Effects of Personalized Training at Home Combining Endurance and Resistance in Patients Suffering From Marfan Syndrome

Study Overview
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Brief Summary
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Marfan syndrome (MS) is an autosomal dominant genetic disorder caused by a mutation in the fibrillin-1 gene (FBN1) encoding the protein fibrillin-1. Fibrillin is the main component of microfibrils, elements found in all of the body's tissues, and this pathology is characterized by the multitude of its clinical manifestations. These patients may develop aneurysms in the aortic root and one of the main factors of morbidity in patients with MS is aortic dissection. Prevention mainly involves preventive aortic surgery. However, the repercussions are global and can affect the functioning of other tissues such as skeletal muscle tissue, bone tissue, lung tissue and the eyes. The association of skeletal (scoliosis, hyperlaxity), muscular and ocular disorders is clearly associated with an impairment in the quality of life. These disorders are associated with pain and disability which affect professional activity, leisure and family life. Physical activity could represent a relevant alternative for these patients. A recent animal study suggests that moderate training is beneficial.

Detailed Description
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The main objective is to show that the quality of life of patients with Marfan syndrome can be improved by personalized training at home. The goal is to be able to offer new non-drug management based on physical activity to these patients. Improved quality of life; Improvement of muscle strength by a muscle strengthening protocol; Improvement of cardiovascular function parameters. Regular coaching throughout the study. / Assessment of muscular capacities / Assessment of cardiovascular and respiratory capacities / Response to psychometric questionnaires / Participation in a training circuit (training protocol)

Official Title
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Evaluation of the Effects of Personalized Training at Home Combining Endurance and Resistance in Patients Suffering From Marfan Syndrome

Conditions
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Marfan Syndrome

Intervention / Treatment
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* Other: Endurance training
* Other: Muscle building training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patient with Marfan syndrome and followed up at Bichat Claude Bernard hospital, Paris. Marfan syndrome should be diagnosed according to the Ghent nosology revised in 2010 Patient taking protective treatment for the aorta (beta blocker, calcium channel blocker, ACE inhibitor, angiotensin II receptor antagonist). Valid patient, able to return to consultation and carry out functional assessments and personalized physical training at home. Patients operated prophylactically on the ascending aorta may be included at a distance > 6 months from their surgery. Exclusion Criteria: Myocardial pathology other than Marfan syndrome. Thoracic aorta dissection. Aortic diameter > 45 millimeters. Uncontrolled high blood pressure at rest (systolic blood pressure > 140 Millimeter of mercury and diastolic blood pressure > 90 Millimeter of mercury) Increase in systolic blood pressure > 160 Millimeter of mercury during exercise. Pregnancy at the time of the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 3 groups of physical training intervention compared with control group
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Group 1<br>No physical training | |
| Experimental: Group 2<br>Endurance training | Other: Endurance training<br>* Aerobic circuit training<br>|
| Experimental: Group 3<br>Muscle building training | Other: Muscle building training<br>* Muscle strengthening circuit training<br>|
| Experimental: Group 4<br>Training combining endurance + muscle building | Other: Endurance training<br>* Aerobic circuit training<br>Other: Muscle building training<br>* Muscle strengthening circuit training<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of life assessment: questionnaire | Assessed with Medical Outcome Study Short Form 36 questionnaire, a scale scored on a 0 to 100 range so that the lowest is the worth condition and highest is the best condition. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain assessment: Fibromyalgia Rapid Screening Tool | Assessed with Fibromyalgia Rapid Screening Tool | 3 months | 
| Self-perception assessment | Assessed with Physical Self Inventory questionnaire, a scale scoring 25 items rated on a 6-point scale ranging from 1 (Not at all) to 6 (Entirely) and assessing 6 dimensions (global self-worth (10-50), physical self-worth (10-50), physical condition (10-50), sport competence (10-40), physical attractiveness (10-30), and physical strength (10-30)) of the physical self-conception. | 3 months | 
| Aortic diameter | Evolution of the aortic diameter (in millimeter) in echocardiography, safety cardiovascular parameters | 3 months | 
| Blood pressure | Evolution of the systolic and diastolic blood pressures (in Millimeter of mercury) during exercise, monitoring of physiological parameters | 3 months | 
| Heart rate | Evolution of heart rate (Beats per minute) during exercise, monitoring of physiological parameters | 3 months | 
| oxygen consumption | Evolution of oxygen consumption (in liter) during exercise, monitoring of physiological parameters | 3 months | 
| Maximal voluntary contraction | Evolution of maximal voluntary contraction (in Newtons) during exercise, monitoring of physiological parameters | 3 months | 
| Left Ventricular Ejection Fraction (LVEF) | Evolution of Left Ventricular Ejection Fraction (in percentage) at rest, monitoring of cardiovascular parameters. | 3 months | 
| Global longitudinal strain (GLS) | Evolution of GLS (in percentage) at rest, monitoring of cardiovascular parameters | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Physical training