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Can Interval Walking Influence on Fatigue in the Danish Cohort of Myasthenia Gravis Patients

Primary Purpose

Myasthenia Gravis

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Interval walking
Sponsored by
Rigshospitalet, Denmark
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myasthenia Gravis

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Able to provide signed informed consent.
  • Able to read and understand Danish or English.
  • Diagnosed with mild to moderate myasthenia gravis (I-IV on the Myasthenia Gravis Foundation of American Clinical Classification, MGFA).
  • Documented history of acetylcholine receptor (AChR) or Muscle Specific Kinase (MuSK) antibody positive, or abnormal repetitive nerve stimulation testing (decrement > 10%) on EMG or abnormal single fiber EMG (conduction block or jitter) or based on their clinical history and symptom improvement with acethylcholinesterase inhibitors.
  • If the patient is on oral corticosteroids, the dose must be stable for at least 1 month prior to inclusion.
  • If the patient is on cholinesterase inhibitors the dose must be stable 2 weeks prior to inclusion.

Exclusion Criteria:

  • MGFA grade V disease
  • Other disorders that are not related to MG, or drugs, that interfere with muscle strength, balance and fatigue.
  • Serious medical illness (e.g. uncontrolled insulin dependent diabetes mellitus, symptomatic coronary artery disease, and cancer).
  • Dementia or pregnancy.
  • Unspecified reasons judged by the investigator.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    No Intervention

    Arm Label

    Interval walking

    Control

    Arm Description

    Interval walking for 10 weeks, 150 minutes per week administered by an app on the patient's telephone.

    Patients live as normal, though aerobe training restricted to a maximum of 30 minutes a week.

    Outcomes

    Primary Outcome Measures

    6 minutes walk test
    Walk test

    Secondary Outcome Measures

    30-s sit to stand test
    How many times in 30 seconds can the patient stand up from sitting on a chair?
    Quantitative Myasthenia Gravis Score
    The Quantitative Myasthenia Gravis (QMG) score is an established and validated measure of disease severity used in myasthenia gravis (MG) trials. This scoring system is based on quantitative testing of sentinel muscle groups by means of a 4 point scale ranging from 0 (no symptoms) to 3 (severe symptoms). The scale measures ocular, bulbar, respiratory and limb function, grading each finding, and the total score ranges from 0(no myasthenic findings) to 39 (maximal myasthenic deficits).
    Myasthenia gravis composite score
    The Myasthenia Gravis composite score (MGC) covers 10 important functional domains most frequently involved in patients with MG. This scoring system is based on quantitative testing of muscle groups, or symptom history told by the patient, by means of a 4 point scale ranging from 0 (no symptoms) to 9 (severe symptoms). The scale measures ocular, bulbar, respiratory and limb function, grading each finding, and the total score ranges from 0(no myasthenic findings) to 50 (maximal myasthenic deficits).
    Myasthenia gravis activity of daily living profile (MG-ADL)
    Impact on daily living is assessed using the MG-ADL. An eight-question survey of symptoms severity, with each response graded from 0 (normal) to 3 (most severe). Questions include ocular, oropharyngeal, respiratory, and extremity functions. Total MG-ADL score ranges from 0 to 24. MG-ADL is also an indirect measurement of disease severity.
    Myasthenia gravis quality of life 15-item score (MG-QoL15)
    MG -specific quality-of-life instrument is a 15-item questionnaire encompassing physical and psychological domains of MG to assess disease-specific Qol in MG patients. Rating consist of a 5-point scale ranging from 0 ("not at all") to 4 ("very much") as to the degree to which patients agree with the given statement summing up to a total score 0-60 points.
    Multidimensional Fatigue Inventory (MFI-20)
    Self-reported questionnaire that measure fatigue severity. It contains 20 items and consists of five domains: mental fatigue, reduced motivation, reduced activity, physical fatigue and general fatigue. The response options consist of five check boxes ranging from "yes, that is true" to "No, that is not true". The scores in each domain range from 4 to 20, with higher scores indicating higher levels of fatigue. A total fatigue score for all five domains is not used. MFI-20 has been used in several clinical and healthe populations.

    Full Information

    First Posted
    February 25, 2019
    Last Updated
    March 9, 2021
    Sponsor
    Rigshospitalet, Denmark
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03900585
    Brief Title
    Can Interval Walking Influence on Fatigue in the Danish Cohort of Myasthenia Gravis Patients
    Official Title
    Physical Activity and Fatigue in Danish Patients With Myasthenia Gravis - an Intervention Study
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Due to restricted and new rules for data protection, the use of an app could not be approved
    Study Start Date
    August 2019 (Anticipated)
    Primary Completion Date
    January 1, 2021 (Actual)
    Study Completion Date
    January 1, 2021 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Rigshospitalet, Denmark

