None listed
Conditions
Brief summary
The proposed project is a crossover prospective design study which aims to: 1.) compare hydrotherapy versus land based exercise for patients with CHF with respect to functional capacity and quality of life. 2.) measure cardiac function during immersion and exercise in water in this patient group. Patients will be recruited through the Heart Failure Services at Royal Brisbane and Women's Hosptal (RBWH) and Princess Alexandra Hospital (PAH). Patients will only be eligible if they have stable CHF and have successfully completed a hospital based, disease specific rehabilitation programme. Patients will be enrolled over a 6 month period and will be randomly selected into one of 2 intervention groups. All individuals will attend an exercise session once per week for 12 weeks which will include 6 weeks of land based exercise and 6 weeks of water based exercise. Whilst some will commence in the land based programme to be followed by the water based programme, the second intervention group will commence in the water based programme followed by the land based programme. Participants will undertake an assessment on 3 occasions: before starting, after the first 6 weeks and at completion of the 12 weeks. During each assessment a number of measures will be collected. These include exercise capacity using a submaximal walking test, grip strength using a hand held dynamometer and 4 balance tests. Participants will also be asked to complete a survey regarding their perception of water based exercise. In a small subgroup of 10 patients, cardiac function will be measured on 1 occasion. This will be done using a portable echo machine and measures will be completed in 3 positions which include: standing outside of the pool, and standing waist deep in the pool prior to and at the completion of the exercise session. To date, no studies have compared aquatic therapy versus land based maintenance exercise in patients with CHF. If shown to be at least equally effective as traditional maintenance exercise, this may provide patients with a valid alternative that is more accomodating for those with musculoskeletal or balance issues that normally hinder land based exercise. This study will inform clinical practice and will provide valuable pilot data that will enable our research team to participate in more comprehensive trials in the future.
Interventions
Participants will be allocated into Group A (6-weeks aquatic exercise) or Group B (6-weeks land exercise) first. Participants will undertake both exercise blocks with a washout period of 1 week in between. Both the aquatic and land – based exercise interventions will involve one session per week, lasting 60 minutes, for 6 weeks.
Exercise sessions for both the land and water based interventions will be conducted as per current evidence for exercise and chronic heart failure and the land programm
Participants will be allocated into Group A (6-weeks aquatic exercise) or Group B (6-weeks land exercise) first. Participants will undertake both exercise blocks with a washout period of 1 week in between. Both the aquatic and land – based exercise interventions will involve one session per week, lasting 60 minutes, for 6 weeks. Exercise sessions for both the land and water based interventions will be conducted as per current evidence for exercise and chronic heart failure and the land programme will reflect that currently conducted at each trial site. As such, both programmes will include a warm up and cool down period of 10 minutes duration, as well as a combination of upper limb and lower limb aerobic and resistance activities. Each session will also include 10 minutes of balance activities. Exercise intensity will be similar in both the land and water based programmes (9-13 on the Borg scale), ensuring that the only difference between the 2 groups is the type of exercise performed (ie water versus land).
Sponsors
Royal Brisbane and Women's Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
Patients with stable CHF who have attended a disease specific heart failure rehabilitation programme NYHA I-III live locally
Exclusion criteria
decompensated CHF deemed unsafe to exercise according to ACSM guidelines VO2peak <15 mls/kg/min active infection skin breakdown/ open wounds skin sensitivity to chemicals heat sensitive condition (eg MS) or acute inflammatory condition urinary or faecal incontinence
Outcome results
None listed