RecruitingPhase 2NCT05925634

Improving Cardiac Rehabilitation Exercise Using Target Heart Rate Trial

Improving Outcomes From Cardiac Rehabilitation Among Older Adults Through Exercise Testing and Individualized Exercise Intensity Prescriptions


Sponsor

Baystate Medical Center

Enrollment

320 participants

Start Date

Aug 10, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to compare two types of exercise prescriptions in cardiac rehabilitation eligible older adults (60 years or older) with heart disease. The investigators found in a single site pilot trial (insert NCTxxx) that one exercise prescription was better and are now repeating this study in a larger population at two sites (Baystate Medical Center, Springfield MA and Henry Ford Health System, Detroit MI). The main questions the investigators aim to answer are: 1. Compare two different exercise prescriptions in cardiac rehabilitation on exercise outcomes 1. Graded exercise test +Target heart rate range prescription \[GXT-THRR\] 2. Rating of perceived exertion (RPE) 2. What is the role of psychological feedback on fitness outcomes during cardiac rehabilitation and physical activity outside of cardiac rehabilitation. 3. What are the long-term clinical outcomes between the two exercise prescriptions Participants will be asked to: * Complete surveys about physical activity, exercise anxiety, exercise efficacy, and fears about exercising * Perform fitness measures (6-minute walk test, balance tests, stand to sit tests, a 400 meter walk, and handgrip strength) * Attend at least 18 sessions of cardiac rehabilitation after they are randomized to their exercise prescription group * Wear a heart rate monitor and a physical activity monitor per study protocol Participants will be randomized (flip of a coin) to either receive a graded exercise test and psychoeducational feedback or lifestyle education (nutrition for cardiac). The graded exercise test will be used to create a personalized exercise prescription with the target heart rate range calculated from the test and the lifestyle education group will use their ratings of perceived exertion for their exercise prescription.


Eligibility

Min Age: 60 YearsMax Age: 99 Years

Plain Language Summary

Simplified for easier understanding

This study is testing whether using a personalized target heart rate — calculated specifically for each patient based on a fitness test — leads to better outcomes in cardiac rehabilitation compared to the standard approach. Cardiac rehab is a supervised exercise program for people who have had a heart attack, heart failure, or heart surgery, and it is crucial for recovery. The trial recruits patients aged 60 and older in Springfield, MA or Detroit, MI. **You may be eligible if:** - You are 60 years or older - You have had a heart attack, heart failure, coronary artery bypass surgery, a stent procedure, or heart valve surgery within the past 6 months - You are enrolled in a Phase 2 cardiac rehabilitation program at Baystate Medical Center or Henry Ford Health System - You are willing to attend at least 18 cardiac rehabilitation sessions, at least twice a week - You live in or near Springfield, MA or Detroit, MI **You may NOT be eligible if:** - You have permanent atrial fibrillation (which makes heart rate monitoring unreliable) - You have had a heart transplant or have a left-ventricular assist device (mechanical heart pump) - You have stable angina, high-risk unresolved coronary artery disease, or significant valve narrowing (aortic or mitral stenosis) - You have symptomatic peripheral artery disease (pain in the legs when walking) - You have any condition that makes exercise unsafe or significantly limits your ability to exercise Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

BEHAVIORALRPE (usual care)

Patients in the active comparator group will follow standard exercise prescription protocols in cardiac rehabilitation.

BEHAVIORALGXT+THHR (intervention)

Patients in the personalized care group will perform a graded exercise test and the peak heart rate from the test will allow the researcher to calculate a target heart rate range (THRR). Then, the patients will receive psychoeducational feedback (PF) about their test results and exercise performance. After PF, their THRR will be reviewed and how it will be used to guide exercise intensity in CR will be discussed.


Locations(2)

Baystate Medical Center

Springfield, Massachusetts, United States

Henry Ford Health System

Detroit, Michigan, United States

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NCT05925634


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