scholarly journals A secondary analysis of data from the OPTICARE randomized controlled trial investigating the effects of extended cardiac rehabilitation on functional capacity, fatigue, and participation in society

2019 ◽  
Vol 33 (8) ◽  
pp. 1355-1366
Author(s):  
Nienke ter Hoeve ◽  
Madoka Sunamura ◽  
Henk J Stam ◽  
Ron T van Domburg ◽  
Rita JG van den Berg-Emons
Keyword(s):  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
Walk Test ◽  
Face To Face ◽  
Randomized Controlled ◽  
After Care ◽  
6 Minute Walk Test ◽  
Minute Walk

Objective: In this secondary analysis of data from the OPTICARE trial, we compared the effects of two behavioral interventions integrated into cardiac rehabilitation to standard rehabilitation with regard to functional capacity, fatigue, and participation in society. Design: This is a randomized controlled trial. Setting: This study was conducted in a cardiac rehabilitation setting. Subjects: A total of 740 patients with acute coronary syndrome were recruited for this study. Interventions: Patients were randomized to (1) three months of standard rehabilitation; (2) cardiac rehabilitation plus nine months after-care with face-to-face group lifestyle counseling; or (3) cardiac rehabilitation plus nine months after-care with individual lifestyle telephone counseling. Main measures: Functional capacity (6-minute walk test), fatigue (Fatigue Severity Scale), and participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation) were measured at randomization, 3, 12, and 18 months. Results: Additional face-to-face sessions resulted at 12 months in 12.49 m more on the 6-minute walk test compared to standard rehabilitation ( P = .041). This difference was no longer present at 18 months. Prevalence of fatigue decreased from 30.2% at baseline to 11.9% at 18 months compared to an improvement from 37.3% to 24.9% after standard rehabilitation (between-group difference: odds ratio = 0.47; P = .010). The additional improvements in functional capacity seemed to be mediated by increases in daily physical activity. No mediating effects were found for fatigue. No additional improvements were seen for participation in society. Additional telephonic sessions did not result in additional intervention effects. Conclusion: Extending cardiac rehabilitation with a face-to-face behavioral intervention resulted in additional long-term improvements in fatigue and small improvements in functional capacity up to 12 months. A telephonic behavioral intervention provided no additional benefits.

scholarly journals Feasibility and Acceptability of a Physical Activity Tracker and Text Messages to Promote Physical Activity During Chemotherapy for Colorectal Cancer: Pilot Randomized Controlled Trial (Smart Pace II)

JMIR Cancer ◽  
10.2196/31576 ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. e31576
Author(s):  
Erin L Van Blarigan ◽  
Anand Dhruva ◽  
Chloe E Atreya ◽  
Stacey A Kenfield ◽  
June M Chan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Digital Health ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Walk Test ◽  
Randomized Controlled ◽  
6 Minute Walk Test ◽  
Minute Walk

Background We conducted a pilot 2-arm randomized controlled trial to assess the feasibility of a digital health intervention to increase moderate-to-vigorous physical activity in patients with colorectal cancer (CRC) during chemotherapy. Objective This study aimed to determine whether a digital health physical activity intervention is feasible and acceptable during chemotherapy for CRC. Methods Potentially eligible patients with CRC expected to receive at least 12 weeks of chemotherapy were identified in person at the University of California, San Francisco, and on the web through advertising. Eligible patients were randomized 1:1 to a 12-week intervention (Fitbit Flex, automated SMS text messages) versus usual care. At 0 and 12 weeks, patients wore an Actigraph GT3X+ accelerometer for 7 days and completed surveys, body size measurements, and an optional 6-minute walk test. Participants could not be masked to their intervention arm, but people assessing the body size and 6-minute walk test outcomes were masked. The primary outcomes were adherence (eg, Fitbit wear and text response rate) and self-assessed acceptability of the intervention. The intervention would be considered feasible if we observed at least 80% complete follow-up and 70% adherence and satisfaction, a priori. Results From 2018 to 2020, we screened 240 patients; 53.3% (128/240) of patients were ineligible and 26.7% (64/240) declined to participate. A total of 44 patients (44/240, 18%) were randomized to the intervention (n=22) or control (n=22) groups. Of these, 57% (25/44) were women; 68% (30/44) identified as White and 25% (11/44) identified as Asian American or Pacific Islander; and 77% (34/44) had a 4-year college degree. The median age at enrollment was 54 years (IQR 45-62 years). Follow-up at 12 weeks was 91% (40/44) complete. In the intervention arm, patients wore Fitbit devices on a median of 67 out of 84 (80%) study days and responded to a median of 17 out of 27 (63%) questions sent via SMS text message. Among 19 out of 22 (86%) intervention patients who completed the feedback survey, 89% (17/19) were satisfied with the Fitbit device; 63% (12/19) were satisfied with the SMS text messages; 68% (13/19) said the SMS text messages motivated them to exercise; 74% (14/19) said the frequency of SMS text messages (1-3 days) was ideal; and 79% (15/19) said that receiving SMS text messages in the morning and evening was ideal. Conclusions This pilot study demonstrated that many people receiving chemotherapy for CRC are interested in participating in digital health physical activity interventions. Fitbit adherence was high; however, participants indicated a desire for more tailored SMS text message content. Studies with more socioeconomically diverse patients with CRC are required. Trial Registration ClinicalTrials.gov NCT03524716; https://clinicaltrials.gov/ct2/show/NCT03524716

