Mobility Promotion for Cardiovascular Disease

Overseen By Shirko Ahmadi, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Université de Sherbrooke

Disqualifiers: Other trials, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 2 weeks

60 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if increasing physical activity in hospitalized patients with heart problems can enhance their overall health. A kinesiologist will encourage daily activities like walking and standing to help reduce frailty, which measures overall health, and potentially shorten hospital stays. The trial will compare results between males and females to assess any differences in benefits. Ideal participants include those with a major heart issue, likely to stay in the hospital for three or more days, and able to communicate in French or English. As an unphased trial, this study offers participants the chance to contribute to important research that could improve hospital care for heart patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What prior data suggests that this mobilization program is safe for inpatients with cardiovascular disease?

Research shows that increased physical activity in individuals with heart problems can be safe and beneficial. Studies have found that exercise reduces the risk of heart attacks and hospital visits for both men and women with heart issues. Regular activities, such as walking or using resistance bands, improve heart health and decrease the likelihood of worsening heart problems.

Exercise programs are associated with fewer deaths and less severe heart conditions. Active individuals have a lower risk of dying from any cause, including heart disease. This suggests that promoting movement in hospitals is generally safe and aids in the recovery of patients with heart problems. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about mobility promotion for cardiovascular disease because it offers a fresh approach by incorporating daily kinesiologist visits to encourage physical activity. Unlike standard treatments that often rely on medications and lifestyle advice, this method actively engages patients in movement, helping them maximize their physical capabilities through regular, personalized interactions. This hands-on approach not only aims to improve cardiovascular health but also enhances overall mobility and quality of life, potentially leading to better long-term outcomes for patients.

What evidence suggests that this mobility promotion program is effective for reducing frailty in cardiovascular patients?

Research has shown that encouraging movement can help people with heart disease. Studies have found that cardiac rehabilitation, which includes exercise, lowers the risk of heart attacks and reduces hospital visits. Increased activity in those with heart issues is linked to shorter hospital stays and better health. Wearable devices that track activity can enhance these benefits by motivating more movement. Overall, promoting movement improves heart health and reduces frailty, a measure of overall health, in patients. In this trial, a team of kinesiologists will visit participants daily to promote movement and help them mobilize to the best of their capabilities. ^{1 2 6 7 8}

Are You a Good Fit for This Trial?

This trial is for male and female inpatients with cardiovascular disease who are at risk of frailty. Participants must have a major heart problem, be expected to stay in the hospital for at least 3 days, and be able to give consent independently. The study aims to include 60 patients (30 females).

Inclusion Criteria

Patients who are admitted to unit 4C at the Vitalité Health Network

Patients who are projected to be in-hospital for at least 3 days

Patients who are not in a shared room with another study participant

Exclusion Criteria

Patients enrolled in other clinical trials or interventions that might confound the results of the study

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Treatment

Participants receive a mobilization program with daily check-ins by a Kinesiologist to promote movement and reduce frailty

2 weeks

Daily visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Mobility promotion

Trial Overview

The trial tests a mobilization program led by a Kinesiologist involving daily movement activities like standing, using resistance bands, and promoting physical activity. It aims to reduce frailty levels among these patients, with an expectation that it may benefit females more due to their generally higher levels of frailty.

How Is the Trial Designed?

Group I: Males Experimental Treatment 1 Intervention

A team of Kinesiologists visit the patients daily from admission to discharge to promote movement and help them mobilize to the best of their capabilities (e.g., walking, standing, or sitting on the edge of the bed).

Group II: Females Experimental Treatment 1 Intervention

A team of Kinesiologists visit the patients daily from admission to discharge to promote movement and help them mobilize to the best of their capabilities (e.g., walking, standing, or sitting on the edge of the bed).

Who Is Running the Clinical Trial?

