NCT01732419

Brief Summary

Physical exercise training appears effective for low to moderate patients assigned to cardiac rehabilitation. However, adherence to cardiac rehabilitation is low and physical activity levels often drop after attending the last supervised rehabilitation session. This study will compare home based physical exercise training including telemonitoring with regular centre based physical exercise training. Main outcome measures are the change in physical activity and the change in physical fitness (peak Oxygen uptake) after the initial rehabilitation period (12 weeks) and after 1 year. Secondary outcome measures are cost-effectiveness, training adherence, health-related quality of life and patient satisfaction.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
90

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2013

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

November 19, 2012

Completed
3 days until next milestone

First Posted

Study publicly available on registry

November 22, 2012

Completed
1 month until next milestone

Study Start

First participant enrolled

January 1, 2013

Completed
2.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2015

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2015

Completed
3.9 years until next milestone

Results Posted

Study results publicly available

August 29, 2019

Completed
Last Updated

August 29, 2019

Status Verified

August 1, 2019

Enrollment Period

2.7 years

First QC Date

November 19, 2012

Results QC Date

October 24, 2017

Last Update Submit

August 28, 2019

Conditions

Keywords

Rehabilitation, exercise therapy, coronary artery disease

Outcome Measures

Primary Outcomes (2)

  • Physical Fitness

    Changes in peak oxygen uptake (VO2max) in mL O2/kg/min

    Measured after 12 weeks and after one year

  • Physical Activity Level (PAL)

    PAL is calculated by combining data from an accelerometer with data from a heart monitor, after wearing both for five days continuously. To determine PAL, physical activity energy expenditure is divided by resting metabolic rate, calculated by the Harris-Benedict equation. PAL expressed a person's daily energy expenditure. When PAL is used to classify the intensity of an activity, PAL\<3, PAL\<6 and PAL\>6 are characterized as light, moderate and vigorous intensity activities respectively. An average daily PAL of 1.2 represents the activity level of a bed-bound subject, while the average PAL for the adult population is 1.7.

    measured after 12 weeks and after one year

Secondary Outcomes (3)

  • Training Adherence

    12 weeks

  • Health Related Quality of Life

    measured at baseline, at discharge (12 weeks), and follow-up (one year)

  • Patient Satisfaction

    Measured at CR discharge (12 weeks)

Study Arms (2)

Home-based training

EXPERIMENTAL

After the first three supervised training sessions in the hospitals, patients in the home-based training group are instructed to wear a heart rate monitor during exercise training at home. Prescribed exercise exists of two or three exercise sessions per week, of one hour at 70 - 85% of their maximum heart rate. Once a week the heart rate data is uploaded and evaluated by an exercise specialist together with the patient by telephone.

Behavioral: Home-based training

Centre-based training

ACTIVE COMPARATOR

Patients in the centre-based training group will perform all trainings sessions under direct supervision of a physical therapist specialized in CR. Training sessions will be performed on an cycle ergometer, starting with a warm up phase of 5 min, followed by 50 min of cycling at 70-85% of the maximal HR and a cooling down period of 5 min. During the training period, physical therapists will record attendance, training duration and actual training intensity. After the 12-week training period patients receive individual advice from their physical therapist on physical activities.

Behavioral: Centre-based training

Interventions

Home-based exercise training for cardiac patients.

Also known as: Homebased exercise training, Home-based cardiac rehabilitation
Home-based training

Usual exercise training in an outpatient setting.

Also known as: Hospital-based training, Outpatient exercise training, Centre-based cardiac rehabilitation, hospital-based cardiac rehabilitation
Centre-based training

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Patients with an ACS (including non ST and ST elevation myocardial infarction and unstable angina) or a cardiac revascularization procedure (PCI or CABG) entering outpatient CR at Maxima Medical Center.
  • Indication for exercise training according to the Dutch clinical algorithm for assessment of patient needs in cardiac rehabilitation.
  • Internet access and PC at home (i.e. more than 90 percent of the Dutch household)

You may not qualify if:

  • High risk according to the Dutch CR practice guideline.
  • Systolic heart failure (left ventricular ejection fraction of more than 40 percent.
  • New York Heart Association class III-IV (i.e. breathlessness during light exercise or at rest).
  • Severe arrhythmia.
  • Hemodynamically significant valvular disease.
  • Implantable cardioverter-defibrillator (ICD) implantation
  • Heart transplantation.
  • Chronic angina or silent ischemia.
  • Comorbidity impairing exercise capacity (e.g. COPD, diabetes mellitus, peripheral vascular disease and orthopedic or neurological conditions).
  • Severe psychological or cognitive impairments.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Máxima Medisch Centrum

Veldhoven, 5504 DB, Netherlands

Location

Related Publications (2)

  • Kraal JJ, Peek N, Van den Akker-Van Marle ME, Kemps HM. Effects of home-based training with telemonitoring guidance in low to moderate risk patients entering cardiac rehabilitation: short-term results of the FIT@Home study. Eur J Prev Cardiol. 2014 Nov;21(2 Suppl):26-31. doi: 10.1177/2047487314552606.

  • Kraal JJ, Peek N, van den Akker-Van Marle ME, Kemps HM. Effects and costs of home-based training with telemonitoring guidance in low to moderate risk patients entering cardiac rehabilitation: The FIT@Home study. BMC Cardiovasc Disord. 2013 Oct 8;13:82. doi: 10.1186/1471-2261-13-82.

MeSH Terms

Conditions

Acute Coronary SyndromeMyocardial InfarctionCoronary Artery Disease

Condition Hierarchy (Ancestors)

Myocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular DiseasesInfarctionIschemiaPathologic ProcessesPathological Conditions, Signs and SymptomsNecrosisCoronary DiseaseArteriosclerosisArterial Occlusive Diseases

Limitations and Caveats

blinding of patients due to nature of the study protocol

Results Point of Contact

Title
Dr. J. Kraal
Organization
Maxima Medical Center

Study Officials

  • Hareld Kemps, Dhr. MD.

    Maxima Medical Center

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD, PhD

Study Record Dates

First Submitted

November 19, 2012

First Posted

November 22, 2012

Study Start

January 1, 2013

Primary Completion

October 1, 2015

Study Completion

October 1, 2015

Last Updated

August 29, 2019

Results First Posted

August 29, 2019

Record last verified: 2019-08

Locations