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Trial registered on ANZCTR
Registration number
ACTRN12614000766617
Ethics application status
Approved
Date submitted
10/07/2014
Date registered
18/07/2014
Date last updated
9/04/2019
Date data sharing statement initially provided
9/04/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of combining manual therapy with exercise for stable mild chronic obstructive pulmonary disease: a
randomised controlled trial
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Scientific title
The effect of combining manual therapy with exercise for stable mild chronic obstructive pulmonary disease: a
randomised controlled trial
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Secondary ID [1]
284955
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Nil known
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Universal Trial Number (UTN)
U1111-1159-3374
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Trial acronym
MT COPD trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic obstructive pulmonary disease
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Condition category
Condition code
Respiratory
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0
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Chronic obstructive pulmonary disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1: Exercise
Arm 2: Manual therapy and exercise
Exercise: 36 x 30 minute exercise sessions over an 18 week period at an average rate of 2x/week. Administered by respiratory physiotherapists. Exercise consists of gentle aerobic exercise routines.
Manual Therapy: 15 x 20 minute manual therapy sessions over a 6 week period at an average rate of 2-3x/week. Administered by chiropractors and/or osteopaths. Manual therapy consists of massage and thoracic spinal manipulation.
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Intervention code [1]
289782
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Treatment: Other
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Comparator / control treatment
Active Control: Standardised exercise regime for COPD.
This program is the exercise component of the existing pulmonary rehabilitation program at Sutherland Hospital. It consists of a mix of aerobic, resistance & flexibility exercises performed at moderate intensity
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Control group
Active
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Outcomes
Primary outcome [1]
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Lung function assessed by spirometry
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Assessment method [1]
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Timepoint [1]
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Baseline, 4, 8, 16, 24, 32, and 48 weeks
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Secondary outcome [1]
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Exercise capacity as measured by 6 minute walking test
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Assessment method [1]
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Timepoint [1]
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Baseline, 4, 8, 16, 24, 32 and 48 weeks
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Secondary outcome [2]
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C-Reactive protein and leukocyte levels assessed through blood samples (10ml)
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Assessment method [2]
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Timepoint [2]
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Baseline, 4, 8, 24 and 48 weeks
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Secondary outcome [3]
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Quality of Life measured by St Georges Respiratory Questionnaire (SGRQ) and Hospital of Anxiety and Depression (HAD) scale.
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Assessment method [3]
309496
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Timepoint [3]
309496
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Baseline, 4, 8, 16, 24, 32 and 48 weeks
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Eligibility
Key inclusion criteria
1. Existing diagnosis of mild COPD (60% < FEV1 < 80%)
2. Stable COPD (no exacerbations for preceding 6 months)
3. Current non-smoker (non-smoking for > 6 months)
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Minimum age
50
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Inability to complete 6 minute walking test unassisted
2. History of auto-immune disease that may have permanently altered systemic inflammatory biomarkers
3. Contra-indication for thoracic spinal manipulation (Bone density T score < -2.5 and/or Z score < -1)
4. Thoracic joint instability
5. Acute pain on thoracic joint range of motion testing
6. Below normal chest wall musculature for age and gender
7. High level of anxiety related to receiving thoracic spinal manipulation
8. Completed a pulmonary rehabilitation program within the previous 12 months
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Volunteers, who meet the inclusion criteria will be given an information sheet and asked to sign the consent form. They will then undergo a screening for contra-indications to
thoracic spinal manipulation. After a volunteer has passed the screening test they will be enrolled in the trial and given a trial specific ID number. Baseline measurements for each participant will then be taken. Participants will then be allocated to one of the two trial groups according to a computer generated random number sequence.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated random number sequence
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Sample size calculation
Minimum clinically important difference in lung volume (FVC) = 200 ml
Standard deviation = 480ml (obtained from previous studies)
Power = 0.8 (80%)
Alpha = 0.05
Minimum sample size for two sample t-test = 92 per group
Minimum cohort size (i.e. 2 groups) is 2 x 92 = 184
Assuming a drop-out rate = 10%
Minimum cohort size = 202 (2 Groups @ 101)
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Other reasons/comments
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Other reasons
Interim analysis of 24 week data of first 60 participants showed no difference between groups.
