None listed
Conditions
Brief summary
Raised blood pressure (BP) is the leading but modifiable risk factor for preventable death and physical inactivity can substantially lower BP. However, participation in physical activity is low in Australia. To overcome this, people with hypertension in Australia can be referred to a Medicare-subsidised Accredited Exercise Physiologist (AEP) to receive individualised exercise counselling. Yet, the uptake of this service remains low, in part due to a lack of awareness of the benefits of physical activity. Thus, this randomised controlled trial aims to investigate the feasibility and efficacy of an online 12-week exercise physiologist intervention for improving fitness and reducing high BP in people who are diagnosed with hypertension compared to the control group who will receive usual care.
Interventions
Brief name: Feasibility and efficacy of a virtual exercise physiologist intervention for people with hypertension
- Physical or informational materials: No physical materials will be provided, personalised information about exercise will be delivered during the exercise sessions. The exercise component will be evidence-based as per American College of Sports Medicine guidelines, a combination of aerobic, resistance, balance and flexibility exercises such as brisk walking/jogging (indoor or outdo
Brief name: Feasibility and efficacy of a virtual exercise physiologist intervention for people with hypertension - Physical or informational materials: No physical materials will be provided, personalised information about exercise will be delivered during the exercise sessions. The exercise component will be evidence-based as per American College of Sports Medicine guidelines, a combination of aerobic, resistance, balance and flexibility exercises such as brisk walking/jogging (indoor or outdoor), or step-up will be prescribed as is suitable and relevant to the participant. - procedures: Once all baseline data collection is completed, participants will be randomly allocated into the intervention or control groups. Participants in the intervention group will be connected with an Accredited Exercise Physiologist (AEP) at UNSW lifestyle clinics to provide online consultations. AEPs will have a current accreditation issued by the regulatory body Exercise and Sports Science Australia (ESSA) as well as a current Medicare provider number for the UNSW Lifestyle Clinic. The intervention group will receive 7 online consultations using Microsoft Team or UNSW Zoom platform at participants' preferred time and premises (e.g. their home or other location with an internet connection) over the 12-week intervention period. During these consultations, participants will be taught techniques to increase their physical activity level based on their capability and their initial physical activity level. - who will deliver the intervention: AEPs with a current accreditation issued by the regulatory body Exercise and Sports Science Australia (ESSA) as well as a current Medicare provider number for the UNSW Lifestyle Clinic. - the mode of delivery: Online using teleconferencing tools such as Zoom or Microsoft Team individually - the number of times the intervention will be delivered and over what period of time including the number of sessions, their schedule: Overall, 7 sessions x 1 hour each over 12 weeks will be delivered weekly for the first month, then fortnightly and monthly in the second and third months of the intervention. - the location where the intervention occurs: Online at participants' preferred premises (e.g. their home) - personalised intervention: The AEP will provide online personalised exercise consultations. During these consultations, participants will be taught techniques to increase their physical activity level based on their capability and their initial physical activity level. The exercise advice will be evidence-based as per American College of Sports Medicine guidelines, a combination of aerobic, resistance, balance and flexibility exercises will be prescribed as is suitable and relevant to the participant. Intervention adherence and fidelity: Adherence will be assessed by calculating the retention rate for the study (i.e. number of participants completed all aspects of study/ number of participants consented). Further performance will be monitored as follows. At the beginning of each session, the AEP will follow up with participants on their performance since the last session. At the end of each session, participants will set a specific goal to be completed based on their capability and their physical activity level (e.g. a set of exercises to be completed every other day). Participants will be asked to share their performance by specifying the percent of tasks completed between each session. Strategies to improve fidelity: Participants will be reimbursed for their participation by means of a shopping gift voucher to the value of $100. The reimbursement/reward will be provided to participants who complete all aspects of the study. Participants who attend the focus group interview will receive an additional shopping gift voucher valued at $50 as an incentive.
Sponsors
A/Prof Xiaoqi Feng
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• be 18 years of age or older; • diagnosed with hypertension and recent clinic systolic blood pressure greater than or equal to 130 mmHg and/or diastolic blood pressure greater than or equal to 80 mmHg; • willing to wear wrist-based blood pressure device for seven consecutive days at baseline and after 3 months; • willing to undergo initial exercise tests by an Exercise Physiologist to determine eligibility; • have access to a smartphone and the internet and feel comfortable to use it to download an App for use with a blood-pressure device, complete online assessments, and join online video consultations with an Accredited Exercise Physiologist; • no plan to change medications; • have a personal weighing bathroom scale; and • independently ambulant for 200m (be confident to walk 200m or around the block unassisted).
Exclusion criteria
• significant alcohol or drug use; • pregnancy (or planned pregnancy); • unstable cardiovascular, respiratory and neurological disorders; established chronic kidney disease (eGFR <60ml/kg/1.73m2); known arrhythmias (irregular heart rhythms); known vascular aneurysm; implanted electrical devices (e.g. cardiac pacemakers or defibrillators); severe or untreated mental health illnesses (including eating disorders); active cancer or requiring treatment for cancer; other health conditions, (e.g. orthopaedic or neuromuscular limitations) or hospital admissions within the last 6 months that would make it difficult or unsafe to participate in the exercise sessions at home safely. prior mastectomy (breast removal); • wrist circumference >22cm and upper arm circumference >64 cm because of the BP device size; • participation in any other behaviour change program or clinical trial that may interfere with the outcomes of this study, e.g. weight loss, physical activity or drug; • unable to speak English (a translator is not available) or give written informed consent; • allergy to the silicone material from the BP device.
Outcome results
None listed