Protocol summary

Study aim
Determining the effect of an eight-week aerobic and strength training program with creatine supplementation on fatigue and function in patients with chronic fatigue syndrome
Design
Clinical trial with a control group, parallel groups, single-blind, randomized, sample size 36
Settings and conduct
This study is conducted in the Imam Khomeini Hospital. In the first visit, the participants will enter the study after filling out a written consent form. In this visit, anthropometric indicators are measured and questionnaires are completed. On the second visit, all study subjects are educated about diet. In the second visit, an exercise test is performed and the maximum strength test is measured for the lower limb with a leg press machine and the upper limb with a chest press machine with a standard protocol. Also, during this visit, Traband is delivered to patients. On the third visit, strength exercises are taught to the patients. Also, in the third visit, creatine supplementation is started for the intervention group. The subjects under the study are visited at the end of the eighth week and the parameters at the beginning of the study are measured again by a person who is not aware of the grouping.
Participants/Inclusion and exclusion criteria
Inclusion criteria: 1. Age 18-65 years 2. Meet National Academy of Medicine (NAM) criteria for chronic fatigue 3. Must have moderate to severe fatigue Exclusion criteria: 1. Currently have respiratory failure due to uncontrolled cardiopulmonary disease or COVID-19 2. Existence of severe musculoskeletal symptoms or other diseases that interfere with exercise.
Intervention groups
Intervention group: 8 weeks of aerobic and strength training program and 4 weeks of creatine supplement. Control group: receive 8 weeks of aerobic and strength training program.
Main outcome variables
Fatigue; Function

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20111025007903N14
Registration date: 2024-10-04, 1403/07/13
Registration timing: registered_while_recruiting

Last update: 2024-10-04, 1403/07/13
Update count: 0
Registration date
2024-10-04, 1403/07/13
Registrant information
Name
Zahra Alizadeh
Name of organization / entity
Tehran University of Medical Sciences
Country
Iran (Islamic Republic of)
Phone
+98 21 6119 2282
Email address
z_alizadeh@tums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2024-05-20, 1403/02/31
Expected recruitment end date
2024-10-22, 1403/08/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
"Examining the effect of eight-week aerobic and strength exercise program with Creatine supplement on performance and fatigue in patients with Chronic Fatigue Syndrome
Public title
Investigating the effect of exercise and creatine supplement in Chronic Fatigue Syndrome
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Age 18-65 years Meet US National Academy Of Medicine criteria (NAM), (have cognitive and/or orthostatic symptoms along with three of the following: A) substantial decrease or impairment in ability to participate in pre-illness levels of occupational, educational, social, or personal activities that has persisted for 6 months or more and is accompanied by profound fatigue, has a new onset (not lifelong), is not the result of ongoing excessive exertion, and is not significantly relieved by rest ‌‌‌B) Post-exertional malaise (PEM) C) Sleep that is not restorative. Must have moderate to severe fatigue.
Exclusion criteria:
Currently have respiratory failure due to uncontrolled cardiopulmonary disease or COVID-19. Existence of acute infectious symptoms such as fever and vital sign abnormalities. Existence of severe musculoskeletal symptoms or other diseases that interfere with exercise. Existence history of severe allergies, neurological, rheumatological, or psychological disorders that significantly impact fatigue. Existence history of kidney disease, proteinuria, or abnormal kidney function tests such as elevated BUN and creatinine.
Age
From 18 years old to 65 years old
Gender
Both
Phase
N/A
Groups that have been masked
  • Outcome assessor
  • Data analyser
Sample size
Target sample size: 36
Randomization (investigator's opinion)
Randomized
Randomization description
Randomization will be done with 12 blocks, each including three persons, and involves a structured process to ensure unbiased and balanced allocation of participants to different study groups. Here is a detailed description of this randomization process: 1. Blocks Formation: Creating 12 blocks, each with three slots for participants. 2. Random Sequence Generation: Using a random number generator to create a sequence assigning blocks to either the intervention (I) or control (C) group. Example: I, C, I, C, I, C, I, C, I, C, I, C. 3. Assignment Process: A person blind to group details assigns blocks according to a random sequence. Example Assignments: Block 1: I, Block 2: C, Block 3: I, and so on. 4. Participant Allocation: Participants are enrolled sequentially and placed into the next available slot in the current block. Example: Participants 1-3 in Block 1 (I), Participants 4-6 in Block 2 (C), etc. 5. Ensuring Balance: 6 blocks for intervention and 6 for control ensure equal group sizes (18 participants each). Small block size maintains balance throughout enrollment. This structured randomization process ensures unbiased, balanced allocation of participants to study groups, enhancing the reliability and validity of the study outcomes.
Blinding (investigator's opinion)
Single blinded
Blinding description
In this study, the patients in both groups engage in the same aerobic and strength exercises, receive identical nutrition advice, and are provided with exercise elastic bands for their resistance workouts. However, the intervention group has an additional element in their regimen: starting from the second week, they receive a creatine supplement. The control group does not receive this supplement. Participants are aware of interventions, they complete the consent form and in the consent form, we explain the trial process and describe interventions in both groups. In addition, in this study principal investigator and the assessor are unaware of the participants' group assignments. This reduces the risk of bias in the administration of the intervention and the assessment of outcomes. A third person, who is not involved in any aspect of patient interaction or assessment, performs the randomization and manages the allocation of participants to either the intervention or control group. This person ensures the sequence and assignment remain confidential and strictly adheres to the randomization protocol to maintain the study's validity and reliability.
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Research Ethics Committees of Imam Khomeini Hospital Complex- Tehran University of Medical Sciences
Street address
Dr. Gharib street, Tohid square
City
Tehran
Province
Tehran
Postal code
1419733141
Approval date
2024-01-23, 1402/11/03
Ethics committee reference number
IR.TUMS.IKHC.REC.1402.430

