Total value of intensive exercise training (three weeks) immediately after hospital discharge for arthritis patients due to a flare of disease activity or for elective joint replacements

ISRCTN	ISRCTN24488371
DOI	https://doi.org/10.1186/ISRCTN24488371
Secondary identifying numbers	N/A

Submission date: 29/12/2006
Registration date: 16/01/2007
Last edited: 22/10/2008

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Musculoskeletal Diseases

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Mart van de Laar
Scientific

University of Twente
Institute for Behavioural Research
Department of Psychology and Communication of Health Risk (PCHR)
P.O. Box 217
Enschede
7500 AE
Netherlands

Phone	+31 (0)53 489 2398
Email	m.a.f.j.vandelaar@utwente.nl

Study information

Study design	The DAPPER study is a randomised controlled clinical trial
Primary study design	Interventional
Secondary study design	Randomised controlled trial
Study setting(s)	Hospital
Study type	Treatment
Scientific title
Study acronym	DAPPER-study: Disabled Arthritis Patients Post-hospitalisation Exercise Recovery/Rehabilitation
Study objectives	1. Three weeks of intensive training immediately after hospital discharge improves the functional ability, mobility, quality of life in patients with arthritis on the short term and on the long term. 2. Over a period of one year the total cost of the intensive training group are equal or lower to the usual care associated with better effectiveness. 3. The arm ergometer is a valid and reliable measuring device to measure the aerobic condition with the use of the Åstrand Rhyming test.
Ethics approval(s)	The trial was reviewed and accepted by the certified medical ethical commission (METC) of the Medisch Spectrum Twente in May 2002 (ref: P02-023)
Health condition(s) or problem(s) studied	Rheumatoid arthritis and Osteoarthritis
Intervention	Directly following hospital discharge the patients of this study design recieved Intensive Exercise Therapy (IET) or Usual Care (UC). The IET group were referred to a dedicated convalescent hotel. The hotel facilities and professional care for disabled people were offered for three-weeks. Thereafter, the IET group received regular care only. During their three week stay patients were trained twice a day by physical therapists, for 75 minutes per session. The goals of the training were improvement of range of motion, muscle strength, aerobic capacity and activities of daily life. The therapy sessions were given individually as well as in groups. In the first two weeks, treatment focused on individual limitations (range of motion, strength, balance, aerobic capacity and simple functionality). Aerobic capacity was trained daily on a sub maximal level. Hydrotherapy was applied after sufficient wound healing. During the third week, the training was focused on the functional capacities as prioritised by the patient. A group education program was given twice a week. This program was based on the self management training for arthritis patients by Kate Lorig modified for the Netherlands by Taal. In contrast, the patients in the UC group received usual care at the discretion of their attending physician only. Usual care consists of either physical therapy by a local physical therapist or temporary admission to a nursing home, when applicable.
Intervention type	Other
Primary outcome measure	Function ability as measured with the McMaster Toronto Arthritis patient preference questionnaire (MACTAR) and Health Assessment Questionnaire (HAQ).
Secondary outcome measures	1. Quality of life as measured with the RAND-36/Short Form health survey (SF-36) and Arthritis Impact Measurement Scales (AIMS) 2. Mobility as measured with the Escola Paulista de Medicina Range Of Motion (EPM-ROM) 3. Pain, general health as measured with a Visual Analogue Scale 4. Costs
Overall study start date	01/01/2002
Completion date	05/01/2005

Eligibility

Participant type(s)	Patient
Age group	Adult
Lower age limit	18 Years
Sex	Not Specified
Target number of participants	130
Key inclusion criteria	1. Aged over 18 2. Rheumatoid Arthritis (RA) according to the American College of Rheumatology (ACR) 1987 or polyarticular OsteoArthritis (OA)
Key exclusion criteria	1. Presence of serious cardiac disease (New York Heart Association [NYHA] class III and IV) 2. Incapacitating pulmonary disease Global initiative for chronic Obstructive Lung Disease (GOLD) stage IV 3. Serious hypertension (diastolic blood pressure more than 110 mmHg) 4. Pregnancy 5. Insufficient understanding of the Dutch language 6. Functional incapacity (Steinbrocker functional class four)
Date of first enrolment	01/01/2002
Date of final enrolment	05/01/2005

Locations

Countries of recruitment

Netherlands

Study participating centre

University of Twente

Enschede
7500 AE
Netherlands

Sponsor information

University of Twente (The Netherlands)
University/education

Institute for Behavioural Research
Department of Psychology and Communication of Health Risk (PCHR)
P.O. Box 217
Enschede
7500 AE
Netherlands

Phone	+31 (0)53 489 2398
Email	m.a.f.j.vandelaar@utwente.nl
Website	http://www.utwente.nl/en/
"ROR"	https://ror.org/006hf6230

Funders

Funder type

Government

RVVZ (Reserve Voormalige Vrijwillige Ziekenfondsen) a governmental non profit health organisation (The Netherlands)

No information available

Dutch Arthritis Foundation (The Netherlands)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
Publication and dissemination plan	Not provided at time of registration
IPD sharing plan

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Results article	results	15/02/2008		Yes	No