickly as they are able. The research staff started the stopwatch on "begin" and stopped timing after the individual had completed the fifth round of standing/sitting. Faster times are better, and scores are recorded in seconds. | Posted | Mean | Standard Deviation | seconds | 12 weeks post-intervention |
|
|
|
|
| Secondary | PROMIS-Global at 12-week Session | Patient-Reported Outcome Measurement Information System (PROMIS) Global 10-item short form. Results are reported as a T-score. PROMIS-Global is a self-reported questionnaire to assess global health. T-scores are calculated for 2 subscales- physical health and mental health. A higher T-score indicates better physical health and better mental health; a T-score of 50 indicates the general population mean with a standard deviation of 10. T-scores for physical health range from 16.2 to 67.7. T-scores for mental health range from 21.2 to 67.6. | Posted | Mean | Standard Deviation | T-score | 12 weeks post-intervention |
|
|
|
|
| Secondary | PROMIS-Depression at 12 Weeks | Patient-Reported Outcome Measurement Information System (PROMIS) Depression 4-item short form. Results are reported as a T-score. PROMIS-Depression is a self-reported questionnaire to assess depression. A higher T-score indicates greater depression; a T-score of 50 indicates the general population mean with a standard deviation of 10. T-scores range from 41.0 to 79.4 for the 4-item short form. | Posted | Mean | Standard Deviation | T-score | 12 weeks post-intervention |
|
|
|
|
| Secondary | PROMIS-Physical Function | Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function 11-item short form. Results are reported as a T-score. PROMIS-Physical Function is a self-reported questionnaire to assess physical function. A higher T-score indicates better physical function; a T-score of 50 indicates the general population mean with a standard deviation of 10. T-scores range from 11.9 to 57.9 for the 11-item short form. | Posted | Mean | Standard Deviation | T-score | 12 weeks post-intervention |
|
|
|
|
| Secondary | Retention | Feasibility measure- did the participant attend all study data collection sessions? | This is a feasibility measure of how many people completed the study from baseline to 12 weeks. Thus, the number of patients that completed the baseline session was used. | Posted | Count of Participants | Participants | Through the end of study participation, approximately 12 weeks |
|
|
|
| Secondary | Adherence | Feasibility measure- % classes attended by participants in the intervention group | Posted | Mean | Standard Deviation | percentage of classes attended | Through the end of study participation, approximately 12 weeks |
|
|
|
| Secondary | EnhanceFitness Program Evaluation | Feasibility measure, satisfaction with exercise program for participants in the intervention group. This satisfaction measure was designed by EnhanceFitness. It included 5 items, each item was rated by participants as 1 (not at all satisfied) to 5 (very satisfied). Responses for the five questions were summed and divided by 5. Scores ranged from 1-5, with better scored indicating higher satisfaction. | Only participants in the exercise arm who attended at least one exercise class (n=6 out of 7 total). | Posted | Mean | Standard Deviation | score on a scale | 12-weeks post-intervention |
|
|
|
| Secondary | Adverse Events | Feasibility measure- number of adverse events, if any, that occurred for each participant. | Posted | Number | adverse events | Through the end of study participation, approximately 12 weeks |
|
|
|
| Other Pre-specified | Recruitment | Feasibility measure- were overall recruitment targets reached? This feasibility measure will be assessed for the overall study and not for each participant. | 34 is the number randomized to group; 40 is the number that we targeted for this study | Posted | Count of Participants | Participants | At the completion of the 2-year study |
|
|
|
| 0 |
| 7 |
| 0 |
| 7 |
| 0 |
| 7 |
| EG001 | Control | Usual care. | 0 | 11 | 0 | 11 | 0 | 11 |
Not provided
Not provided
| D007871 |
| Leg Ulcer |
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
| D003929 | Diabetic Neuropathies |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| 0.80 |
p-value is interaction of group and time. Alpha level= 0.10; not adjusted for multiple comparisons (pilot study) |
| Superiority |