scholarly journals Cardiac Rehabilitation Increases the Reliability of the 6-Minute Walk Test in Patients After Coronary Artery Bypass Graft Surgery

2017 ◽  
Vol 20 (6) ◽  
pp. 247
Author(s):  
Emrulah Hayta ◽  
Özge Korkmaz
Keyword(s):  
Body Mass Index ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Walk Test ◽  
Artery Bypass Graft ◽  
Vo2 Max ◽  
6 Minute Walk Test ◽  
Minute Walk

Background: Few data are available on the capacity for functional exercise after cardiac rehabilitation in patients who have undergone coronary artery bypass graft (CABG) surgery. The aim of this study was to determine the clinical and biochemical factors that affect the 6-minute walk test (6MWT) results in patients who have undergone CABG.Methods: Data were prospectively collected from 56 patients consecutively admitted at our hospital between January 2013 and May 2015 for a 3-month cardiac rehabilitation program. Data were analysed retrospectively up to 90 days after cardiac surgery. In addition to clinical and biochemical parameters, the functional capacity of patients was evaluated by an exercise 6-minute walking test and echocardiography. Functional capacity was evaluated at baseline and after three months of cardiac rehabilitation. Results: Before cardiac rehabilitation, the 6MWT values were negatively correlated with Body Mass Index (BMI) and abdominal and buttock diameters (r = -0.375, -0.386, and -0.370, respectively; P < .05), and were positively correlated with metabolic equivalent (MET) values (r = 0.493, P < .05). After cardiac rehabilitation, the 6MWT values were negatively correlated with body mass index (BMI) and abdominal and buttock diameters (r = -0.382, -0.274, and -0.405, respectively; P < .05) and were positively correlated with MET and VO2 max values (r = 0.456 and 0.573, respectively; P < 0.05). Before cardiac rehabilitation, VO2 max and FEV1/FEVC values were found as factors that significantly increased 6MWT values (P < .05). After cardiac rehabilitation, VO2 max values were found as factors that significantly increased 6MWT values (P < .05).Conclusion: Overall, in current clinical settings, cardiac rehabilitation increases the reliability of the 6MWT. Improvement in pulmonary function after cardiac rehabilitation reduces the impact of pulmonary function on 6MWT values. The functional capacity of patients may be more reliably determined by 6MWT after cardiac rehabilitation.

scholarly journals Feasibility and Acceptability of a Physical Activity Tracker and Text Messages to Promote Physical Activity During Chemotherapy for Colorectal Cancer: Pilot Randomized Controlled Trial (Smart Pace II) (Preprint)

2021 ◽  
Author(s):  
Erin L Van Blarigan ◽  
Anand Dhruva ◽  
Chloe E Atreya ◽  
Stacey A Kenfield ◽  
June M Chan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Digital Health ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Walk Test ◽  
Randomized Controlled ◽  
6 Minute Walk Test ◽  
Minute Walk

