Autonomic Nervous System Imbalance, Frailty
Conditions
Keywords
Cardiac rehabilitation, Cardiac surgery, Resistance training, Exercise training, Frailty, Elderly
Brief summary
To develop and investigate an unobtrusive technology for long-term monitoring of autonomic nervous system (ANS) function's response to daily physical stressors and exercise training for elderly patients with different frailty stages.
Interventions
OTHERHome training program
Subjects randomized to the IG will participate at home training program that will last 12 weeks and consists of endurance, flexibility, balance and cardiovascular resistance training performed with low to moderate intensity, in 20-60 minutes sessions, five times a week. Study participants will be asked to wear wrist and chest unobtrusive devices during active day time or at least during the training session and two hours before and after.
Sponsors
Kaunas University of Technology
Lithuanian University of Health Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients admitted to CR after open heart surgery. * Age 65 years and older. * 6-minute walk distance (6-MWD) ≥150 meters. * Patient's agreement to participate in the study. * Edomonton Frailty Scale score 5 points and more
Exclusion criteria
* Cardiac devices (due to artificially altered heart rate series) * Diseases in the musculoskeletal system or other organs complicating physical activity and exercise training; * Exercise-limiting comorbidities (primarily orthopedic and neurological conditions that would exclude individuals from participating in CR according to study protocol), including chronic heart failure New York Heart Association Class IV, hemoglobin less than 9 g/dL, wound healing disturbance, cognitive or linguistic deficits.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Autonomic nervous function by Heart Rate Recovery (HRR) | 3 weeks | HRR (beats per minute) is a difference of the maximal HR obtained during stress testing and HR during the recovery period: HR30-360 the decay of heart rate from 30 to 360 s after the recovery onset. |
| Autonomic nervous function by Heart Rate Fragmentation (HRR) | 3 weeks | HRF measured by RR interval indexes:percentage of inflection points (PIP), inverse of the average length of the acceleration/deceleration segments (IALS), percentage of short segments (PAS), percentage of alternation segments (PSS). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional capacity by six minutes walking test (6MWT) | 3 weeks | 6MWT measured by meters |
| Physical performance by Timed up and Go test (TUG) | 3 weeks | TUG measured by seconds |
| Cardiopulmonary exercise capacity by maximal oxygen consumption (peakVO2) | 3 weeks | PeakVO2 measured with spiroergometry by millilitres of oxygen per kilogram of body mass per minute |
| Frailty level by Edmonton frailty scale (EFS) | 3 weeks | 0-17 points, the higher the worse. The EFS assesses 9 domains: cognition, general health status, functional independence, social support, medication use, nutrition, mood, continence, and functional performance. |
| Gait evaluation by step time | 3 weeks | Step time measured with treadmill ergometer by seconds |
| Cardiopulmonary exercise capacity by maximal load (maxWatt) | 3 weeks | Maximal load measured with spiroergometry by maximal watts |
Countries
Lithuania
Outcome results
None listed