Ignite Creation Date:
2024-05-06 @ 5:48 PM
Last Modification Date:
2024-10-26 @ 2:35 PM
Study NCT ID:
NCT05434117
Status:
RECRUITING
Last Update Posted:
2023-09-06
First Post:
2022-06-14
Brief Title:
Feasibility of High-Intensity Interval Nordic Walking in Patients With Coronary Artery Disease
Sponsor:
Ottawa Heart Institute Research Corporation
Organization:
Ottawa Heart Institute Research Corporation
Study Overview
Official Title:
Feasibility and Preliminary Efficacy of High-intensity Interval Nordic Walking in Patients With Coronary Artery Disease A Pilot Randomized Clinical Trial HIIT-NoW
Status:
RECRUITING
Status Verified Date:
2024-07
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
HIIT-NoW
Brief Summary:
Coronary revascularization such as heart bypass surgery CABG and percutaneous coronary intervention PCI inserting a stent to open up blood vessels improve survival for people with coronary artery disease Yet many patients suffer from poor physical and mental health after coronary revascularization Traditional cardiac rehabilitation involving moderate-to-vigorous intensity continuous training MICT improves physical and mental health However alternative exercise programs such as high-intensity interval training HIIT and Nordic walking may provide superior benefits Nordic walking is like Nordic skiing but uses specifically designed poles for walking Nordic walking involved core upper and lower body muscles resulting in greater energy expenditure while reducing loading stress at the knee To date HIIT used in cardiac rehabilitation settings has focused on lower body eg leg cycling The investigators are not aware of HIIT protocols that target both upper and lower body at the same time An exercise program that combines HIIT and Nordic walking HIIT-NoW may offer an alternative time-efficient whole-body exercise to improve physical and mental health This study will test if HIIT-NoW can be an alternative exercise option to improve physical and mental health in patients with coronary artery disease
Detailed Description:
Coronary revascularization improves survival for patients with coronary artery disease CAD Despite successful coronary revascularization treatment however many patients with CAD are left suffering from poor exercise capacity and frequently experience difficulties in performing daily activities eg getting dressed sitting down or getting up from the toilet because of diminished cardiovascular function and exercise tolerance Decreased exercise capacity leads to a dramatic reduction in quality of life QoL and more severe depression symptoms Low exercise capacity poor quality of life QoL and severer depression symptoms heighten the risk of subsequent cardiovascular events and mortality
Current guidelines recommend that persons with CAD who have undergone coronary artery bypass graft surgery CABG or percutaneous coronary intervention PCI participate in exercise-based cardiovascular rehabilitation CR Exercise-based CR is safe effective and a class IA recommendation following CABG and PCI Irrefutable evidence demonstrates that exercise-based CR including moderate-to-vigorous intensity continuous exercise training MICT improves exercise capacity QoL depression and reduces hospital readmissions and cardiovascular morbidity and mortality MICT has long been used to manage the physical and mental health of CAD patients as per the Canadian Guidelines for Cardiovascular Rehabilitation and Cardiovascular Disease Prevention however such exercise may be less efficient and perceived as less motivatingenjoyable Growing evidence suggests that non-conventional exercise interventions such as high-intensity interval training HIIT and Nordic walking are more effective exercise modalities and maybe more enjoyable to improve clinical outcomes eg exercise capacity QoL and depression symptoms in patients with CAD
HIIT repeated bouts of brief high-intensity exercise interspersed with active recovery is an effective and efficient exercise training paradigm A recent meta-analysis n10 studies comparing HIIT and MICT in patients with CAD suggests that 1 HIIT is superior to MICT in improving cardiorespiratory fitness VO2peak of patients with CAD an important clinical vital sign and strong predictor of mortality and 2 HIIT and MICT are equally effective in improving QoL and depression symptoms in patients including CAD Increases in cardiorespiratory fitness decrease mortality risk -- every 35 mlkgmin increase in VO2peak yields a 13 improvement in survival Exercise training-induced increases in cardiorespiratory fitness are therefore highly desirable for the improvement of important patient outcomes
Nordic walking is similar to Nordic skiing but uses specifically designed poles for walking Nordic walking includes the recruitment of core upper and lower body muscles resulting in greater exergy expenditure while reducing loading stress at the knee joint Regular participation in Nordic walking leads to increased exercise capacity Although data is limited regarding the impact of Nordic walking in comparison to MICT on mental health in patients with CAD some studies in patients with heart failure have shown superior improvements in QoL and fewer depressive symptoms following Nordic walking when compared to MICT Our previous randomized controlled trial simultaneously comparing 12 weeks of supervised HIIT MICT and Nordic walking in patients with CAD showed that Nordic walking was statistically and clinically superior in increasing functional capacity ie distance walked over 6 minutes and have similar effects on QoL and depression when compared to HIIT or MICT
