An Evaluation of the Talk Test for Exercise Prescription for Home-Based Cardiac Rehabilitation
- Conditions
- Coronary Artery Disease
- Interventions
- Behavioral: Talk test prescriptionBehavioral: CPET prescription
- Registration Number
- NCT05157932
- Lead Sponsor
- Ottawa Heart Institute Research Corporation
- Brief Summary
The objectives of this pilot RCT are to examine if the Talk Test is an effective and safe tool as compared with CPET for exercise prescription in patients who have undergone CABG or PCI and enrolled in a home-based CR program with virtual exercise training monitoring.
- Detailed Description
The Talk Test has been shown to be a valid, practical and inexpensive tool for guiding exercise training in patients with CAD. The general premise of the Talk Test is that exercising at or above the ventilatory threshold or lactate threshold does not allow comfortable, conversational speech and thus serves as a means of estimating the cut point between moderate and vigorous intensity exercise. The Talk Test can be used to produce exercise intensities (64 to 95% HR peak i.e. moderate-to-vigorous intensity exercise) within accepted Canadian Association of Cardiovascular Prevention and Rehabilitation (CACPR) guidelines for exercise training, to avoid exertional ischemia, and has been shown to be consistent across various modes of exercise (i.e. walking, jogging, cycling, elliptical trainer and stair stepper).
There is a critical need to evaluate the effectiveness and safety of using the Talk Test as the principal method of exercise prescription in patients with CAD who have undergone CABG or PCI when compared to standard care CPET. Such a trial has wide-scale appeal for CR programs across Canada and beyond. It will directly and positively impact patient care by reducing the need for in-person interactions for CPET, of paramount importance during COVID-19 outbreaks, between patients and CR staff, thus reducing COVID-19 infection risk and concerns of contracting the virus.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 40
- recently underwent PCI or CABG (at least 4 weeks but less than 12 weeks post-event or procedure);
- able to perform a CPET;
- at least 40 years of age;
- access to MyChart; and,
- access to email and the internet
- access to a cellphone with broadband internet (4G, LTE, 5G).
- currently participating in a virtual or on-site CR program;
- ventricular ejection fraction ≤45%;
- unstable angina or established diagnosis of chronic obstructive pulmonary disease, severe mitral or aortic stenosis, or hypertrophic obstructive cardiomyopathy;
- unable to return for 12-week follow-up visits.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Talk Test Talk test prescription Virtual Cardiac Rehab + Exercise prescription based on the Talk test. Cardiopulmonary Exercise Test CPET prescription Virtual Cardiac Rehab + Exercise prescription based on the CPET results.
- Primary Outcome Measures
Name Time Method Exercise capacity from baseline to follow-up at week 12 will be measured by the Incremental Shuttle Walk Test.
- Secondary Outcome Measures
Name Time Method Cardiovascular health indicators - Plasma glucose average from baseline to follow-up at week 12 will be measured using the glycated hemoglobin A1C (%) test
Cardiovascular health indicators - Cholesterol LDL from baseline to follow-up at week 12 will be measured low-density lipoprotein cholesterol.
Cardiovascular health indicators - Cholesterol HDL from baseline to follow-up at week 12 will be measured high-density lipoprotein cholesterol.
Cardiovascular health indicators - Plasma glucose from baseline to follow-up at week 12 will be measured by fasting plasma glucose (mmol/L) test
Cardiovascular health indicators - Lipid profile from baseline to follow-up at week 12 will be measured using the triglycerides test
Cardiac Rehab safety from baseline to follow-up at week 12 meticulously track all mild, moderate, and severe symptoms and adverse events throughout this study. Symptoms may include tightness in chest, leg tightness/pain, dizziness, lightheaded, foot cramping, and heart palpitations.
VO2peak at baseline will be measured using a gold standard symptom-limited CPET on an electronically braked cycle ergometer (alternatively it will be administered on a treadmill or another aerobic equipment). Gas exchange (VO2 in mL/kg/min) and heart rate will be monitored continuously. The highest 20-s interval average of VO2 and HR will be considered the peak VO2 and HR values.
Trial Locations
- Locations (1)
University of Ottawa Heart Institute
🇨🇦Ottawa, Ontario, Canada