BACKGROUND We conducted a pilot 2-arm randomized controlled trial to assess the feasibility of a digital health intervention to increase moderate-to-vigorous physical activity in patients with colorectal cancer (CRC) during chemotherapy. OBJECTIVE This study aimed to determine whether a digital health physical activity intervention is feasible and acceptable during chemotherapy for CRC. METHODS Potentially eligible patients with CRC expected to receive at least 12 weeks of chemotherapy were identified in person at the University of California, San Francisco, and on the web through advertising. Eligible patients were randomized 1:1 to a 12-week intervention (Fitbit Flex, automated SMS text messages) versus usual care. At 0 and 12 weeks, patients wore an Actigraph GT3X+ accelerometer for 7 days and completed surveys, body size measurements, and an optional 6-minute walk test. Participants could not be masked to their intervention arm, but people assessing the body size and 6-minute walk test outcomes were masked. The primary outcomes were adherence (eg, Fitbit wear and text response rate) and self-assessed acceptability of the intervention. The intervention would be considered feasible if we observed at least 80% complete follow-up and 70% adherence and satisfaction, a priori. RESULTS From 2018 to 2020, we screened 240 patients; 53.3% (128/240) of patients were ineligible and 26.7% (64/240) declined to participate. A total of 44 patients (44/240, 18%) were randomized to the intervention (n=22) or control (n=22) groups. Of these, 57% (25/44) were women; 68% (30/44) identified as White and 25% (11/44) identified as Asian American or Pacific Islander; and 77% (34/44) had a 4-year college degree. The median age at enrollment was 54 years (IQR 45-62 years). Follow-up at 12 weeks was 91% (40/44) complete. In the intervention arm, patients wore Fitbit devices on a median of 67 out of 84 (80%) study days and responded to a median of 17 out of 27 (63%) questions sent via SMS text message. Among 19 out of 22 (86%) intervention patients who completed the feedback survey, 89% (17/19) were satisfied with the Fitbit device; 63% (12/19) were satisfied with the SMS text messages; 68% (13/19) said the SMS text messages motivated them to exercise; 74% (14/19) said the frequency of SMS text messages (1-3 days) was ideal; and 79% (15/19) said that receiving SMS text messages in the morning and evening was ideal. CONCLUSIONS This pilot study demonstrated that many people receiving chemotherapy for CRC are interested in participating in digital health physical activity interventions. Fitbit adherence was high; however, participants indicated a desire for more tailored SMS text message content. Studies with more socioeconomically diverse patients with CRC are required. CLINICALTRIAL ClinicalTrials.gov NCT03524716; https://clinicaltrials.gov/ct2/show/NCT03524716

A randomized controlled trial of supplemental oxygen versus air in cancer patients with dyspnea

2003 ◽  
Vol 17 (8) ◽  
pp. 659-663
Author(s):  
Eduardo Bruera ◽  
Catherine Sweeney ◽  
Jie Willey ◽  
J Lynn Palmer ◽  
Florian Strasser ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Treatment Phase ◽  
Supplemental Oxygen ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Walk Test ◽  
Shortness Of Breath ◽  
Double Blind ◽  
6 Minute Walk Test ◽  
Minute Walk

Context: The symptomatic benefits of oxygen in patients with cancer who have nonhypoxic dyspnea are not well defined. Objective: To determine whether or not oxygen is more effective than air in decreasing dyspnea and fatigue and increasing distance walked during a 6-minute walk test. Patients and methods: Patients with advanced cancer who had no severe hypoxemia (i.e., had an O2 saturation level of] / 90%) at rest and had a dyspnea intensity of] / 3 on a scale of 0–10 (03/4/no shortness of breath, 103/4/worst imaginable shortness of breath) were recruited from an outpatient thoracic clinic at a comprehensive cancer center. This was a double-blind, randomized crossover trial. Supplemental oxygen or air (5 L/min) was administered via nasal cannula during a 6-minute walk test. The outcome measures were dyspnea at 3 and 6 minutes, fatigue at 6 minutes, and distance walked. We also measured oxygen saturation levels at baseline, before second treatment phase, and at the end of study. Results: In 33 evaluable patients (31 with lung cancer), no significant differences between treatment groups were observed in dyspnea, fatigue, or distance walked (dyspnea at 3 minutes: P = 0.61; dyspnea, fatigue, and distance walked at 6 minutes: P = 0.81, 0.37, and 0.23, respectively). Conclusions: Currently, the routine use of supplemental oxygen for dyspnea during exercise in this patient population cannot be recommended.

scholarly journals Exercise before, during, and after Hospitalization for Allogeneic Hematological Stem Cell Transplant: A Feasibility Randomized Controlled Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1854
Author(s):  
Daniel Santa Mina ◽  
Lianne B. Dolan ◽  
Jeffrey H. Lipton ◽  
Darren Au ◽  
Encarna Camacho Pérez ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Stem Cell ◽  
Stem Cell Transplant ◽  
Controlled Trial ◽  
Retention Rates ◽  
Cell Transplant ◽  
Walk Test ◽  
Randomized Controlled ◽  
Six Minute Walk Test ◽  
Minute Walk

People with cancer who undergo allogeneic hematological stem cell transplant (allo-HSCT) experience significant deconditioning that can compromise quality of life. Exercise has shown to be beneficial before or after allo-HSCT; however, little is known about exercise therapy delivered across the continuum of care. We conducted a feasibility randomized controlled trial of exercise delivered prior to admission, during the inpatient stay, and after discharge versus control in people with planned allo-HSCT. Feasibility was assessed via recruitment and retention rates, the incidence of adverse events, and adherence to the exercise prescription. Estimates of efficacy were measured at baseline, one week prior to hospital admission, and 100 days and one year after transplant. The recruitment and retention rates were 20% and 33%, respectively. One serious adverse event occurred during the baseline six-minute walk test that precluded participation in the study and no adverse events were associated with the intervention. From baseline to pre-transplant, the intervention group improved six-minute walk test distances by 45 m (95% CI: −18.0 to 108.7)—a finding that warrants further investigation with an adequately powered trial. Our study contributes important feasibility considerations and pilot data for future exercise intervention research in allo-HSCT recipients.