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    The study is a controlled, randomized intervention trial. Patients are randomized into either an intervention group or a control group. The duration of the study is 10 weeks. Patients in the intervention group participate in a 10 weeks exercise program consisting of 150 minutes interval walking per week administered by an app on the patient's telephone. Patients in the control group live as usually, with a maximum of 30 minutes aerobic exercise per week. Before and after the 10 weeks study period, patients (from both the intervention and the control group) participate in a 2 hours session of functional testing (e.g. walk tests, test of muscle strength ect.) at Rigshospitalet.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Myasthenia Gravis

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Interval walking
    Arm Type
    Experimental
    Arm Description
    Interval walking for 10 weeks, 150 minutes per week administered by an app on the patient's telephone.
    Arm Title
    Control
    Arm Type
    No Intervention
    Arm Description
    Patients live as normal, though aerobe training restricted to a maximum of 30 minutes a week.
    Intervention Type
    Behavioral
    Intervention Name(s)
    Interval walking
    Intervention Description
    Interval walking administered by an app on the patient's telephone. Interval walking for 150 minutes/week for 10 weeks.
    Primary Outcome Measure Information:
    Title
    6 minutes walk test
    Description
    Walk test
    Time Frame
    6 minutes
    Secondary Outcome Measure Information:
    Title
    30-s sit to stand test
    Description
    How many times in 30 seconds can the patient stand up from sitting on a chair?
    Time Frame
    30 seconds
    Title
    Quantitative Myasthenia Gravis Score
    Description
    The Quantitative Myasthenia Gravis (QMG) score is an established and validated measure of disease severity used in myasthenia gravis (MG) trials. This scoring system is based on quantitative testing of sentinel muscle groups by means of a 4 point scale ranging from 0 (no symptoms) to 3 (severe symptoms). The scale measures ocular, bulbar, respiratory and limb function, grading each finding, and the total score ranges from 0(no myasthenic findings) to 39 (maximal myasthenic deficits).
    Time Frame
    45 minutes
    Title
    Myasthenia gravis composite score
    Description
    The Myasthenia Gravis composite score (MGC) covers 10 important functional domains most frequently involved in patients with MG. This scoring system is based on quantitative testing of muscle groups, or symptom history told by the patient, by means of a 4 point scale ranging from 0 (no symptoms) to 9 (severe symptoms). The scale measures ocular, bulbar, respiratory and limb function, grading each finding, and the total score ranges from 0(no myasthenic findings) to 50 (maximal myasthenic deficits).
    Time Frame
    30 minutes
    Title
    Myasthenia gravis activity of daily living profile (MG-ADL)
    Description
    Impact on daily living is assessed using the MG-ADL. An eight-question survey of symptoms severity, with each response graded from 0 (normal) to 3 (most severe). Questions include ocular, oropharyngeal, respiratory, and extremity functions. Total MG-ADL score ranges from 0 to 24. MG-ADL is also an indirect measurement of disease severity.
    Time Frame
    10 minutes
    Title
    Myasthenia gravis quality of life 15-item score (MG-QoL15)
    Description
    MG -specific quality-of-life instrument is a 15-item questionnaire encompassing physical and psychological domains of MG to assess disease-specific Qol in MG patients. Rating consist of a 5-point scale ranging from 0 ("not at all") to 4 ("very much") as to the degree to which patients agree with the given statement summing up to a total score 0-60 points.
    Time Frame
    3 minutes
    Title
    Multidimensional Fatigue Inventory (MFI-20)
    Description
    Self-reported questionnaire that measure fatigue severity. It contains 20 items and consists of five domains: mental fatigue, reduced motivation, reduced activity, physical fatigue and general fatigue. The response options consist of five check boxes ranging from "yes, that is true" to "No, that is not true". The scores in each domain range from 4 to 20, with higher scores indicating higher levels of fatigue. A total fatigue score for all five domains is not used. MFI-20 has been used in several clinical and healthe populations.
    Time Frame
    5 minutes

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    80 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Able to provide signed informed consent. Able to read and understand Danish or English. Diagnosed with mild to moderate myasthenia gravis (I-IV on the Myasthenia Gravis Foundation of American Clinical Classification, MGFA). Documented history of acetylcholine receptor (AChR) or Muscle Specific Kinase (MuSK) antibody positive, or abnormal repetitive nerve stimulation testing (decrement > 10%) on EMG or abnormal single fiber EMG (conduction block or jitter) or based on their clinical history and symptom improvement with acethylcholinesterase inhibitors. If the patient is on oral corticosteroids, the dose must be stable for at least 1 month prior to inclusion. If the patient is on cholinesterase inhibitors the dose must be stable 2 weeks prior to inclusion. Exclusion Criteria: MGFA grade V disease Other disorders that are not related to MG, or drugs, that interfere with muscle strength, balance and fatigue. Serious medical illness (e.g. uncontrolled insulin dependent diabetes mellitus, symptomatic coronary artery disease, and cancer). Dementia or pregnancy. Unspecified reasons judged by the investigator.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    John Vissing, Professor
    Organizational Affiliation
    Rigshospitalet, Denmark
    Official's Role
    Study Director

    12. IPD Sharing Statement

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