< Terug naar vorige pagina


Home-based exercise in patients with coronary heart disease: Effects on physical fitness and physical activity

Boek - Dissertatie

Aerobic exercise capacity (peak VO2) and active life style are related to long-term survival and to reduction in cardiovascular morbidity in subjects with cardiovascular disease. However, the majority of cardiac patients do not engage enough in physical activity to obtain or maintain the benefits of a physically active lifestyle. There is a need for innovative rehabilitation methods aiming at increasing longer-term adherence and hence more sustained effects on health related physical fitness. One strategy might be the use of home-based training in combination with telemonitoring guidance. Thus, the first study on this doctoral plan will be the Tele-Rehabilitation in Coronary Heart disease study (TRiCH). The main objective of TRiCH is to compare the longer-term (=1 year) effects of a 3-month supervised center-based cardiac rehabilitation program (Center-CR) with a patient-tailored home-based cardiac rehabilitation program with telemonitoring guidance (Home-CR) in CAD patients (phase III). The study is planned as a randomized controlled prospective trial thatwill randomize 105 coronary artery disease patients that have successfully completed a three month-ambulatory cardiac rehabilitation program (phase II) to one of the three groups: Home-CR, Center-CR or a control group on a 1:1:1 basis. The training programs (frequency, intensity, mode and time of exercise) of patients randomized to Home-CR or Center-CR willbe designed according to current exercise recommendations. Patients in the control group will receive only the advice to maintain a physically active lifestyle. Assessments will be performed at baseline, after12 weeks of intervention and at one year of follow-up. The primary endpoint of the study is change in physical fitness (peak VO2 and muscle strength) at one-year of follow-up. Secondary outcomes include changes in traditional cardiovascular risk factors, endothelial function, physical activity and quality of life. It is hypothesized that home-based training with telemonitoring guidance will result in higher levels of physical fitness at one year of follow-up. Enrollment started inFebruary 2014; last enrollment is expected in September 2015. The second part will be a methodological study. The on-kinetics study is a study that will evaluate the cardiorespiratory responses before, during and after two submaximal tests at different intensities: the Ventilatory Anaerobic Threshold (low intensity) and at the Respiratory Compensation Point(moderate to high intensity); this will give information related to theoxygen on and off kinetics in subjects with coronay arterial disease.
Jaar van publicatie:2018