Université de Sherbrooke

Lead Sponsor

Trials

317

Recruited

79,300+

Vitalite Health Network

Collaborator

Trials

3

Recruited

130+

Published Research Related to This Trial

The 'Movement as Medicine for CVD Prevention' program showed promise in increasing physical activity levels among patients at risk for cardiovascular disease, with a significant increase in objective moderate to vigorous physical activity after 3 months (Cohen d=0.77).

Health care professionals who completed the web-based training reported improved self-efficacy and planning skills for promoting physical activity, indicating that the intervention may enhance their ability to support patients in making lifestyle changes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Movement as Medicine for Cardiovascular Disease Prevention: Pilot Feasibility Study of a Physical Activity Promotion Intervention for At-Risk Patients in Primary Care. Knittle, K., Charman, SJ., O'Connell, S., et al.[2022]

Cardiac rehabilitation programs have been updated to include coronary risk factor reduction, which is crucial for patients with established cardiovascular disease to lower their risk of future heart attacks, strokes, and death.

These modernized rehabilitation programs have been shown to significantly improve health outcomes for both men and women with coronary heart disease, enhancing their long-term well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modern cardiac rehabilitation: Integrating the best measures to reduce a second cardiac event. Armbruster, RA., Lim, MJ.[2021]

A systematic review of 19 smartphone app interventions for people with cardiovascular disease identified 40 different behaviour change techniques, with habit reversal and self-monitoring being the most common for sedentary behaviour and physical activity, respectively.

Action planning and graded tasks showed medium positive associations with increased physical activity, suggesting these techniques could be effective in future app designs aimed at improving physical activity in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behaviour change techniques in cardiovascular disease smartphone apps to improve physical activity and sedentary behaviour: Systematic review and meta-regression. Patterson, K., Davey, R., Keegan, R., et al.[2022]

A meta-analysis of 79 studies involving 11,877 participants found that interventions to increase physical activity (PA) in adults with cardiovascular disease resulted in a significant effect size of 0.35, indicating that treatment groups burned more calories (1984 kcal/week) compared to control groups (1615 kcal/week).

The analysis revealed that interventions focusing solely on physical activity, providing more contact with interventionists, and including supervised exercise sessions led to larger improvements in physical activity levels, suggesting that these factors enhance the effectiveness of such interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meta-analysis of interventions to increase physical activity among cardiac subjects. Conn, VS., Hafdahl, AR., Moore, SM., et al.[2021]

Cardiac rehabilitation has been proven to significantly improve health outcomes for patients with cardiovascular disease, yet less than 50% of eligible patients participate in these programs.

To increase participation, a collaborative approach involving multiple agencies and professionals is necessary, along with tailored programs that address individual patient needs to enhance adherence and effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving wellbeing with cardiac rehabilitation. Edmunds, L.[2016]

A scoping review of 20 studies involving patients with various cardiovascular diseases (CVDs) found that physiotherapy-led health promotion (PLHP) primarily focuses on exercise and physical activity, which were included in 85% of the studies.

Most interventions were short-term, lasting less than 12 months, and were personalized to encourage adherence and promote health behavior changes, highlighting the need for further exploration of additional health promotion components like sleep and substance use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physiotherapy-Led Health Promotion Strategies for People with or at Risk of Cardiovascular Diseases: A Scoping Review. Ngeh, EN., Lowe, A., Garcia, C., et al.[2023]

In a 1.5-year study involving 274 male veterans with cardiovascular disease risk factors, only one serious adverse event (atrial fibrillation) occurred, indicating that a progressive walking program can be safely recommended for high-risk individuals.

While minor musculoskeletal issues were common, over half of the reported adverse events were unrelated to the exercise program, highlighting the need for strategies to help individuals with chronic illnesses safely resume physical activity after any health setbacks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events among high-risk participants in a home-based walking study: a descriptive study. Goodrich, DE., Larkin, AR., Lowery, JC., et al.[2022]

This study aims to evaluate how patient education interventions can enhance physical activity (PA) capacity and behavior in individuals with peripheral arterial disease (PAD) and intermittent claudication (IC), which are conditions that limit physical activity.

