Diastolic Heart Failure Clinical Trial
Official title:
Enhancement of Physical Activity in Elderly Patients With Diastolic Heart Failure by a Motivational Intervention - Pilot Data From an add-on Following the Ex-DHF Trial
The aim of our pilot study is to evaluate the feasibility, acceptance and efficacy of motivational interviewing (MI) to support elderly patients with heart failure with preserved ejection fraction (HFpEF) in maintaining or starting physical activity (PA).
Patients discharged from the Ex-DHF trial were recruited from June 2013 to December 2015 and
offered participation in a controlled add-on pilot study. The treatment group (n=19) received
5 sessions of MI, each lasting 15-30 min over 6 months to enhance physical activity.
For the first two and the last sessions participants met with the psychologist-counsellor
face-to-face for about 45 minutes. The remaining three sessions could be conducted via
telephone or face-to-face, depending on participants' preferences, and typically lasted 15-30
minutes. Per study protocol, counsellors (physicians and psychologists trained in
motivational interviewing) assisted the participants in: (1) Setting goals for their physical
activity; (2) developing a plan to increase physical activities; (3) setting specific plans
for the implementation of the plan; and (4) overcoming possible barriers. Participants were
also asked to keep track of their daily physical activity in a diary, which counsellors then
discussed with them during the sessions.
After patients had given their written informed consent, counsellors assessed all
participants via structured interview and self-rating scales. At baseline only,
sociodemographic information was recorded.
At baseline and at the final 6-month visit participants' motivation to be physically active
in the upcoming weeks was assessed using the SSK-scale ("Sportbezogene Selbstkonkord" =
sports-related self-concordance, Seelig and Fuchs 2006) to assess the self concordance of
sport- and exercise-related goals.
The kind and extent of patients' daily physical activity was recorded using patient diaries.
At baseline and 6 months we also conducted a symptom-limited cardiopulmonary exercise test on
a bicycle ergometer, in order to assess changes in maximum rate of oxygen consumption during
the last 30 seconds before the termination of the exercise (peak oxygen consumption (VO2
[ml/min/kg])) as measure of maximal exercise capacity. Participants also completed the
6-minute walk test on flat surface (6-MWT) as an additional parameter to assess submaximal
exercise capacity.
Additionally, at the 6-month assessment, intervention participants filled out a questionnaire
about their subjective evaluation of the counseling program.
The control group (n=20) received usual care.
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