Does Pulmonary Rehabilitation Improve Frailty?

Study Overview
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Brief Summary
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Frailty is a state of health with predisposition to adverse events, morbidity and mortality. Frailty consists of weakness, slowness, low physical activity, exhaustion, and wasting. Frailty is associated with increased hospitalizations and death in lung disease. It is unknown if pulmonary rehabilitation will improve frailty markers.

Detailed Description
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Individuals referred to pulmonary rehabilitation will be examined for frailty markers. After completing pulmonary rehabilitation, the same tests will be performed. The effects of pulmonary rehabilitation will be examined.

Official Title
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Does Pulmonary Rehabilitation Improve Frailty in Chronic Lung Disease?

Conditions
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Disease, Pulmonary

Intervention / Treatment
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* Other: Pulmonary Rehabilitation
* Device: Dynamometer
* Radiation: DEXA
* Other: Gait Speed Test
* Device: Activity Monitor
* Other: Questionnaires


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Referred for pulmonary rehabilitation consenting to research Exclusion criteria: -Under 18 years of age

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Pulmonary Rehabilitation<br>One arm study - all participants will go to pulmonary rehabilitation, received questionnaires, Dual-energy X-ray absorptiometry (DEXA) scans, Dynamometer and gait speed tests and activity measured through an activity monitor. | Other: Pulmonary Rehabilitation<br>* Measures of frailty taken before and after pulmonary rehabilitation.<br>Device: Dynamometer<br>* Grip Test<br>Radiation: DEXA<br>* Body Composition Testing<br>Other: Gait Speed Test<br>* 15 foot walk test<br>Device: Activity Monitor<br>* Measures energy expenditure and activity<br>Other: Questionnaires<br>* Health-related questionnaires measuring self-reported exhaustion, emotions and disease symptoms.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With Frailty Phenotype at Baseline and 6 Months | Frailty phenotype is 3 or more of: slow gait speed, exhaustion, decreased hand grip strength, decreased activity level, or wasting. Grip strength parameters, gait speed, exhaustion per Fried et al. 2001. Wasting is defined as further decrease in fat free mass by body composition measurement using DEXA. Low physical activity would be activity monitor in lower quartile. | Baseline, Six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wasting | DXA measurement of body mass index pre- and post- PR. | after pulmonary rehabilation completion, appoximately 8 weeks | 
| Change in Strength | Change in Grip Strength as measured by hand dynamometer. | after completion of pulmonary rehab, approximately 8 weeks | 
| Change in Gait Speed | gait speed test measured over 15 feet | pre and post pulmonary rehab, approximately 8 weeks | 
| Improvement in Exhaustion | Self-reported exhaustion - measured by two questions in the Center for the Epidemiological Studies in Depression (CES-D) scale and reported as a dichotomous variable (exhausted or not exhausted). | pre and post pulmonary rehab, approximately 8 weeks | 
| Change in Physical Activity Level | Measured by Body Media armband activity monitor using total energy expenditure divided by the resting metabolic rate | pre and post pulmonary rehab, approximately 8 weeks |