scholarly journals Effects of Phase IV Pedometer Feedback Home-Based Cardiac Rehabilitation on Cardiovascular Functional Capacity in Patients With Myocardial Infarction: A Randomized Controlled Trial

2019 ◽  
Vol 4 (2) ◽  
pp. 75-80
Author(s):  
Mostafa Dehghani ◽  
Mostafa Cheraghi ◽  
Mehrdad Namdari ◽  
Valiollah Dabidi Roshan
Keyword(s):  
Myocardial Infarction ◽  
Randomized Controlled Trial ◽  
Cardiac Rehabilitation ◽  
Functional Capacity ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Control Groups ◽  
Randomized Controlled ◽  
Home Based

Introduction: Pedometer feedback home-based cardiac rehabilitation (PFHCR) programs have been effective in augmenting exercise tolerance. Our aim was to investigate the effects of PFHCR on cardiovascular functional capacity in patients with myocardial infarction (MI).Methods: Forty MI patients were divided into two intervention and two control groups (n=10)in a randomized controlled trial. The intervention group received a PFHCR program including routine medications along with continuous exercise program, whereas the control group received traditional care without PFHCR. Baseline evaluations and cardiovascular stresses were controlled during the 8-week follow-up rehabilitation program in all patients. Data analysis was conducted using one-way ANOVA and paired sample student’s t-test (P ≤ 0.05).Results: At baseline, no significant differences were observed between the groups. After eight weeks of PFHCR, the intervention groups had significantly higher metabolic equivalent(P = 0.001), VO2max (P = 0.001), total exercise times (P = 0.001), and total distance traveled(P = 0.003) when compared with the control groups. However, no significant intra-group or inter-group differences in variables were observed between the men and women.Conclusion: Our results showed that PFHCR exhibited significant optimal effects on the cardiovascular functional capacity in MI patients.

THE 6 MINUTE WALK TEST FOR EVALUATION OF FUNCTIONAL CAPACITY IN ELDERLY ADULTS 907

1996 ◽  
Vol 28 (Supplement) ◽  
pp. 152 ◽  
Author(s):  
K M Stillwell ◽  
D E Forman ◽  
D McElwain ◽  
C Simpson ◽  
C E Garber
Keyword(s):  
Functional Capacity ◽  
Walk Test ◽  
Elderly Adults ◽  
6 Minute Walk Test ◽  
Minute Walk

scholarly journals Effects of Home‐Based Cardiac Rehabilitation on Time to Enrollment and Functional Status in Patients With Ischemic Heart Disease

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
David W. Schopfer ◽  
Mary A. Whooley ◽  
Kelly Allsup ◽  
Mark Pabst ◽  
Hui Shen ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cardiac Rehabilitation ◽  
Ischemic Heart ◽  
Walk Test ◽  
Home Based ◽  
Test Distance ◽  
6 Minute Walk Test ◽  
Minute Walk

Background Cardiac rehabilitation is an established performance measure for adults with ischemic heart disease, but patient participation is remarkably low. Home‐based cardiac rehabilitation (HBCR) may be more practical and feasible, but evidence regarding its efficacy is limited. We sought to compare the effects of HBCR versus facility‐based cardiac rehabilitation (FBCR) on functional status in patients with ischemic heart disease. Methods and Results This was a pragmatic trial of 237 selected patients with a recent ischemic heart disease event, who enrolled in HBCR or FBCR between August 2015 and September 2017. The primary outcome was 3‐month change in distance completed on a 6‐minute walk test. Secondary outcomes included rehospitalization as well as patient‐reported physical activity, quality of life, and self‐efficacy. Characteristics of the 116 patients enrolled in FBCR and 121 enrolled in HBCR were similar, except the mean time from index event to enrollment was shorter for HBCR (25 versus 77 days; P <0.001). As compared with patients undergoing FBCR, those in HBCR achieved greater 3‐month gains in 6‐minute walk test distance (+95 versus +41 m; P <0.001). After adjusting for demographics, comorbid conditions, and indication, the mean change in 6‐minute walk test distance remained significantly greater for patients enrolled in HBCR (+101 versus +40 m; P <0.001). HBCR participants reported greater improvements in quality of life and physical activity but less improvement in exercise self‐efficacy. There were no deaths or cardiovascular hospitalizations. Conclusions Patients enrolled in HBCR achieved greater 3‐month functional gains than those enrolled in FBCR. Our data suggest that HBCR may safely derive equivalent benefits in exercise capacity and overall program efficacy in selected patients. Registration URL: https://www.clini​caltr​ials.gov ; Unique identifier: NCT02105246.

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