The review will analyze both quantitative and qualitative data from various databases, focusing on changes in PA capacity and adherence to PA improvements, using rigorous methods to ensure the quality and reliability of the findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient education interventions to improve physical activity in patients with intermittent claudication: a protocol for a systematic mixed-studies review. Abaraogu, UO., Dall, PM., Seenan, CA.[2022]

A 12-week telemonitored exercise-based cardiac rehabilitation program significantly improved physical capacity, muscle endurance, muscle power, muscle strength, and health-related quality of life in 34 moderate-risk cardiac patients.

Participants experienced a 10% increase in peak oxygen uptake and notable improvements in muscle endurance (17%), power (7%), and strength (10%), along with a 19% enhancement in physical and 17% in mental health-related quality of life, although peak oxygen uptake did not show long-term improvement at the 12-month follow-up.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telemonitored exercise-based cardiac rehabilitation improves physical capacity and health-related quality of life. Laustsen, S., Oestergaard, LG., van Tulder, M., et al.[2020]

In a review of over 5,500 participants from 11 physical activity interventions, no serious study-related adverse events were reported, indicating a high level of safety in these exercise programs.

While minor musculoskeletal injuries were noted, the studies emphasized a 'start low and go slow' approach, suggesting that moderate-intensity physical activity is safe and effective for sedentary, chronically ill, or older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium. Ory, M., Resnick, B., Jordan, PJ., et al.[2022]

Walking is associated with a reduced risk of developing cardiovascular disease (CVD), with stronger effects observed for ischaemic stroke compared to other CVD types, based on a systematic review of 21 studies.

Higher walking duration, distance, energy expenditure, and pace lead to greater reductions in CVD risk, supporting current physical activity recommendations, although potential biases from pre-existing health conditions need to be addressed in future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Walking for prevention of cardiovascular disease in men and women: a systematic review of observational studies. Boone-Heinonen, J., Evenson, KR., Taber, DR., et al.[2021]

Research over the past 70 years shows that increased physical activity significantly reduces the risk of cardiovascular disease (CVD) and overall mortality, yet many people still do not engage in enough physical activity.

Even small increases in physical movement, such as transitioning from a sedentary lifestyle to a moderately active one, can lead to substantial health benefits, independent of overall cardiorespiratory fitness levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of moving more, physical activity, and cardiorespiratory fitness: Why we should strive to measure and improve fitness. Myers, J., Kokkinos, P., Arena, R., et al.[2021]

The EXPERT tool was developed to assist clinicians in prescribing exercise for patients with various cardiovascular diseases and risk factors, providing tailored recommendations based on specific conditions and individual patient factors.

This digital system offers exercise training recommendations and safety advice for 10 cardiovascular diseases and several chronic conditions, potentially improving the implementation of exercise rehabilitation in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology. Hansen, D., Dendale, P., Coninx, K., et al.[2018]

Comprehensive risk factor interventions, including regular physical activity, significantly improve outcomes for patients with cardiovascular disease (CVD), enhancing physical work capacity and overall survival while reducing the need for invasive procedures.

These interventions are beneficial not only for patients with coronary artery disease (CAD) but also for those with other atherosclerotic conditions, as they share common risk factors and can lead to improved quality of life and reduced cardiovascular events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reducing the risk of heart disease and stroke. Franklin, BA., Sanders, W.[2010]

In a study of 914 post-acute coronary syndrome patients, those who participated in less than 75% of a standard 12-week cardiac rehabilitation program experienced significantly higher rates of major adverse cardiac events (MACE), with an incidence of 11.3% compared to 3.8% for those who completed the program.

Patients with incomplete cardiac rehabilitation were also more likely to be persistent smokers, suggesting lifestyle factors may contribute to their higher risk of adverse cardiac events, highlighting the importance of full participation in rehabilitation for better long-term outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patients who do not complete cardiac rehabilitation have an increased risk of cardiovascular events during long-term follow-up. Sunamura, M., Ter Hoeve, N., van den Berg-Emons, RJG., et al.[2020]

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