Novel Strategies to Improve Cardiometabolic Status and Adherence to Exercise Regimens in Patients at High Risk for Cardiovascular Disease

NCT ID: NCT03103854

Last Updated: 2018-07-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-01

Study Completion Date

2019-12-31

Brief Summary

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This is a 2x2 study examining the impacts of a novel exercise regimen and daily text message reminders in patients at high risk for cardiovascular disease. Patients participating in cardiac rehabilitation will be randomized to either moderate intensity continuous training (MICT) or a novel exercise regimen consisting of three periods of high intensity exercise, called BURST exercise. Additionally, half of the patients in each exercise group will be randomized to receive daily text message reminders to improve adherence to the prescribed exercise regimen.

Detailed Description

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Numerous studies have demonstrated the important cardiometabolic impacts of high intensity exercise in patients at high risk for cardiovascular disease. It is also known that adherence to exercise regimens is poor within these populations. This study compares the impacts of the current standard of care, moderate intensity continuous training (MICT) to a novel exercise regimen called BURST exercise within a population of patients at high risk for cardiovascular disease. BURST exercise consists of three periods of high intensity physical activity spread throughout the day. Additionally, as mobile technologies continue to be used more to improve adherence to exercise regimens, this study also seeks to compare the impacts of text message reminders in patients prescribed each of the exercise regimens examined in this study. Thus, patients were also randomized to either receive daily text message reminders, or to receive no text message reminders.

Recruitment will be conducted at Cambridge Cardiac Rehab in Ontario, Canada. Potential study subjects are evaluated for inclusion and exclusion criteria, give written informed consent, and are randomized, in a 1:1 ratio, to either MICT or BURST exercise. Additionally, patients are then randomized in a 1:1 ratio to either receive text message reminders or not receive text message reminders.

Patients prescribed the MICT regimen will be asked to exercise for 30 minutes per day at moderate intensity, at least five days per week. Patients prescribed the BURST exercise regimen will be asked to exercise for 10 minutes per session, three times a day at high intensity, at least five days per week. Patients randomized to receive text message reminders will be sent four daily text message reminders reading: "Please remember to exercise for 30 minutes today."

Adherence to exercise regimens will be measured by daily logbooks. Patients are asked to log the times they exercised and for what duration. BRUCE protocol stress tests will be conducted for all patients at baseline (before beginning the study), after three months and after one year. Hemoglobin A1C blood tests, height and weight measurements and lipid profile blood tests will also be conducted at baseline (before the beginning of the study), after three months and after one year.

Conditions

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Diabetes Mellitus, Type 2 Myocardial Infarction Coronary Artery Disease Atrial Fibrillation Congestive Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

This is a 2x2 of burst physical activity (BURST) vs moderate intensity continuous training (MICT) and text message reminders vs no text message reminders. Patients will be randomized to either BURST or MICT and then further randomized to either receive text message reminders or not receive text message reminders.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Control

Patients in the "Control" arm of the study performed Moderate Intensity Continuous Training (MICT) and did not receive text message reminders.

Group Type ACTIVE_COMPARATOR

Moderate Intensity Continuous Training

Intervention Type BEHAVIORAL

This is the current standard of care for cardiac rehabilitation patients. It consists of 1 daily period of 30 minutes of moderate intensity physical activity.

BURST

Patients in the "BURST" arm of the study performed BURST physical activity and did not receive text message reminders

Group Type EXPERIMENTAL

BURST physical activity

Intervention Type BEHAVIORAL

BURST is a novel exercise regimen consisting of three daily periods of 10 minutes of high intensity physical activity spread throughout the day.

Text Message Reminders

Patients in the "Text Message Reminders" arm of the study performed Moderate Intensity Continuous Training and received text message reminders.

Group Type EXPERIMENTAL

Text Message Reminders

Intervention Type BEHAVIORAL

Patients were sent daily text message reminders to remind them to exercise.

