Reducing Sedentary Time in Patients with Heart Failure (ReST-HF)

项目总结 心力衰竭(HF)主要是一种衰老综合征，会导致功能衰退和残疾。 基于证据的策略，帮助有身体残疾风险的心力衰竭老年人保持身体健康 积极和独立是非常需要的。联合委员会最近包括活动评估和 建议作为HF门诊项目获得高级认证的过程措施， 强调体力活动对所有心力衰竭患者的重要性。目前，几乎没有证据表明 如何帮助患有心力衰竭的老年人增加活动量。国家提供的教材 组织(美国心脏协会和美国心力衰竭协会)的目标是年轻和 更健壮的心力衰竭患者，他们可以比年长、虚弱的心力衰竭患者进行更大强度的运动。重塑 相反，锻炼建议专注于减少久坐行为可能更容易实现 对于患有心力衰竭的老年人来说是可持续的。我们假设，专注于减少久坐的策略 行为将比促进一个锻炼计划更有效。在这项研究中，我们将确定心力衰竭患者 将72名患者随机分为减少久坐行为计划和 增加锻炼的标准计划。在两个小组中使用激励性面试技巧，我们将 帮助患者认识到自己的潜力和设定目标。患者将使用 Active PAL：监视器，这是一项新技术，可以量化每天的久坐时间和步数。病人将会是 监测12周，并接受2次教育和目标设定会议。干预组 将强调久坐行为的改变，并从活动PAL监视器获得反馈。对照组 将重点关注他/她的锻炼日记中的标准锻炼建议和反馈。结果包括 久坐时间的变化，步数/天，心力衰竭特定健康状况指标的变化，堪萨斯城 心肌病问卷和计时起跑。预期结果包括重大变化 干预组与对照组相比：久坐时间减少，每天步数增加， 堪萨斯城心肌病问卷得分和起身时间的减少。这个 这项研究的结果将为设计更大规模的随机对照试验以研究 减少久坐行为和/或增加运动对残疾、跌倒和身体质量的影响 对于患有心力衰竭的老年人来说，这是一种生活方式。如果这项研究的结果是积极的，它有可能改变 促进老年心力衰竭患者体力活动和行为改变的方法。

PROJECT SUMMARY Heart Failure (HF) is primarily a syndrome of aging and contributes to functional decline and disability. Evidence based strategies to help older adults with HF who are at risk for physical disability stay physically active and independent are greatly needed. The Joint Commission recently included Activity Assessment and Recommendations as a process measure for HF outpatient programs to gain Advanced Certification, highlighting the importance of physical activity in all patients with HF. Currently, there is little evidence to direct how to help older adults with HF increase their activity. The teaching materials provided by national organizations (American Heart Association and Heart Failure Society of America) are aimed at younger and more robust HF patients who can exercise at a greater intensity than older, frail adults with HF. Reframing exercise recommendations to instead concentrate on reducing sedentary behavior may be more achievable and sustainable for older adults with HF. We hypothesize that strategies that focus on decreasing sedentary behavior will be more effective then promoting a program of exercise. In this study, we will identify HF patients at risk for physical disability and randomize 72 patients to either a program to decrease sedentary behavior vs. a standard program to increase exercise. Using motivational interviewing techniques in both groups we will assist the patients in recognizing their potential and goal-setting. Patients will be monitored using the ActivPAL:monitor, a new technology that quantifies sedentary time and steps per day. Patients will be monitored for 12 weeks and receive 2 educational and goal setting sessions. Those in the intervention group will have sedentary behavior change emphasized and feedback from the ActivPAL monitor. The control group will focus on standard exercise recommendations and feedback from his/her exercise diary. Outcomes include change in sedentary time, steps/day, change in the HF specific health status measure, the Kansas City Cardiomyopathy Questionnaire and the Timed Get Up and Go. Anticipated results include a significant change in the intervention group vs the control: a decrease in sedentary time, an increase in steps/day, an increase in the Kansas City Cardiomyopathy Questionnaire scores and a decrease in the Timed Get Up and Go. The results of this study will provide the basis for designing a larger randomized controlled trial to investigate the effects of an intervention to reduce sedentary behavior and/or increase exercise on disability, falls and quality of life for older adults with HF. If the results from this study are positive, it has the potential to change the approach to promotion of physical activity and behavior change for older adults with HF.