Ischemic Heart Disease Clinical Trial
Official title:
Impact of Telemonitoring Intervention on Physical Activity, CVD Risk Factors, During Phase 2-3 Cardiac Rehabilitation
In this study, 80 coronary artery disease patients with successful coronary
revascularisation (by CABG or PCI) will be included. Patients are excluded in case of:
congestive heart failure, ICD or pacemaker, any disability limiting exercise participation.
These patients are attending phase 2-3 cardiac rehabilitation, and have completed 6 weeks of
rehabilitation. Next, subjects are randomly assigned to a control group or an intervention
group.
Outcome parameters: physical activity, exercise capacity, blood glucose, insulin level and
lipid profile, body weight and waist circumference, cardiovascular morbidity and mortality.
Hypothesis: telemonitoring of physical activity will increase physical activity, and improve
cardiovascular disease risk factors, in CAD patients attending phase 2-3 cardiac
rehabilitation.
We included patients that suffered from an acute coronary syndrome for which a percutaneous
coronary intervention or coronary artery bypass graft was performed.
All patients had access to a computer with internet connection.
Patients that (i) were more than 80 years old, (ii) had an implantable cardioverter
defibrillator or pacemaker, (iii) suffered from severe arrhythmias, or (iv) had persistent
exertional ischaemia after revascularization therapy, were not invited to participate in
this study. Patients with severe heart failure (NYHA class III and IV), or neurological or
orthopaedic disability limiting their capability to exercise, were also excluded.
The study was a prospective randomized controlled trial, including an 18-week intervention.
All patients were included after week six of their conventional phase II cardiac
rehabilitation (CR). During phase II of conventional CR, all patients (those in the
intervention and control group) were educated about the core components of CR including
healthy nutrition, risk factor management (lipids, hypertension, weight, diabetes, and
smoking), psychosocial management and physical activity counseling.
During the first six weeks of the intervention, patients in the intervention group continued
exercising in the hospital's rehabilitation centre using an outpatient service, in
combination with an exercise training program with telemonitoring support. Patients in the
control group continued exercising in the hospital's rehabilitation centre using an
out-patient service, without participating in the exercise training program with
telemonitoring support. Starting from the seventh week in the study period, patients in the
intervention group finished their phase II CR in the hospital's rehabilitation centre but
continued their exercise training program with telemonitoring support; patients in the
control group finished their phase II CR in the hospital's rehabilitation centre.
All patients underwent a maximal cardiopulmonary exercise test (CPET) and a clinical
examination (with determination of waist circumference, blood pressure, body mass index)
after randomization, and also during the sixth and 18th week of the Telerehab II study
period. A fasting blood sampling was taken from all patients during the first and 18th week
of the Telerehab II study period.
The hypothesis was that telemonitoring of physical activity will increase physical activity,
and improve cardiovascular disease risk factors, in CAD patients attending phase 2-3 cardiac
rehabilitation.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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