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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT06419699
Registration number
NCT06419699
Ethics application status
Date submitted
13/05/2024
Date registered
17/05/2024
Date last updated
22/10/2024
Titles & IDs
Public title
CPAx: Responsiveness and Minimal Clinically Important Difference
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Scientific title
Responsiveness and the Minimal Clinically Important Difference of the Chelsea Critical Care Physical Assessment Tool (CPAx) in Critically Ill, Mechanically Ventilated Adults
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Secondary ID [1]
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5678
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Muscle Weakness
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Critical Illness Myopathy
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Critical Illness Polyneuropathy
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Critical Illness Polyneuromyopathy
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Physical Inactivity
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Condition category
Condition code
Neurological
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Other neurological disorders
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Chelsea Critical Care Physical Assessment tool (CPAx) change score
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Assessment method [1]
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CPAx change score for ICU period (ICU baseline to ICU discharge); CPAx ranges from 0 (worst score) to 50 (best score)
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Timepoint [1]
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Assessed at ICU discharge (within 24 hours before or after ICU discharge)
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Secondary outcome [1]
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CPAx change score
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Assessment method [1]
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CPAx change score for hospital period (ICU to hospital discharge); CPAx ranges from 0 (worst score) to 50 (best score)
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Timepoint [1]
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Assessed at hospital discharge (last value before discharge)
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Secondary outcome [2]
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Global rating of change scale
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Assessment method [2]
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Seven-point global rating of change scale (GRC): (1) very much improved; (2) much improved; (3) little improved; (4) no change; (5) little deterioration; (6) much deterioration; (7) very much deterioration for 'physical function and activity' (rated by treating physiotherapist)
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Timepoint [2]
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ICU and hospital discharge (change for ICU and hospital period)
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Secondary outcome [3]
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ICU Mobility Scale
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Assessment method [3]
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To evaluate mobility level, the score ranges from 0 (worst) to 10 (best)
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Timepoint [3]
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ICU baseline (within 72-144h after ICU admission), ICU and hospital discharge
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Secondary outcome [4]
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Medical Research Council Sum Score
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Assessment method [4]
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To assess muscle strength, the minimal score is 0 (worst), the maximal score 60 (best), ICUAW is defined as \<48 points
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Timepoint [4]
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ICU baseline (within 72-144h after ICU admission), ICU and hospital discharge
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Secondary outcome [5]
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Richmond Agitation-Sedation Scale
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Assessment method [5]
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To assess the level of sedation and/or cooperation, score ranges from -5 (unarousable) to +4 (combative)
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Timepoint [5]
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ICU baseline (within 72-144h after ICU admission), ICU and hospital discharge
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Secondary outcome [6]
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Modified Iowa Level of Assistance Scale
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Assessment method [6]
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To determine assistance in functional tasks, the score ranges from 0 (worst) to 36 (best)
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Timepoint [6]
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ICU baseline (within 72-144h after ICU admission), ICU and hospital discharge
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Secondary outcome [7]
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ICU and discharge destinations
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Assessment method [7]
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Categorical variable (death, external/internal hospital ward, external ICU/hospital, rehabilitation, home, other) to assess the predictive validity of the CPAx score
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Timepoint [7]
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ICU and hospital discharge
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Eligibility
Key inclusion criteria
* Age = 18 years
* Mechanical ventilation = 72 hours
* Expected to remain for = 48 hours in the ICU
* Physiotherapy referral
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Minimum age
18
Years
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Maximum age
No limit
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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
* Not expected to survive to hospital discharge (imminent to death)
* Second or subsequent ICU admission for this hospital stay
* Transfer from external ICU (with an ICU stay of >72 hours)
* Primary neurological admission diagnosis (i.e., of the central nervous system including stroke, intracerebral haemorrhage, traumatic brain injury)
* Known pregnancy
* Living in a care facility pre-admission (severe pre-existing mental or physical disability)
* Local regulations (i.e. Switzerland: refusal of general consent)
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Study design
Purpose
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Duration
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Selection
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
23/05/2024
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/10/2025
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Actual
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Sample size
Target
120
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Monash Health - Clayton
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Recruitment hospital [2]
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Alfred Health - Melbourne
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Recruitment postcode(s) [1]
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- Clayton
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Recruitment postcode(s) [2]
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- Melbourne
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Recruitment outside Australia
Country [1]
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Switzerland
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State/province [1]
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Bern
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Funding & Sponsors
Primary sponsor type
Other
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Name
Insel Gruppe AG, University Hospital Bern
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Monash University
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Intensive care unit (ICU) acquired weakness is a common complication associated with long-term physical impairments in survivors of a critical illness. The Chelsea Critical Care Physical Assessment tool (CPAx) is a valid and reliable instrument for physical function and activity in critically ill patients at risk for muscle weakness. However, its ability to measure change over time (responsiveness) and the minimal clinically important difference (MCID) have not yet been rigorously investigated. This multi-centre, mixed-methods, longitudinal cohort study therefore aims to establish responsiveness and the MCID of the CPAx in the target population from ICU baseline to ICU and hospital discharge. The study uses routine data from standard physiotherapy sessions like mobility, function and activity with no additional burden for critically ill adults. The investigators expect the CPAx to be responsive allowing its use as a primary outcome in future effectiveness trials for the treatment of ICU-acquired weakness using the newly established MCID for sample size calculation. A high quality, rigorously tested measurement tool for physical function and activity in the ICU should benefit researchers, clinicians and patients.
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Trial website
https://clinicaltrials.gov/study/NCT06419699
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Trial related presentations / publications
Corner EJ, Wood H, Englebretsen C, Thomas A, Grant RL, Nikoletou D, Soni N. The Chelsea critical care physical assessment tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study. Physiotherapy. 2013 Mar;99(1):33-41. doi: 10.1016/j.physio.2012.01.003. Epub 2012 Mar 30. Eggmann S, Verra ML, Stefanicki V, Kindler A, Seyler D, Hilfiker R, Schefold JC, Bastiaenen CHG, Zante B. German version of the Chelsea Critical Care Physical Assessment Tool (CPAx-GE): translation, cross-cultural adaptation, validity, and reliability. Disabil Rehabil. 2022 Aug;44(16):4509-4518. doi: 10.1080/09638288.2021.1909152. Epub 2021 Apr 19. Eggmann S, Verra ML, Stefanicki V, Kindler A, Schefold JC, Zante B, Bastiaenen CHG. Predictive validity of the Chelsea Critical Care Physical Assessment tool (CPAx) in critically ill, mechanically ventilated adults: a prospective clinimetric study. Disabil Rehabil. 2023 Jan;45(1):111-116. doi: 10.1080/09638288.2021.2022785. Epub 2022 Jan 7.
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Public notes
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Contacts
Principal investigator
Name
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Sabrina Eggmann, PhD
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Address
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Inselspital, Bern University Hospital, Switzerland; Monash University, Australia
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Sabrina Eggmann, PhD
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Address
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Country
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Phone
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+41 31 632 30 41
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Fax
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Email
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[email protected]
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Contact person for scientific queries
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
Solely anonymised main outcome data
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT06419699
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