As many adults with cardiovascular disease consider lack of time a barrier to exercise HIIT may be an appealing exercise training paradigm as cardiovascular health benefits can be achieved in less time when compared to MICT HIIT may also address other frequently reported deterrents to MICT including lack of interest and motivation boredom not challenging enough and tailored for older peoples needs To date HIIT used in CR settings has predominantly focused on lower body eg leg cycling There are few HIIT protocols that simultaneously target both upper and lower body such as high-intensity interval Nordic walking HIIT-NoW Studies have shown that HIIT and Nordic walking are feasible enjoyable and have similar or superior effects on physical and mental health when compared to MICT By combining HIIT and Nordic walking HIIT-NoW may offer an alternative time-efficient whole-body exercise to improve physical and mental health of patients with CAD
Current guidelines recommend that persons with CAD who have undergone coronary artery bypass graft surgery CABG or percutaneous coronary intervention PCI participate in exercise-based cardiovascular rehabilitation CR Exercise-based CR is safe effective and a class IA recommendation following CABG and PCI Irrefutable evidence demonstrates that exercise-based CR including moderate-to-vigorous intensity continuous exercise training MICT improves exercise capacity QoL depression and reduces hospital readmissions and cardiovascular morbidity and mortality MICT has long been used to manage the physical and mental health of CAD patients as per the Canadian Guidelines for Cardiovascular Rehabilitation and Cardiovascular Disease Prevention however such exercise may be less efficient and perceived as less motivatingenjoyable Growing evidence suggests that non-conventional exercise interventions such as high-intensity interval training HIIT and Nordic walking are more effective exercise modalities and maybe more enjoyable to improve clinical outcomes eg exercise capacity QoL and depression symptoms in patients with CAD
HIIT repeated bouts of brief high-intensity exercise interspersed with active recovery is an effective and efficient exercise training paradigm A recent meta-analysis n10 studies comparing HIIT and MICT in patients with CAD suggests that 1 HIIT is superior to MICT in improving cardiorespiratory fitness VO2peak of patients with CAD an important clinical vital sign and strong predictor of mortality and 2 HIIT and MICT are equally effective in improving QoL and depression symptoms in patients including CAD Increases in cardiorespiratory fitness decrease mortality risk -- every 35 mlkgmin increase in VO2peak yields a 13 improvement in survival Exercise training-induced increases in cardiorespiratory fitness are therefore highly desirable for the improvement of important patient outcomes
Nordic walking is similar to Nordic skiing but uses specifically designed poles for walking Nordic walking includes the recruitment of core upper and lower body muscles resulting in greater exergy expenditure while reducing loading stress at the knee joint Regular participation in Nordic walking leads to increased exercise capacity Although data is limited regarding the impact of Nordic walking in comparison to MICT on mental health in patients with CAD some studies in patients with heart failure have shown superior improvements in QoL and fewer depressive symptoms following Nordic walking when compared to MICT Our previous randomized controlled trial simultaneously comparing 12 weeks of supervised HIIT MICT and Nordic walking in patients with CAD showed that Nordic walking was statistically and clinically superior in increasing functional capacity ie distance walked over 6 minutes and have similar effects on QoL and depression when compared to HIIT or MICT
As many adults with cardiovascular disease consider lack of time a barrier to exercise HIIT may be an appealing exercise training paradigm as cardiovascular health benefits can be achieved in less time when compared to MICT HIIT may also address other frequently reported deterrents to MICT including lack of interest and motivation boredom not challenging enough and tailored for older peoples needs To date HIIT used in CR settings has predominantly focused on lower body eg leg cycling There are few HIIT protocols that simultaneously target both upper and lower body such as high-intensity interval Nordic walking HIIT-NoW Studies have shown that HIIT and Nordic walking are feasible enjoyable and have similar or superior effects on physical and mental health when compared to MICT By combining HIIT and Nordic walking HIIT-NoW may offer an alternative time-efficient whole-body exercise to improve physical and mental health of patients with CAD
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None