The purpose of this study is to investigate the effect of an early, coordinated rehabilitation intervention for patients with severe heart failure in NYHA class III and IV with a ejection fraction of \<40% of normal cardiac function measured on frequency of readmissions, physical ability and participation in activities of daily living and quality of life.
Approximately 400,000 Danes live today with heart disease. Disease severity is crucial for patients quality of life. Patients with severe heart disease often struggle with everyday life, characterized by reduced physical capacity, tendency to depression and anxiety to perform everyday activities that may provoke symptoms. A large proportion of patients who are offered cardiac rehabilitation deselect that offer. Of the patients who do participate, more than 50% stop the rehabilitation ahead of time. A large group of patients with severe heart failure and classified in NYHA Class III and IV, deselect the offer because of lack of energy to participate in cardiac rehabilitation or is when specified by a medical assessment discharged from the hospital without the offer of training or any other form of rehabilitation. The offer of rehabilitation for patients with severe heart failure is lacking as it is today. This study assesses the effectiveness of an early home based rehabilitation program that complements the general psycho-social support, symptom-oriented and preventive medical treatment that these patients always have the option to get.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
80
Training begins 3-5 days after discharge from hospital, performed by an occupational therapist and a physiotherapist from Gentofte Hospital in the first two weeks. From week three to six the training will be carried out by an occupational therapist and a physiotherapist from the local municipality (Gentofte municipality and Lyngby Taarbæk municipality). Training will take place at home twice a week for 6 weeks, each session lasting 45 minutes. The intervention is individualized and focuses on functional physical and compensatory training to help the patient to manage everyday life at home. A training program will be provided and the patient will be instructed to do the exercises every day
After discharge from the hospital the patients are offered the usual symptom-oriented and preventive medical care and psychosocial support
Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital Gentofte,
Copenhagen, Gentofte, Denmark
Readmission due to heart failure
Time frame: assessed one year after inclusion
Physical capacity
measured by the Morton Mobility Index, Timed Up \& Go and Modified Sit to Stand Test
Time frame: Assessed at baseline, after 6 weeks, after 6 month and after one year
Activity of Daily Living
Recorded at an ADL interview to assess the performance of everyday activities
Time frame: Assessed at baseline, after 6 weeks, after 6 month and after one year
Number of total hospital admissions
Time frame: at baseline, after 6 weeks, after 6 month and after one year
Exercise Compliance
registration of exercise
Time frame: at baseline, after 6 weeks, after 6 month and after one year
Anxiety and depression
measured by Hospital Anxiety and Depression Scale (HAD)
Time frame: at baseline, after 6 weeks, after 6 month and after one year
Quality of life
measured by The Minnesota Living with Heart Failure Questionnaire
Time frame: at baseline, after 6 weeks, after 6 month and after one year
Number of patients who starts outpatient cardiac rehabilitation after intervention (municipality or hospital)
Time frame: at 6 weeks, after 6 month and after one year
Laura Staun Valentiner, Master in health scien
CONTACT
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.