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Date of first participant enrolment
Anticipated
21/07/2014
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Actual
4/11/2014
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Date of last participant enrolment
Anticipated
20/07/2018
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Actual
20/05/2018
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Date of last data collection
Anticipated
20/06/2019
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Actual
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Sample size
Target
202
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Accrual to date
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Final
81
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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The Sutherland Hospital - Caringbah
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Recruitment postcode(s) [1]
8424
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2228 - Miranda
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Chiropractors Association of Australia (NSW)
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Address [1]
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P.O. Box 61
St Leonards
NSW 1590
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Country [1]
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Australia
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Funding source category [2]
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Hospital
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Name [2]
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St George & Sutherland Medical Research Foundation
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Address [2]
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Suite 8/13 Hogben Street, KOGARAH NSW 2217
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Country [2]
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Australia
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Primary sponsor type
University
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Name
Macquarie University
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Address
Balaclava Road
North Ryde
NSW 2109
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Sutherland Hospital
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Address [1]
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126 Kareena Road
Miranda
NSW 2228
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Country [1]
288265
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Associate Professor Subramanyam Vemulpad
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Address [2]
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Department of Chiropractic
Building C5C Room 351
Macquarie University
Balaclava Road
North Ryde
NSW 2109
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Country [2]
288266
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Eastern Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [1]
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Room G71 East Wing Edmund Blackett Building Prince of Wales Hospital
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
291317
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Approval date [1]
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23/06/2014
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Ethics approval number [1]
291317
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13/004
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Summary
Brief summary
The aim of this study is to measure the medium to long term effects on lung function, exercise capacity and quality of life of a new combination of interventions for people with COPD. The interventions are manual therapy and exercise. The rationale behind the study is that manual therapy delivers short-term improvements in respiratory mechanics which delays the onset of exercise-induced breathlessness. This permits an increase in exercise performance and ultimately exercise capacity. As exercise capacity is an indicator of mortality in COPD, any increase represents an improvement in the long-term prognosis of the disease.
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Trial website
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Trial related presentations / publications
Engel RM, Vemulpad S, Beath K. Short term effects of combining manual therapy and exercise on moderate chronic obstructive pulmonary disease (COPD): a randomized pilot study. Journal of Manipulative Physiological Therapeutics, 2013. 36: p. 490-496. Engel RM, Gonski P, Beath K, Vemulpad S. Medium term effects of including manual therapy in a pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD): a randomized controlled pilot trial. Journal of Manual and Manipulative Therapies. 2014. doi: 10.1179/2042618614Y.0000000074.
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Public notes
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Contacts
Principal investigator
Name
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Dr Roger Engel
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Address
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Department of Chiropractic Room 354, 17 Wally's Walk Macquarie University Balaclava Road North Ryde NSW 2109
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Country
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Australia
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Phone
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+61 2 98506387
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Fax
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+61 2 98509389
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Email
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[email protected]
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Contact person for public queries
Name
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Roger Engel
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Address
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Department of Chiropractic
Building C5C Room 354
Macquarie University
Balaclava Road
North Ryde
NSW 2109
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Country
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Australia
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Phone
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+61 2 98506387
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Fax
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+61 2 98509389
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Email
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[email protected]
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Contact person for scientific queries
Name
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Roger Engel
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Address
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Department of Chiropractic
Building C5C Room 354
Macquarie University
Balaclava Road
North Ryde
NSW 2109
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Country
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Australia
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Phone
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+61 2 98506387
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Fax
49828
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+61 2 98509389
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Didn't receive consent for sharing data in ethics approval.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
1823
Study protocol
366692-(Uploaded-09-04-2019-10-42-50)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
The effect of combining manual therapy with exercise for mild chronic obstructive pulmonary disease: Study protocol for a randomised controlled trial.
2017
https://dx.doi.org/10.1186/s13063-017-2027-z
N.B. These documents automatically identified may not have been verified by the study sponsor.
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