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

16. august 2012 oppdatert av: 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.

Studieoversikt

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Forventet)

80

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

    • Gentofte
      • Copenhagen, Gentofte, Danmark, 2900
        • Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital Gentofte,
        • Ta kontakt med:
        • Ta kontakt med:
        • Hovedetterforsker:
          • Laura Staun Valentiner, Masters in Health Science

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Early homebased rehabilitation
After discharge from the hospital patients are offered a homebased rehabilitation program lasting 6 weeks.
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
Andre navn:
  • fysisk trening
  • severe heart failure
  • homebased rehabilitation
  • activities of daily living
Eksperimentell: control group: Ususal care
After discharge from the hospital the patients are offered the usual symptom-oriented and preventive medical care and psychosocial support
After discharge from the hospital the patients are offered the usual symptom-oriented and preventive medical care and psychosocial support

Hva måler studien?

Primære resultatmål

Resultatmål
Tidsramme
Readmission due to heart failure
Tidsramme: assessed one year after inclusion
assessed one year after inclusion

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Physical capacity
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: at 6 weeks, after 6 month and after one year
at 6 weeks, after 6 month and after one year

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. september 2012

Primær fullføring (Forventet)

1. september 2015

Studiet fullført (Forventet)

1. juli 2016

Datoer for studieregistrering

Først innsendt

14. august 2012

Først innsendt som oppfylte QC-kriteriene

16. august 2012

Først lagt ut (Anslag)

21. august 2012

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

21. august 2012

Siste oppdatering sendt inn som oppfylte QC-kriteriene

16. august 2012

Sist bekreftet

1. august 2012

Mer informasjon

Begreper knyttet til denne studien

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