Home-based Exercise for Frail Individuals Prior to Cardiac Surgery

Summary

The goal of this quasi-experimental feasibility study is to determine if a home based exercise program, that is supported virtually by a physiotherapist, is feasible for frail adults that are waiting for cardiac surgery. The main questions it aims to answer are:

* Will patients be interested in participating in a virtual home-based exercise program before surgery?
* Is the prescribed program practical? Will participants complete the exercises as prescribed, 3x/week?
* Are the exercise images, videos, and live, virtual sessions with the physiotherapists good enough to allow the participant to be independent with good exercise technique?
* Are the 4 virtual sessions able to be done in the specified time frames (1hr initial assessment, 30 minute follow ups)?
* Can the exercise program be done with out any major adverse events?
* What are the physical activity behaviours of frail participants awaiting cardiac surgery? Do they improve with an exercise program?

Participants will be required to:

* meet with a physiotherapist virtually (Zoom or Microsoft Teams) 4 times over a 3 week period.

1. the first session will be 1 hour to complete an interview about current health and upcoming surgery, a physical assessment, followed by individual exercise demonstration and education.
2. the second and third session will be follow up sessions to review exercise technique and progress, the presence of abnormal responses, provide encouragement and to address any barriers to activity completion.
3. the fourth, final session will be at the end of week 3 and will take 30 minutes to review exercise progress, presence of abnormal responses with activity and complete a reassessment of physical function.
* Complete an individualized exercise program 3x/week independently as instructed by the physiotherapist following the initial assessment.
* Complete a home exercise diary to track exercises done and intensity of exercise, in addition to documenting any abnormal responses

For participants who reside in Winnipeg:

* Accelerometers will be delivered to the patients home to wear for:

1. 7 days prior to the initial assessment
2. 14 days, from day 8 - 21 of the initial assessment.
* Accelerometer diaries will be provided for participants to complete during the days when the accelerometers are worn.

Conditions

• Frailty
• Pre-operative Exercise
• Prehabilitation
• Cardiac Surgery
• Telerehabilitation

Interventions

BEHAVIORAL

Prehabilitation

Everyone will participate in a home-based prehab program with individual video sessions with a physiotherapist at 4 time points over a period of 3 weeks. The initial session will take an hour and consist of a subjective and physical assessment followed by an individualized exercise program demonstration and education. Patients will be instructed to complete the exercises independently 3x/week. The second and third sessions will be 30 minutes in duration and will check in on activity progress, the presence of abnormal responses to exercise, review exercise technique, address barriers and facilitators to activity completion as well as provide support and encouragement for the current level of activity. The final session will take 30 minutes and will review exercise progress, presence of abnormal responses to exercise followed by a reassessment of physical function.

Sponsors & Collaborators

• Dr. Todd A Duhamel

  lead OTHER

Principal Investigators

• Kelly Codispodi, BMR PT · University of Manitoba

• Rakesh Aroroa, MD · University of Manitoba

• Todd Duhamel, PhD · University of Manitoba

Study Design

Allocation

NA

Purpose

TREATMENT

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-07-18

Primary Completion

2024-03-31

Completion

2024-03-31

Countries

• Canada

Study Locations