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Integrating Exercise Into Lifestyle of Cardiac Outpatients

Recruiting
Conditions
Cardiovascular Diseases
Physical Inactivity
Quality of Life
Aging
Physician-Patient Relations
Interventions
Other: Medical history and functional evaluation
Other: Health education
Registration Number
NCT05817305
Lead Sponsor
Università degli Studi di Ferrara
Brief Summary

The purpose of the study is to investigate the long-term effects of a personalized physical activity program on exercise capacity and quality of life in patients with stable cardiovascular disease. The analysis also intends to evaluate the prognostic value of cardiovascular function estimated through a walking test (1km Treadmill Walking Test, 1k-TWT) in relation to survival, hospitalization, and medical costs. The program considers clinical, socio-economic, and behavioural aspects, psychological support, and risk factor control. Patients receive indications for carrying out a home training program based on the performance of moderate-intensity aerobic activity at least 3-4 days a week for at least 30-60 minutes a day. All patients are also encouraged to improve their daily habits by preferring a more active lifestyle both at home and at work.

Detailed Description

BACKGROUND: Physical activity and cardiorespiratory fitness are considered major markers of cardiovascular risk and core components of secondary prevention programs for cardiovascular diseases (CVD). The benefits of regular physical activity are well-recognized both for men and women and are inversely associated with mortality risk and the incidence of many chronic diseases. Despite the efforts of many health organizations to increase awareness of this evidence, physical inactivity and low cardiorespiratory fitness remain overlooked risk factors. Directly measured peak oxygen consumption (VO2peak) determined during maximal incremental cardiopulmonary exercise testing (CPX) is the gold standard objective measure of cardiorespiratory fitness. However, because of physical, financial, and time limitations, a direct determination is often not routinely assessed in clinical settings. Submaximal exercise testing can be a viable alternative to CPX. These tests are more practical for examining older adults or a large patient cohort. Also, they are helpful in defining functional limitations, setting up appropriate physical activity programs, and assessing the outcomes of pharmacological treatments.

RATIONALE AND OBJECTIVE OF THE STUDY: The benefits of regular physical activity are well-recognized both for men and women and are inversely associated with mortality risk and the incidence of many chronic diseases. The purpose of this observational registry is to evaluate the efficacy of an exercise-based secondary prevention program among male and female outpatients with stable cardiovascular disease.

DESCRIPTION OF THE FUNCTIONAL EVALUATION: During each session, information about weight, height, body mass index (BMI), blood pressure, cardiometabolic risk factors, and drug therapy in progress are registered. Physical activity habits are assessed using the Seven-Day Physical Activity Recall questionnaire. In addition, patients complete a sub-maximal test of 1km treadmill walking (1k-TWT), which is performed at a moderate intensity and adjusted according to the patient's perception of fatigue. Patients unable to complete the test at a walking speed ≥ 3.0 km/h can perform the test over 500m or 200m. Based on the results of the test, patients receive indications for the proper execution of a home training program, (i.e., at the same effort perceived in the test). The activity should be done at least 3-4 times per week, preferably every day, for at least 30-60 minutes. All patients are also encouraged to improve their daily habits by opting for a more active lifestyle at home and at work. Written informed consent is required from all participants at the time of enrollment.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
5000
Inclusion Criteria
  • the presence of one or more previous cardiovascular events
Exclusion Criteria
  • Ejection fraction < 30%
  • Chronic heart failure NYHA III-IV
  • Severe aortic or mitral valvulopathy
  • Severe physical or cognitive impairment
  • Exercise-induced complex arrhythmias

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Cardiac outpatientsHealth educationPatients with stable cardiovascular disease who have been referred to the service by their general practitioner or cardiologist
Cardiac outpatientsMedical history and functional evaluationPatients with stable cardiovascular disease who have been referred to the service by their general practitioner or cardiologist
Primary Outcome Measures
NameTimeMethod
MortalityFrom date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

Association of all-cause mortality and cause-specific death with exercise capacity

Secondary Outcome Measures
NameTimeMethod
Peak Oxygen Uptake (VO2peak)From date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

Measurement of cardiorespiratory fitness, reported as ml/kg/min and estimated through a moderate and perceptually regulated 1km treadmill walk test (1k-TWT) or through related short-forms (500m or 200m)

Leisure time physical activity levelsFrom date of enrollment until the date of end of follow-up or date of death from any cause, whichever came first, assessed up to 12 years

Measurement of physical activity levels, reported as MET/h-week and estimated through the 7-day physical activity recall questionnaire

HospitalizationFrom date of enrollment until the first hospitalization (any hospital admission is considered an event), assessed up to 12 years

Association of cause-specific hospitalization with exercise capacity

Trial Locations

Locations (1)

Center for Exercise Science and Sport

🇮🇹

Ferrara, Italy

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