Health conditions studied

1

Description of health condition studied
Chronic Fatigue Syndrome
ICD-10 code
G93.3
ICD-10 code description
Postviral fatigue syndrome, Myalgic encephalomyelitis

Primary outcomes

1

Description
Fatigue severity in Chalder's questionnaire
Timepoint
Before starting the intervention, ending the intervention
Method of measurement
Chalder's questionnaire

Secondary outcomes

1

Description
Function, Quality of Life
Timepoint
Before starting the intervention, ending the intervention
Method of measurement
GPAQ questionnaire, SF-36 questionnaire

Intervention groups

1

Description
Intervention group: creatine supplement (produced by Karen company) is consumed for one month in the form of 25 grams in 5 divided doses in the first 5 days and then in the amount of 5 grams daily. Aerobic exercise program according to the results of the exercise test in the range of 40 to 60% of the reserve heart rate for 5 days a week for 8 weeks and strength exercise of the upper and lower limbs according to the results of the 1RM test in the range of perceived exertion rating of 11-12 with Traband' band is performed for 6 weeks.
Category
Treatment - Other

2

Description
Control group:The control group receives the same exercise program as the intervention group.
Category
Treatment - Other

Recruitment centers

1

Recruitment center
Name of recruitment center
Imam Khomeini Hospital
Full name of responsible person
Zahra Alizadeh
Street address
Dr. Gharib street, Tohid square
City
Tehran
Province
Tehran
Postal code
۱۴۱۹۷۳۳۱۴۱
Phone
+98 21 6119 5270
Email
za_al10@yahoo.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Faride Sanaie Kermani
Street address
4th Floor, The Center of Tehran University of Medical Sciences, Ghods St., Keshavarz Blvd
City
Tehran
Province
Tehran
Postal code
1417653761
Phone
+98 21 6405 3405
Email
z_alizade@tums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Tehran University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Zahra Alizadeh
Position
professor
Latest degree
Specialist
Other areas of specialty/work
Sport Medicine
Street address
No7, Ale-Ahmad Highway, Opposite of Shariati Hospital, Tehran,Iran
City
Tehran
Province
Tehran
Postal code
1411734143
Phone
+98 21 6119 2282
Fax
+98 21 8800 3539
Email
z_alizadeh@tums.ac.ir

Person responsible for scientific inquiries

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Zahra Alizadeh
Position
Professor of Sports Medicine
Latest degree
Specialist
Other areas of specialty/work
Sport Medicine
Street address
No7, Ale-Ahmad Highway, Opposite of Shariati Hospital, Tehran,Iran
City
Tehran
Province
Tehran
Postal code
1439557832
Phone
+98 21 6119 2282
Fax
Email
z_alizadeh@tums.ac.ir
Web page address

Person responsible for updating data

Contact
Name of organization / entity
Tehran University of Medical Sciences
Full name of responsible person
Zahra Alizadeh
Position
Professor of Sports Medicine
Latest degree
Specialist
Other areas of specialty/work
Sport Medicine
Street address
No7, Ale-Ahmad Highway, Opposite of Shariati Hospital, Tehran,Iran
City
Tehran
Province
Tehran
Postal code
1411734143
Phone
+98 21 6119 2282
Fax
Email
z_alizadeh@tums.ac.ir
Web page address

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
No - There is not a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
Title and more details about the data/document
Primary outcomes and others according to researchers request
When the data will become available and for how long
Starting 6 months after publication
To whom data/document is available
Please contact with this e-mail: z_alizadeh@tums.ac.ir
Under which criteria data/document could be used
Please contact with this e-mail: z_alizadeh@tums.ac.ir
From where data/document is obtainable
Please contact with this e-mail: z_alizadeh@tums.ac.ir
What processes are involved for a request to access data/document
Please contact with this e-mail: z_alizadeh@tums.ac.ir
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