Severe Heart Failure and Homebased Rehabilitation - An Intersectoral Randomized Controlled Trial

August 16, 2012 updated by: Laura Staun Valentiner, University Hospital, Gentofte, Copenhagen

Early Homebased Rehabilitation for Patients With Severe Heart Failure - An Intersectoral Randomized Controlled Trial

The purpose of this study is to investigate the effect of an early, coordinated rehabilitation intervention for patients with severe heart failure in NYHA class III and IV with a ejection fraction of <40% of normal cardiac function measured on frequency of readmissions, physical ability and participation in activities of daily living and quality of life.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

Approximately 400,000 Danes live today with heart disease. Disease severity is crucial for patients quality of life. Patients with severe heart disease often struggle with everyday life, characterized by reduced physical capacity, tendency to depression and anxiety to perform everyday activities that may provoke symptoms.

A large proportion of patients who are offered cardiac rehabilitation deselect that offer. Of the patients who do participate, more than 50% stop the rehabilitation ahead of time. A large group of patients with severe heart failure and classified in NYHA Class III and IV, deselect the offer because of lack of energy to participate in cardiac rehabilitation or is when specified by a medical assessment discharged from the hospital without the offer of training or any other form of rehabilitation.

The offer of rehabilitation for patients with severe heart failure is lacking as it is today. This study assesses the effectiveness of an early home based rehabilitation program that complements the general psycho-social support, symptom-oriented and preventive medical treatment that these patients always have the option to get.

Study Type

Interventional

Enrollment (Anticipated)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Denmark
    • Gentofte
      • Copenhagen, Gentofte, Denmark, 2900
        • Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital Gentofte,

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients admitted to the Gentofte Hospital due to heart failure.
  • Patients with a functional equivalent to NYHA grade III or IV
  • Patients with ejection fraction <40%
  • Patients who score between10-15 in the total score for question 3 dealing with physical functioning in SF-36 questionnaire on health status
  • Patients who lives in Gentofte Municipality or Lyngby Tårbæk Municipality.
  • Patients who can speak and understand Danish

Exclusion Criteria:

  • Patients with cognitive and psychological problems that prevents cooperation (aphasia, dementia, severe depression).
  • Patients with terminal illness with expected death within a year.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Early homebased rehabilitation
After discharge from the hospital patients are offered a homebased rehabilitation program lasting 6 weeks.
Other: Early homebased rehabilitation after hospital admission
Training begins 3-5 days after discharge from hospital, performed by an occupational therapist and a physiotherapist from Gentofte Hospital in the first two weeks. From week three to six the training will be carried out by an occupational therapist and a physiotherapist from the local municipality (Gentofte municipality and Lyngby Taarbæk municipality). Training will take place at home twice a week for 6 weeks, each session lasting 45 minutes. The intervention is individualized and focuses on functional physical and compensatory training to help the patient to manage everyday life at home. A training program will be provided and the patient will be instructed to do the exercises every day
Other Names:
  • physical exercise
  • severe heart failure
  • homebased rehabilitation
  • activities of daily living
Experimental: control group: Ususal care
After discharge from the hospital the patients are offered the usual symptom-oriented and preventive medical care and psychosocial support
Other: Usual care
After discharge from the hospital the patients are offered the usual symptom-oriented and preventive medical care and psychosocial support

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Readmission due to heart failure
Time Frame: assessed one year after inclusion
assessed one year after inclusion

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Physical capacity
Time Frame: Assessed at baseline, after 6 weeks, after 6 month and after one year
measured by the Morton Mobility Index, Timed Up & Go and Modified Sit to Stand Test
Assessed at baseline, after 6 weeks, after 6 month and after one year
Activity of Daily Living
Time Frame: Assessed at baseline, after 6 weeks, after 6 month and after one year
Recorded at an ADL interview to assess the performance of everyday activities
Assessed at baseline, after 6 weeks, after 6 month and after one year
Number of total hospital admissions
Time Frame: at baseline, after 6 weeks, after 6 month and after one year
at baseline, after 6 weeks, after 6 month and after one year
Exercise Compliance
Time Frame: at baseline, after 6 weeks, after 6 month and after one year
registration of exercise
at baseline, after 6 weeks, after 6 month and after one year
Anxiety and depression
Time Frame: at baseline, after 6 weeks, after 6 month and after one year
measured by Hospital Anxiety and Depression Scale (HAD)
at baseline, after 6 weeks, after 6 month and after one year
Quality of life
Time Frame: at baseline, after 6 weeks, after 6 month and after one year
measured by The Minnesota Living with Heart Failure Questionnaire
at baseline, after 6 weeks, after 6 month and after one year
Number of patients who starts outpatient cardiac rehabilitation after intervention (municipality or hospital)
Time Frame: at 6 weeks, after 6 month and after one year
at 6 weeks, after 6 month and after one year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital, Gentofte, Copenhagen

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2012

Primary Completion (Anticipated)

September 1, 2015

Study Completion (Anticipated)

July 1, 2016

Study Registration Dates

First Submitted

August 14, 2012

First Submitted That Met QC Criteria

August 16, 2012

First Posted (Estimate)

August 21, 2012

Study Record Updates

Last Update Posted (Estimate)

August 21, 2012

Last Update Submitted That Met QC Criteria

August 16, 2012

Last Verified

August 1, 2012

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • H-2-2012-021

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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