Atrial Fibrillation, Congestive Heart Failure, Coronary Artery Disease, Diabetes Mellitus, Type 2, Myocardial Infarction
Conditions
Keywords
Exercise, Secondary Prevention, Diabetes, Rehabilitation
Brief summary
This is a 2x2 study examining the impacts of a novel exercise regimen and daily text message reminders in patients at high risk for cardiovascular disease. Patients participating in cardiac rehabilitation will be randomized to either moderate intensity continuous training (MICT) or a novel exercise regimen consisting of three periods of high intensity exercise, called BURST exercise. Additionally, half of the patients in each exercise group will be randomized to receive daily text message reminders to improve adherence to the prescribed exercise regimen.
Detailed description
Numerous studies have demonstrated the important cardiometabolic impacts of high intensity exercise in patients at high risk for cardiovascular disease. It is also known that adherence to exercise regimens is poor within these populations. This study compares the impacts of the current standard of care, moderate intensity continuous training (MICT) to a novel exercise regimen called BURST exercise within a population of patients at high risk for cardiovascular disease. BURST exercise consists of three periods of high intensity physical activity spread throughout the day. Additionally, as mobile technologies continue to be used more to improve adherence to exercise regimens, this study also seeks to compare the impacts of text message reminders in patients prescribed each of the exercise regimens examined in this study. Thus, patients were also randomized to either receive daily text message reminders, or to receive no text message reminders. Recruitment will be conducted at Cambridge Cardiac Rehab in Ontario, Canada. Potential study subjects are evaluated for inclusion and exclusion criteria, give written informed consent, and are randomized, in a 1:1 ratio, to either MICT or BURST exercise. Additionally, patients are then randomized in a 1:1 ratio to either receive text message reminders or not receive text message reminders. Patients prescribed the MICT regimen will be asked to exercise for 30 minutes per day at moderate intensity, at least five days per week. Patients prescribed the BURST exercise regimen will be asked to exercise for 10 minutes per session, three times a day at high intensity, at least five days per week. Patients randomized to receive text message reminders will be sent four daily text message reminders reading: Please remember to exercise for 30 minutes today. Adherence to exercise regimens will be measured by daily logbooks. Patients are asked to log the times they exercised and for what duration. BRUCE protocol stress tests will be conducted for all patients at baseline (before beginning the study), after three months and after one year. Hemoglobin A1C blood tests, height and weight measurements and lipid profile blood tests will also be conducted at baseline (before the beginning of the study), after three months and after one year.
Interventions
BEHAVIORALBURST physical activity
BURST is a novel exercise regimen consisting of three daily periods of 10 minutes of high intensity physical activity spread throughout the day.
BEHAVIORALText Message Reminders
Patients were sent daily text message reminders to remind them to exercise.
BEHAVIORALModerate Intensity Continuous Training
This is the current standard of care for cardiac rehabilitation patients. It consists of 1 daily period of 30 minutes of moderate intensity physical activity.
Sponsors
Cambridge Cardiac Care Centre
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
This is a 2x2 of burst physical activity (BURST) vs moderate intensity continuous training (MICT) and text message reminders vs no text message reminders. Patients will be randomized to either BURST or MICT and then further randomized to either receive text message reminders or not receive text message reminders.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Newly diagnosed type 2 diabetic patients (within the last 3 months) * Participating in on-site the diabetes rehabilitation program at Cambridge Cardiac Rehab * Deemed capable of high-intensity exercise
Exclusion criteria
* Known or suspected cardiovascular disease * Diabetic end-organ damage * Cerebrovascular disease * Peripheral vascular disease * Arthritis * Joint disease * Taking anti-glycemic medications * Taking lipid lowering medications * Ischemia, hypoxia, arrhythmia or hemodynamic instability during a stress test
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HbA1C at 12 months | 12 months | Hemoglobin A1C blood test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| LDL at 12 months | 12 months | Calculated Low Density Lipoprotein from blood tests |
| HDL at 3 months | 3 months | Measured High Density Lipoprotein from blood tests |
| HDL at 12 months | 12 months | Measured High Density Lipoprotein from blood tests |
| Triglycerides at 3 months | 3 months | Measured Triglycerides from blood tests |
| Triglycerides at 12 months | 12 months | Measured Triglycerides from blood tests |
| LDL at 3 months | 3 months | Calculated Low Density Lipoprotein from blood tests |
| BMI at 12 months | 12 months | Calculated Body Mass Index based on height and weight measurements |
| Exercise Capacity at 3 months | 3 months | Timed number of minutes achieved on a Bruce Protocol treadmill stress test |
| Exercise Capacity at 12 months | 12 months | Timed number of minutes achieved on a Bruce Protocol treadmill stress test |
| Monthly Duration of Exercise | Months 1-12 | Average number of minutes of exercise logged by patients in daily logbooks |
| HbA1C at 3 months | 3 months | Hemoglobin A1C blood test |
| BMI at 3 months | 3 months | Calculated Body Mass Index based on height and weight measurements |
Countries
Canada
Contacts
Primary ContactAvinash Pandey
Backup ContactA. Shekhar Pandey, BSc, MD
Outcome results
None listed