Moderate Intensity Continuous Training

Intervention Type BEHAVIORAL

This is the current standard of care for cardiac rehabilitation patients. It consists of 1 daily period of 30 minutes of moderate intensity physical activity.

BURST and Text Message Reminders

Patients in the "BURST and Text Message Reminders" arm of the study performed Burst physical activity and received text message reminders

Group Type EXPERIMENTAL

BURST physical activity

Intervention Type BEHAVIORAL

BURST is a novel exercise regimen consisting of three daily periods of 10 minutes of high intensity physical activity spread throughout the day.

Text Message Reminders

Intervention Type BEHAVIORAL

Patients were sent daily text message reminders to remind them to exercise.

Interventions

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BURST physical activity

BURST is a novel exercise regimen consisting of three daily periods of 10 minutes of high intensity physical activity spread throughout the day.

Intervention Type BEHAVIORAL

Text Message Reminders

Patients were sent daily text message reminders to remind them to exercise.

Intervention Type BEHAVIORAL

Moderate Intensity Continuous Training

This is the current standard of care for cardiac rehabilitation patients. It consists of 1 daily period of 30 minutes of moderate intensity physical activity.

Intervention Type BEHAVIORAL

Other Intervention Names

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Exercise Snacks MICT

Eligibility Criteria

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Inclusion Criteria

* Newly diagnosed type 2 diabetic patients (within the last 3 months)
* Participating in on-site the diabetes rehabilitation program at Cambridge Cardiac Rehab
* Deemed capable of high-intensity exercise

Exclusion Criteria

* Known or suspected cardiovascular disease
* Diabetic end-organ damage
* Cerebrovascular disease
* Peripheral vascular disease
* Arthritis
* Joint disease
* Taking anti-glycemic medications
* Taking lipid lowering medications
* Ischemia, hypoxia, arrhythmia or hemodynamic instability during a stress test
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cambridge Cardiac Care Centre

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Avinash Pandey

Role: PRINCIPAL_INVESTIGATOR

Western University, Canada

Locations

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Cambridge Cardiac Rehab

Cambridge, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Avinash Pandey

Role: CONTACT

2267502167

A. Shekhar Pandey, BSc, MD

Role: CONTACT

5195906127

Facility Contacts

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A. Shekhar Pandey, BSc, MD

Role: primary

5195906127

M. Michelle Pandey, B Pharm

Role: backup

(519) 624-3511

References

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Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008 Feb 7;358(6):580-91. doi: 10.1056/NEJMoa0706245.

Reference Type BACKGROUND
PMID: 18256393 (View on PubMed)

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. doi: 10.1056/NEJMoa012512.

Reference Type BACKGROUND
PMID: 11832527 (View on PubMed)

Armstrong MJ, Sigal RJ, Arena R, Hauer TL, Austford LD, Aggarwal S, Stone JA, Martin BJ. Cardiac rehabilitation completion is associated with reduced mortality in patients with diabetes and coronary artery disease. Diabetologia. 2015 Apr;58(4):691-8. doi: 10.1007/s00125-015-3491-1. Epub 2015 Jan 26.

Reference Type BACKGROUND
PMID: 25742772 (View on PubMed)

Francois ME, Little JP. Effectiveness and safety of high-intensity interval training in patients with type 2 diabetes. Diabetes Spectr. 2015 Jan;28(1):39-44. doi: 10.2337/diaspect.28.1.39.

Reference Type BACKGROUND
PMID: 25717277 (View on PubMed)

Thakkar J, Kurup R, Laba TL, Santo K, Thiagalingam A, Rodgers A, Woodward M, Redfern J, Chow CK. Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease: A Meta-analysis. JAMA Intern Med. 2016 Mar;176(3):340-9. doi: 10.1001/jamainternmed.2015.7667.

Reference Type BACKGROUND
PMID: 26831740 (View on PubMed)

Other Identifiers

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CCCBE1418

Identifier Type: -

Identifier Source: org_study_id

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