Stair Climbing Outcomes in Cardiac Rehabilitation Exercise (SCORE)

February 25, 2020 updated by: McMaster University

A Feasible High Intensity Interval Exercise Training Intervention in Phase II Cardiac Rehabilitation

This study will evaluate the effect of brief, intermittent stair climbing exercise on key cardiovascular and metabolic markers of health in individuals completing a cardiac rehabilitation program. Participants of this study will be placed into one of two exercise groups: one group will perform the standard exercise protocol currently being used by the Cardiac Health and Rehabilitation Centre at Hamilton General Hospital and the second group will perform a variation of interval exercise training, high intensity interval stair climbing.

Study Overview

Status

Completed

Detailed Description

Cardiac rehabilitation (CR) is a recognized health service for the secondary prevention of CVD, unfortunately, CR is vastly underutilized, due to low referral rates and patient-related factors such as time commitment, travelling distance or user fees. After 2 weeks of CR exercise prescription, ~80% of patients opt to exercise independently rather than join a structured rehabilitation program in the community, suggesting that alternatives for current centre-based CR should focus on at-home programming with the intention of enhancing adherence and maintaining the lifestyle benefits long-term. The implementation of high-intensity interval exercise in CR programming has proven to be time-effective, enjoyable, safe, and capable of inducing similar if not superior cardiorespiratory responses, when compared to traditional, continuous CR programs. Recently, the benefits of interval stair climbing exercise in sedentary women were established, in that completing 3, 60 second bouts of high intensity stair climbing, 3 days/week for 6 weeks improved cardiorespiratory fitness, and represents a model of low-volume high-intensity interval training which is tolerable, effective and easily accessible for sedentary adults.

Study Type

Interventional

Enrollment (Actual)

20

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

    • Ontario
      • Hamilton, Ontario, Canada
        • Cardiac Health and Rehabilitation Centre

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

  • ADULT
  • OLDER_ADULT
  • CHILD

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Men and (post-menopausal) women
  • Registered to participate in the Cardiac Health and Rehabilitation Centre (CHRC) at the Hamilton Health Sciences General Division
  • History of previous myocardial infarction, coronary artery bypass graft, and/or percutaneous coronary intervention
  • Non-smoker (within 3-months)
  • Local resident, with transportation to the CHRC at the Hamilton Health Sciences General Division.
  • Ability to understand written and verbal instructions and provide written informed consent.
  • Stable medical therapy.

Exclusion Criteria:

  • Non-cardiac surgical procedure within two months
  • Positive exercise stress test (i.e. typical symptoms of chest discomfort and ECG changes or positive nuclear scan)
  • Myocardial infarction within two months; coronary artery bypass graft surgery within two months; percutaneous coronary intervention within one month
  • Baseline work capacity < 25 W
  • NYHA class II-IV symptoms of heart failure
  • Documented significant valve stenosis
  • Symptomatic peripheral arterial disease that limits exercise capacity
  • Uncontrolled supraventricular or ventricular dysrhythmia
  • Unstable angina
  • Uncontrolled hypertension (blood pressure >160/90 mmHg)
  • Documented chronic obstructive pulmonary disease (FEV1 <60% and/or FVC <60%)
  • Any musculoskeletal abnormality that would limit exercise participation

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: SUPPORTIVE_CARE
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: High-intensity stair climbing exercise
3 x 60 seconds of stair climbing, at a vigorous pace as described by rating of perceived exertion, separated by 60 seconds of rest. Subjects will complete supervised sessions 3 times/week for 2 weeks, and then continue unsupervised for the following 10 weeks.
High intensity stair climbing exercise at a vigorous pace as measured by rating of perceived exertion.
NO_INTERVENTION: standard cardiac rehabilitation exercise
Subjects will complete the traditional cardiac rehabilitation program, combination of aerobic and resistance exercise 2 times/week for 2 weeks, and then continue unsupervised for the following 10 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
brachial endothelial function as measured by flow-mediated dilation (FMD)
Time Frame: Change from baseline FMD at 12 weeks
This technique involves the placement of a blood pressure cuff around the forearm distal to the olecranon process (elbow). The cuff is inflated above systolic blood pressure to ~200 mmHg (in order to attain cessation of arm blood flow) and is held at this pressure for a period of five minutes. Continual measures of brachial artery diameter and blood flow velocity will be obtained using Doppler ultrasound. A 10 MHz probe will be placed on the upper arm (below the biceps) and moved around until the best signal is found. Images of brachial artery diameter and blood flow velocity will be taken at rest (before cuff inflation), prior to cuff deflation (end of five minute ischemic period), and following cuff deflation for two minutes.
Change from baseline FMD at 12 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
cardiorespiratory fitness
Time Frame: Change from baseline stress test at 12 weeks
Maximal aerobic capacity will be determined using a medically monitored exercise stress test.
Change from baseline stress test at 12 weeks
skeletal muscle capillary content
Time Frame: change from baseline capillary content at 12 weeks
Muscle capillaries will be detected in frozen cross-sections of muscle biopsies based on positive staining with fluorescent lectin Ulex europaeus, and quantified relative to muscle fibre number (capillary:fibre ratio).
change from baseline capillary content at 12 weeks
cardiac diastolic function
Time Frame: change from baseline left ventricular values at 12 weeks
The heart must be imaged at both the base (top) and apex (bottom) of the left ventricle. Images will be taken in the parasternal short axis view with the participant lying in the left lateral decubitus position to allow the expansion of the rib cage and proper orientation of the heart within the chest cavity. Doppler ultrasound (5MHz sector probe) will be applied to the upper-middle section of the chest for the best images. Basal images will be taken at the tips of the mitral valves, while apical images will be taken at the most distal aspect of the left ventricle, with the LV cavity representing ~50% of the left ventricle wall thickness.
change from baseline left ventricular values at 12 weeks

Collaborators and Investigators

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

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

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 (ACTUAL)

January 30, 2018

Primary Completion (ACTUAL)

August 8, 2019

Study Completion (ACTUAL)

September 30, 2019

Study Registration Dates

First Submitted

June 9, 2017

First Submitted That Met QC Criteria

July 30, 2017

First Posted (ACTUAL)

August 1, 2017

Study Record Updates

Last Update Posted (ACTUAL)

February 26, 2020

Last Update Submitted That Met QC Criteria

February 25, 2020

Last Verified

August 1, 2019

More Information

Terms related to this study

Other Study ID Numbers

  • SCORE

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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