None listed
Conditions
Brief summary
Cardiopulmonary exercise testing (CPET) is the gold standard for cardiorespiratory fitness (VO2peak) assessment. CPET is increasingly being used as a preoperative assessment tool, due to its ability to identify and objectively risk stratify patients who may be more vulnerable to the stress of surgery, and those who may benefit from more intensive perioperative care. Traditionally performed on a cycle, CPET can be difficult to perform for those with lower-limb osteoarthritis (OA). Due to population increases in age and obesity, OA prevalence is predicted to continue increasing. These increases are also likely to result in more complex surgical procedures on higher risk individuals, resulting in greater need for CPET to risk stratify and assess patient suitability for surgery. Therefore, it is essential the optimal exercise modality for performing CPET in these patients in known, particularly if traditionally used cycle ergometry may not be the most suitable for those with mobility issues or pain. This study will compare CPET variables (i.e., peak oxygen consumption, anaerobic threshold) on four different exercise modalities (treadmill, cycle, arm ergometer and elliptical cross-trainer), in patients with severe lower-limb OA.
Interventions
We will conduct a four-arm crossover (within participants) study, measuring peak oxygen consumption across cycle, treadmill, cross-trainer and arm ergometer modalities, in those with severe hip or knee osteoarthritis.
Fifteen participants will be recruited to perform maximal, symptom-limited exercise testing on each exercise modality utilising an incremental protocol. Participants will complete a 3-5 minute warm-up, before exercise intensity increases every 1-2 minutes, until volitional fatigu
We will conduct a four-arm crossover (within participants) study, measuring peak oxygen consumption across cycle, treadmill, cross-trainer and arm ergometer modalities, in those with severe hip or knee osteoarthritis. Fifteen participants will be recruited to perform maximal, symptom-limited exercise testing on each exercise modality utilising an incremental protocol. Participants will complete a 3-5 minute warm-up, before exercise intensity increases every 1-2 minutes, until volitional fatigue or test termination; each exercise test takes approximately 8-12 minutes (excluding warm-up). The testing will be administered and supervised by a registered clinical exercise physiologist (with 12 years experience), who is also a university research student. Testing will be conducted at the Dunedin Public Hospital. Tests will be one-on-one sessions, separated by at least 4 days to ensure adequate washout between exercise tests. Participants will be reimbursed $5 per visit to cover travel expenses.
Sponsors
Dr Kate Thomas
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Patient meets the threshold for elective arthroplasty at Dunedin Public Hospital or is expected to meet the threshold within the next year; - Patient is able to travel to the study centre to complete all sessions.
Exclusion criteria
- Contraindication to maximal exercise testing; - Angina; - Recent myocardial infarction (< 3 months ago); - Implanted cardiac device (i.e. ICD, pacemaker etc.); - Charnley C type patients; - Staged bilateral total joint replacement; - Upper-limb pathology that limits upper-limb exercise, e.g., shoulder-joint osteoarthritis; - Any other medical condition deemed a significant risk to study participation; - Scheduled arthroplasty precluding completion of all four maximal exercise tests.
Outcome results
None listed