None listed
Conditions
Brief summary
Each participant will receive physiotherapy treatment involving one-on-one education about physical activity for heart failure, including guidelines for walking and exercise while an inpatient at The Prince Charles Hospital. A walking and exercise program for home will also be provided before discharge. In addition, those in the walking group will receive twice daily walking supervised by a physiotherapist. Treatment will take up to 40 minutes each day to complete and will be carried out each day until discharge. All participants will undergo an assessment prior to discharge involving a walking test to measure walking capacity in 6 minutes and activity levels. Soon after discharge activity levels will again be monitored and all participants will receive surveys looking at quality of life and return to everyday activity in the community.
Interventions
Twice daily, progressive mobilisation of up to 30 minutes each day, performed one on one with a physiotherpist until discharge from hospital, unless contraindicated. All participants (including the intervention and control groups) will receive standard care.
Initial assessment comprises a timed 10m walk test, and the Human actvity Profile questionnaire.
Sponsors
Lisa Moore
Study design
Allocation
Randomised controlled trial
Intervention model
Factorial
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients admitted to hospital with 1. A primary diagnosis of ‘acute heart failure’, ‘heart failure’ or ‘exacerbation of heart failure’ or 'congestive cardiac failure' as diagnosed and documented by their treating physician. 2. Have been started on medical therapy for heart failure 3. Satisfy safety criteria (detailed below) 4. Provide signed written informed consent
Exclusion criteria
Exclusion criteria: New York Heart Association Classification: IV (shortness of breath at rest) Terminally ill Poor cognition or reduced ability for self care as deemed by treating medical team Orthopaedic or other limitations that prevent mobility Awaiting therapeutic cardiovascular procedure or hospitalisation for surgery Presence of heart failure secondary to significant uncorrected primary valvular disease (except for mitral regurgitation secondary to LV dysfunction), new onset atrial fibrillation, anaemia Obstructive and restrictive cardiomyopathies (diastolic heart failure) Pacemakers which do not permit adequate heart rate response to exercise Inability or refusal to sign informed consent Safety criteria Participants will not undergo mobilisation if they: Are haemodynamically unstable Show signs of recent heart attack including such as new/recurrent chest pain in the past 8 hours, rising troponin levels Show new signs of uncompensated heart failure (such as dyspnoea at rest) Show signs of heart electrical conduction problems (e.g. 3rd-degree AV block) Have uncontrolled irregular heart rhythms (e.g. recurrent ventricular tachycardia or ventricular fibrillation, fast heart rate >110 beats per minute) Have a resting systolic blood pressure >200mmHg or resting diastolic blood pressure of >110mmHg Have a resting systolic blood pressure of <90mmHg patient will be reviewed by the medical team prior to mobilisation Have poorly controlled symptomatic postural or low blood pressure (drop of >20mmHg with symptoms) Resting oxygen saturation: <92% Clinical judgement by the exercise specialist that patient clinical presentation is such that it would preclude safe mobility
Outcome results
None listed