Stair Stepping Exercise Training in Patients With Obstructive Sleep Apnea Syndrome
Condition: Sleep Apnea Syndrome
MeSH terms: Apnea; Sleep Apnea Syndromes; Sleep Apnea, Obstructive; Syndrome
Study type: Interventional
Phase: Phase 2

Summary: 
      This 3-year prospective, randomized, control, longitudinal study is aimed to (1) examine the
      effect of stair stepping exercise training on cardiopulmonary fitness and sleep situation in
      patients with Obstructive Sleep Apnea Syndrome (OSAS), and (2) follow the longitudinal change
      after stair stepping exercise training in patients with OSAS. Patients meet the following
      criteria will be invited to participate in this study: being diagnosed with AHI
      (Apnea-hypopnea index)>15/hr and ODI (oxygen desaturation index)>10/hr by Polysomnography,
      aged 19 or older. Based on the power analysis, 70 patients with OSAS treated in the
      outpatient department of Chang Gung Medical Center will be recruited over a period of 26
      months. Each patient will participate in this study for seventeen weeks. Patients will be
      randomly assigned to receive stair stepping exercise in addition to nursing education and
      standard care, or nursing education and standard care alone. Stair stepping exercise will be
      performed at home daily for eight weeks. Outcomes will be determined by changes in the scores
      of cardiopulmonary fitness index, VO2max, six-minute walking distance, daytime sleepiness
      measured by Epworth Sleepiness Scale, sleep time measured by Actigraphy, and AHI measured by
      Polysomnography; those taken four times: before treatment (baseline), five weeks, nine weeks,
      and seventeen weeks of the study. Data will be analyzed using descriptive statistics and
      Generalized Estimating Equation (GEE).
    

Detailed description: 
      This study seeks to verify improvements of the stair stepping exercise training on
      cardiopulmonary fitness condition and sleep condition in patients with obstructive sleep
      apnea syndrome (OSAS). The quasi-experimental, two group repeated-measures study design was
      used. Patients meet the following criteria were invited to participate in this study: being
      diagnosed with AHI (Apnea-hypopnea index)>15/hr and ODI (oxygen desaturation index)>10/hr by
      Polysomnography, aged 19 or older. Eighteen patients with OSAS treated in the outpatient
      department of Chest Medicine were recruited, included study group and control group .The
      study group patients performed stair stepping exercise training daily for eight weeks at
      home. Outcome measures included cardiorespiratory fitness condition assessed by the 3-Minute
      YMCA Step Test, in which including physical fitness index and gross oxygen consumption (VO2),
      and sleep condition assessed by Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and
      Polysomnography. Data were recorded just prior to the stair stepping exercise at Day 1 as
      baseline, at the end of the fourth week, and at the end of the eighth week. Results of this
      study showed, physical fitness index, Epworth Sleepiness Scale , AHI, Pittsburgh Sleep
      Quality Index and symptom scale-snoring were significantly improved. Differences in the
      effect of stair stepping exercise for other outcome variables were either minimal or not
      statistically significant. Eight weeks of stair stepping exercise training could be useful in
      increasing cardiorespiratory fitness condition and improving sleep condition on patients with
      OSAS.
    

Intervention name(s): stair stepping exercise
Intervention type(s): Behavioral
Intervention description(s): Stair stepping exercise performed at home daily for eight weeks
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Stair stepping training; OSAS; cardiopulmonary fitness; sleep disturbance; Actigraphy