The objectives of this pilot RCT are to examine if the Talk Test is an effective and safe tool as compared with CPET for exercise prescription in patients who have undergone CABG or PCI and enrolled in a home-based CR program with virtual exercise training monitoring.
The Talk Test has been shown to be a valid, practical and inexpensive tool for guiding exercise training in patients with CAD. The general premise of the Talk Test is that exercising at or above the ventilatory threshold or lactate threshold does not allow comfortable, conversational speech and thus serves as a means of estimating the cut point between moderate and vigorous intensity exercise. The Talk Test can be used to produce exercise intensities (64 to 95% HR peak i.e. moderate-to-vigorous intensity exercise) within accepted Canadian Association of Cardiovascular Prevention and Rehabilitation (CACPR) guidelines for exercise training, to avoid exertional ischemia, and has been shown to be consistent across various modes of exercise (i.e. walking, jogging, cycling, elliptical trainer and stair stepper). There is a critical need to evaluate the effectiveness and safety of using the Talk Test as the principal method of exercise prescription in patients with CAD who have undergone CABG or PCI when compared to standard care CPET. Such a trial has wide-scale appeal for CR programs across Canada and beyond. It will directly and positively impact patient care by reducing the need for in-person interactions for CPET, of paramount importance during COVID-19 outbreaks, between patients and CR staff, thus reducing COVID-19 infection risk and concerns of contracting the virus.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
40
Participants will be enrolled in the virtual cardiac rehab program and receive an exercise prescription based on the Talk test method.
Participants will be enrolled in the virtual cardiac rehab program and receive an exercise prescription based on their CPET results completed at baseline
University of Ottawa Heart Institute
Ottawa, Ontario, Canada
Exercise capacity
will be measured by the Incremental Shuttle Walk Test.
Time frame: from baseline to follow-up at week 12
Cardiovascular health indicators - Plasma glucose
will be measured by fasting plasma glucose (mmol/L) test
Time frame: from baseline to follow-up at week 12
Cardiovascular health indicators - Plasma glucose average
will be measured using the glycated hemoglobin A1C (%) test
Time frame: from baseline to follow-up at week 12
Cardiovascular health indicators - Lipid profile
will be measured using the triglycerides test
Time frame: from baseline to follow-up at week 12
Cardiovascular health indicators - Cholesterol HDL
will be measured high-density lipoprotein cholesterol.
Time frame: from baseline to follow-up at week 12
Cardiovascular health indicators - Cholesterol LDL
will be measured low-density lipoprotein cholesterol.
Time frame: from baseline to follow-up at week 12
Cardiac Rehab safety
meticulously track all mild, moderate, and severe symptoms and adverse events throughout this study. Symptoms may include tightness in chest, leg tightness/pain, dizziness, lightheaded, foot cramping, and heart palpitations.
Time frame: from baseline to follow-up at week 12
VO2peak
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will be measured using a gold standard symptom-limited CPET on an electronically braked cycle ergometer (alternatively it will be administered on a treadmill or another aerobic equipment). Gas exchange (VO2 in mL/kg/min) and heart rate will be monitored continuously. The highest 20-s interval average of VO2 and HR will be considered the peak VO2 and HR values.
Time frame: at baseline