Inpatient mobilisation and its outcomes on patients admitted with acute heart failure
- Conditions
- Acute heart failurePhysical Medicine / Rehabilitation - PhysiotherapyCardiovascular - Other cardiovascular diseases
- Registration Number
- ACTRN12610001100088
- Lead Sponsor
- isa Moore
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot yet recruiting
- Sex
- All
- Target Recruitment
- 48
Patients admitted to hospital with
1. A primary diagnosis of ‘acute heart failure’, ‘heart failure’ or ‘exacerbation of heart failure’ or 'congestive cardiac failure' as diagnosed and documented by their treating physician.
2. Have been started on medical therapy for heart failure
3. Satisfy safety criteria (detailed below)
4. Provide signed written informed consent
New York Heart Association Classification: IV (shortness of breath at rest)
Terminally ill
Poor cognition or reduced ability for self care as deemed by treating medical team
Orthopaedic or other limitations that prevent mobility
Awaiting therapeutic cardiovascular procedure or hospitalisation for surgery
Presence of heart failure secondary to significant uncorrected primary valvular disease (except for mitral regurgitation secondary to LV dysfunction), new onset atrial fibrillation, anaemia
Obstructive and restrictive cardiomyopathies (diastolic heart failure)
Pacemakers which do not permit adequate heart rate response to exercise
Inability or refusal to sign informed consent
Safety criteria
Participants will not undergo mobilisation if they:
Are haemodynamically unstable
Show signs of recent heart attack including such as new/recurrent chest pain in the past 8 hours, rising troponin levels
Show new signs of uncompensated heart failure (such as dyspnoea at rest)
Show signs of heart electrical conduction problems (e.g. 3rd-degree AV block)
Have uncontrolled irregular heart rhythms (e.g. recurrent ventricular tachycardia or ventricular fibrillation, fast heart rate >110 beats per minute)
Have a resting systolic blood pressure >200mmHg or resting diastolic blood pressure of >110mmHg
Have a resting systolic blood pressure of <90mmHg patient will be reviewed by the medical team prior to mobilisation
Have poorly controlled symptomatic postural or low blood pressure (drop of >20mmHg with symptoms)
Resting oxygen saturation: <92%
Clinical judgement by the exercise specialist that patient clinical presentation is such that it would preclude safe mobility
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Walking capacity measured by the best distance covered in two six minute walk tests conducted consecutively with 15 minutes rest[Day of discharge];Return to activities of daily living measured by the 'Human Activity Profile' questionnaire[At initial assesment, day of discharge and within 2-4 weeks of discharge];Safety and feasibility: measured by the number of adverse events recorded (episodes of haemodynamic instability), the number of times the participant did not meet the safety criteria so intervention could not be performed; and the number of heart failure patients included in the study compared to the number admitted, time taken and compliance of physio to perform the intervention[Daily during the intervention]
- Secondary Outcome Measures
Name Time Method Activity levels both immediately prior to and following discharge from hospital using sensewear armbands and Duke Activity Status Index (DASI) questionnaire[The week prior to and the week following discharge from hospital<br><br>The DASI will be measured at initial assesment, on the day of discharge and at 2-4 weeks following discharge from hospital];Walking speed measured by the 10m walk test[At initial assessment and discharge];Quality of life measured by the Minnesota Living with Heart Failure questionnaire[Day of discharge and within 2-4 weeks of discharge];Hospital length of stay measured by the number of days spent in hospital from admission to discharge taken from medical records.[Measured from admission to discharge from hospital];Readmission to hospital measured over a 12 month period following the intervention as taken from medical records[Monitored over a 12 month period]