Personalised eHealth intervention to increase physical activity and reduce sedentary behaviour in rehabilitation after cardiac operations: study protocol for the PACO randomised controlled trial (NCT03470246)

• Published in: BMJ Open Sport & Exercise Medicine Vol. 5; no. 1; p. e000539
• Main Authors: Vasankari, Ville, Halonen, Jari, Husu, Pauliina, Vähä-Ypyä, Henri, Tokola, Kari, Suni, Jaana, Sievänen, Harri, Anttila, Vesa, Airaksinen, Juhani, Vasankari, Tommi, Hartikainen, Juha
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 2019; BMJ Publishing Group
• Subjects: Accelerometers; Biomarkers; Cardiovascular disease; Coronary vessels; Evidence-based medicine; Exercise; Heart surgery; Hispanic Americans; Intensive care; Intervention; Laboratories; Mortality; Patients; Physical fitness; Protocol; Quality of life; Rehabilitation; Sedentary behavior; Smartphones; coronary artery disease; rehabilitation; aortic valve replacement; mitral valve repair; aortic valve stenosis; exercise; ehealth; mitral valve regurgitation; coronary artery bypass grafting
• ISSN: 2055-7647; 2055-7647
• DOI: 10.1136/bmjsem-2019-000539

IntroductionPersonalized intervention to increase physical Activity and reduce sedentary behaviour in rehabilitation after Cardiac Operations (PACO) is a smartphone-based and accelerometer-based eHealth intervention to increase physical activity (PA) and reduce sedentary behaviour (SB) among patients recovering from cardiac surgery.DesignProspective randomised controlled trial.Methods and analysisThe present protocol describes a randomised controlled clinical trial to be conducted in the Heart Centres of Kuopio and Turku university hospitals. The trial comprises 540 patients scheduled for elective coronary artery bypass grafting, aortic valve replacement or mitral valve repair. The patients will be randomised into two groups. The control group will receive standard postsurgical rehabilitation guidance. The eHealth intervention group will be given the same guidance together with personalised PA guidance during 90 days after discharge. These patients will receive personalised daily goals to increase PA and reduce SB via the ExSedapplication. Triaxial accelerometers will be exploited to record patients’ daily accumulated PA and SB, and transmit them to the application. Using the accelerometer data, the application will provide online guidance to the patients and feedback of accomplishing their activity goals. The data will also be transmitted to the cloud, where a physiotherapist can monitor individual activity profiles and customise the subsequent PA and SB goals online. The postoperative improvement in patients’ step count, PA, exercise capacity, quality of sleep, laboratory markers, transthoracic echocardiography (TTE) parameters and quality of life, and reduction in SB and incidence of major cardiac events are investigated as outcomes.ConclusionsThe PACO intervention aims to build a personalised eHealth tool for the online tutoring of cardiac surgery patients.Trial registration numberNCT03470246.