Exploration of Possible Reasons for the Discrepancy Between Expectation and Indication of Subjective Perceived Exertions (Ex-6-rate)

Exploration of Possible Reasons for the Discrepancy Between Expectation and Indication of Subjective Perceived Exertions of Patients Over 55 Years of Age With Coronary Heart Disease in 6-min Walking Test in Cardiorespiratory Physiotherapy

The 6-minute walk test is a test of physical performance in physiotherapy with lungs and heart patients (Pollentier 2010). However, only 8 and 11% of patients in everyday test situations report a score of 7 or higher on a scale of 0-10 for effort (Jehn 2009). This study is intended to explore, based on grounded theory, why the majority of patients do not assess themselves according to the almost maximum performance.

Study Overview

• Status: Completed
• Conditions: Coronary Disease; Cardiac Rehabilitation; Physical Therapy; Physical Exertion; Exercise Test
• Intervention / Treatment: Other: Questionnaire, Interview; Other: Focus Group

• Study Type: Observational
• Enrollment (Actual): 16

Contacts and Locations

Study Locations

• Switzerland
  • Aargau
    • Barmelweid, Aargau, Switzerland, 5017
      • Klinik Barmelweid AG

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 55 years to 90 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

patients from the department of cardiology in the rehabilitation centre of Klinik Barmelweid AG,

Description

Inclusion Criteria:

• Patients with coronary artery disease undergoing in-patient cardiovascular rehabilitation; over 55 years of age. Patients underwent a 6-minute walk test with assessment of the intensity of the exercise

Exclusion Criteria:

• no understanding of the German language
• Patients would not be able to perform a 6-minute walk test, e. g. surgery on the large joints of the lower extremities, unstable heart disease or predominant neurological symptoms.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patients over 55 Years with coronary heart disease; Questionnaire and semistructured Interview 45 -60 minutes	Other: Questionnaire, Interview; During the stay, a study visit is arranged with the patient after the 6-minute walk test has been performed. This consists of filling out the questionnaire and an interview, which lasts about 45-60 minutes. This is carried out by the investigator on at least 5 subjects. After each interview, a list of influencing factors is kept. If new aspects continue to appear in the 5th interview, the interviews are continued (up to a maximum of the 10th subject). If no new aspects appear in the interviews from number 6 onwards, the interviews are discontinued and no further patients are recruited. The conversations are recorded with an audio recording.
physical therapists working with patients with coronary heart disease; Focus group 60 -90 minutes	Other: Focus Group; The focus group is carried out first in order to identify influencing variables that may be relevant for the interview (duration 60-90 minutes).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
semi-structured interview about reasons, that could influence the rating of patients	Patients were asked in a semi-structured interview about other reasons, that could influence their rating.	during inpatient rehabilitation after the 1st six-minute-walking test within 3 weeks
reasons, what might patients influence for ratings of patients given from physical therapist	physical therapists identify reasons in a focus group, that influence the patients.	with the beginning of the study within 4 weeks, before the patients' questionnaire and interview

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patients' experience with the conduction of the six-minute-walking test	nominal scale (yes-partly-no)	during inpatient rehabilitation after the 1st six-minute-walking test within 3 weeks
Patients' honesty of the statement of effort	nominal scale (yes-no)	during inpatient rehabilitation after the 1st six-minute-walking test within 3 weeks
Patients' exertion and performance limit	open questions	during inpatient rehabilitation after the 1st six-minute-walking test within 3 weeks
Patients' safety during the six-minute-walking test	numeric rating scale 0-10 (more likely no = 0; more likely yes = 10)	during inpatient rehabilitation after the 1st six-minute-walking test within 3 weeks
Patients' performance limit before and after the heart disease	numeric rating scale 0-10 (more likely no = 0; more likely yes = 10)	during inpatient rehabilitation after the 1st six-minute-walking test within 3 weeks
Patients' sportiness	numeric rating scale 0-10 (more likely no = 0; more likely yes = 10)	during inpatient rehabilitation after the 1st six-minute-walking test within 3 weeks
Experience of maximal exertion of activity in the past	4-point nominal scale (weekly to several years ago)	during inpatient rehabilitation after the 1st six-minute-walking test within 3 weeks

Collaborators and Investigators

• Sponsor: Klinik Barmelweid
• Investigators: Principal Investigator: Gilbert Büsching, Klinik Barmelweid AG

Publications and helpful links

General Publications

• Jehn M, Halle M, Schuster T, Hanssen H, Weis M, Koehler F, Schmidt-Trucksass A. The 6-min walk test in heart failure: is it a max or sub-maximum exercise test? Eur J Appl Physiol. 2009 Oct;107(3):317-23. doi: 10.1007/s00421-009-1128-0. Epub 2009 Jul 18.
• Pollentier B, Irons SL, Benedetto CM, Dibenedetto AM, Loton D, Seyler RD, Tych M, Newton RA. Examination of the six minute walk test to determine functional capacity in people with chronic heart failure: a systematic review. Cardiopulm Phys Ther J. 2010 Mar;21(1):13-21.

Helpful Links

• Nationaler Verein für Qualitätsentwicklung in Spitälern und Kliniken. ANQ; Nationaler Vergleichsbericht 2018 - Kardiale Rehabilitation [Internet]. Messergebnisse Rehabilitation. 2018 [zitiert 7. Dezember 2020].

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2021
• Primary Completion (Actual): August 14, 2022
• Study Completion (Actual): August 14, 2022

Study Registration Dates

• First Submitted: May 5, 2021
• First Submitted That Met QC Criteria: May 18, 2021
• First Posted (Actual): May 24, 2021

Study Record Updates

• Last Update Posted (Actual): October 25, 2022
• Last Update Submitted That Met QC Criteria: October 24, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Coronary Disease
• Other Study ID Numbers: 001 (Buy Pharma Ecza Deposu San. Tic. Ltd.)

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