A pragmatiC sTrategy to Promote actIVity and Enhance Quality of Life AFTER Transcatheter Aortic Valve Replacement

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

COMPLETED

Clinical Phase

NA

Total Enrollment

85 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-07

Study Completion Date

2020-03-25

Brief Summary

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This study is being performed in patients who have undergone transcatheter aortic valve replacement (TAVR) for aortic stenosis. The goal is to obtain pilot and feasibility data on a novel post-procedure rehabilitation strategy, including a daily activity goal using a fitness tracking device (Fitbit Alta HR) and in-home resistance training exercises targeting muscles related to activities of daily living. We will evaluate the effect of these interventions on physical performance and several quality of life domains.

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Detailed Description

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The study will be conducted in three phases. Subjects who have been treated commercially with TAVR with a SAPIEN 3 valve and are being discharged to home will be eligible for Phase 1. Once consented prior to discharge, patients will complete the KCCQ, PROMIS Questionnaires, 5m walk, chair stand, and handgrip tests. During phase 1, all subjects will have a Fitbit and answer quality of life questions on the iPad about their activities and quality of life. After 30 days, the subject will return to complete the PROMIS Questionnaires, 5m walk, chair stand, balance tests, and handgrip tests, as well as a KCCQ. If the subject has consistently provided data throughout Phase 1, they will be asked to continue on to Phases 2 and 3 and complete a 6 minute walk test at this baseline visit. For Phase 2, subjects will be randomized to one of two arms. In one arm, they will have a daily activity goal and resistance exercises; in the other arm, there will not be a daily activity goal and no resistance exercises given. After 6 weeks, the subject will return to complete the 5m walk, 6 minute walk test, chair stand, balance tests, and handgrip tests, PROMIS Questionnaires, as well as a KCCQ. Five months after enrollment into Phase 2, subjects will be given a Fitbit to track their daily activity for 1 week (Phase 3). They will also complete a KCCQ, PROMIS Questionnaires, and end of study questionnaire.

Conditions

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Aortic Valve Stenosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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No Resistance Exercise and No Activity Goal Arm

Blinded use of Fitbit with no daily activity goal and no resistance exercises

Group Type ACTIVE_COMPARATOR

Daily Activity Recording

Intervention Type BEHAVIORAL

A Fitbit will be worn by all participants to record daily activity.

Resistance Exercise and Activity Goal Arm

Unblinded use of Fitbit with a daily activity goal (steps per day) and resistance exercises

Group Type EXPERIMENTAL

Daily Activity Goal

Intervention Type BEHAVIORAL

Patients are given a tailored daily activity goal in terms of steps per day for which to aim.

Resistance Exercises

Intervention Type BEHAVIORAL

Patients will instructed to perform 3 different resistance exercises targeting muscles pertinent to activities of daily living on 6 out of 7 days a week.

Daily Activity Recording

Intervention Type BEHAVIORAL

A Fitbit will be worn by all participants to record daily activity.

Interventions

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Daily Activity Goal

Patients are given a tailored daily activity goal in terms of steps per day for which to aim.

Intervention Type BEHAVIORAL

Resistance Exercises

Patients will instructed to perform 3 different resistance exercises targeting muscles pertinent to activities of daily living on 6 out of 7 days a week.

Intervention Type BEHAVIORAL

Daily Activity Recording

A Fitbit will be worn by all participants to record daily activity.

Intervention Type BEHAVIORAL

Other Intervention Names

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Resistance Exercise and Activity Goal Arm Resistance Exercise and Activity Goal Arm

Eligibility Criteria

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Inclusion Criteria

Phase 1 - Starts after the TAVR procedure and prior to discharge • Patients treated commercially with TAVR with a SAPIEN 3 valve

Phases 2 and 3 - Starts at 30 day post-TAVR follow-up visit

• Patients enrolled in Phase 1

Exclusion Criteria

Phase 1 - Starts after the TAVR procedure and prior to discharge

* Stroke during or immediately after the TAVR procedure prior to discharge
* Inability to walk
* Non-English speaking (because the mobile app and CAT questionnaires are only in English)
* Physical or neuropsychiatric limitations that would prevent proficient use of the study tools and successful completion of the physical and quality of life assessments. These limitations may include, but are not limited to: blindness, neuropathy, severe tremor or disabling motor deficit, cognitive impairment (documentation of dementia in the medical record), or illiteracy.
* Unwillingness or inability of the subject to provide informed consent for Phase 1 (no LARs allowed)
* Planned discharge from hospital to skilled nursing or rehabilitation facility

Phases 2 and 3 - Starts at 30 day post-TAVR follow-up visit

* Stroke during Phase 1
* Residing in a skilled nursing facility at the 30 day post-TAVR follow-up visit
* Patients with unreliable use of the iPad mobile app or Fitbit during Phase 1 (e.g. not wearing the Fitbit at least 10 waking hours a day for at least 5 days a week)
* Unwillingness or inability of the subject to provide informed consent for Phases 2/3 (no LARs allowed)

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No