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Trial registered on ANZCTR
Registration number
ACTRN12622000875707
Ethics application status
Approved
Date submitted
7/06/2022
Date registered
21/06/2022
Date last updated
29/09/2024
Date data sharing statement initially provided
21/06/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Cardiac rehabilitation in regional areas: developing a predictive model to determine exercise thresholds
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Scientific title
Cardiac rehabilitation in regional areas: developing a predictive model to determine ventilatory thresholds from common field testing approaches
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Secondary ID [1]
307250
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cardiovascular health
326502
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Condition category
Condition code
Cardiovascular
323765
323765
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will attend a total of three (3) laboratory visits, separated by a minimum of 48 hours, to complete cardiorespiratory fitness assessment. The first two (2) visits are estimated to take approximately 60 minutes total with participants completing two (2) of four (4) randomly assigned field tests to assess cardiorespiratory fitness (two exercise tests in each session). The field tests include the 6 minute walk test, with participants required to walk as far as possible in 6 minutes, in a self-paced and standardized testing procedure. The incremental shuttle walk test, an externally paced walking test with increasing speed required to complete subsequent shuttle levels. The test is terminated when participants reach 85% of their age predicted heart rate maximum. The Astrand Rhyming submaximal cycle, a 6 minute cycle test designed to be completed at a sub-maximal intensity (less than 85% age-predicted heart rate maximum) with estimation of cardiorespiratory fitness based on work rate and heart rate response. Chester Step Test is an externally paced (metronome) step test with progression in intensity elicited every 2 minutes with an increase in speed. During all field test heart rate and visual analogue scales (dyspnea and rating of perceived exertion) will be recorded. The third laboratory visit (expected to take approximately 40 minutes) will involve an additional sub-maximal field test, the 30 second sit to stand. Participants are required to complete as many repetitions of unassisted sit and stand from a chair in 30 seconds. Finally participants will complete a symptom-limited cardiopulmonary exercise test (CPET) on a cycle ergometer, consisting of a ramp protocol and supervised by an Accredited Exercise Physiologist (AEP).
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Intervention code [1]
323689
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Lifestyle
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Comparator / control treatment
Randomized cross-over design with no non-exercise control group. Field testing variables will be compared to symptom-limited cardiopulmonary exercise test (CPET). CPET is anticipated to take 15-20 minutes to complete.
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Control group
Active
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Outcomes
Primary outcome [1]
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Assess validity of 6 minute walk test to determine VO2 peak and ventilatory anaerobic threshold in comparison to symptom-limited CPET conducted via ramp protocol on cycle ergometer
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Assessment method [1]
331559
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Timepoint [1]
331559
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Baseline testing following recruitment and screening
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Primary outcome [2]
331737
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Assess validity of the incremental shuttle walk test to determine VO2 peak and ventilatory anaerobic threshold in comparison to symptom-limited CPET conducted via ramp protocol on cycle ergometer
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Assessment method [2]
331737
0
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Timepoint [2]
331737
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Baseline testing following recruitment and screening
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Primary outcome [3]
331738
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Assess validity of the Astrand Rhyming cycle test to determine VO2 peak and ventilatory anaerobic threshold in comparison to symptom-limited CPET conducted via ramp protocol on cycle ergometer
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Assessment method [3]
331738
0
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Timepoint [3]
331738
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Baseline testing following recruitment and screening
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Secondary outcome [1]
410791
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Assess validity of the Chester Step test to determine VO2 peak and ventilatory anaerobic threshold in comparison to symptom-limited CPET conducted via ramp protocol on cycle ergometer (primary outcome)
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Assessment method [1]
410791
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Timepoint [1]
410791
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Baseline testing following recruitment and screening
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Eligibility
Key inclusion criteria
Able to understand and respond to spoken English
Aged 18 years and older
Diagnosed with cardiovascular disease
Exiting out-patient cardiac rehabilitation program
Available to meet the time commitments
Physically able to complete testing
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Diagnosed with heart failure or hypertrophic myopathy
Heart transplant participants
Unstable angina or myocardial infarction in the previous month
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Concealed allocation with the researcher responsible for participant screening blinded from testing order and group allocation
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomization of testing sequence using computer generated random numbers
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
A random model multiple linear regression was used to estimate sample size with H1 (0.69) based on previous outcomes (R2 = 0.71), H0 = 0.4, alpha of 0.05 and 95% power with 4 predictors (exercise time/distance/speed/repetitions, HR, RPE, body mass). Results indicate 70 participants will be required for adequate power. Ventilatory anaerobic threshold will be identified using ventilatory equivalents and V-slope method. Comparison between CPET and field based data include using paired samples t-test, level of agreement determined through Bland-Altman analysis and Pearson’s product-moment correlation coefficient r with 95% confidence intervals.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
18/08/2022
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Actual
18/09/2022
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Date of last participant enrolment
Anticipated
30/09/2024
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Actual
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Date of last data collection
Anticipated
30/09/2024
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Actual
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Sample size
Target
70
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Accrual to date
50
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
22472
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Bendigo Health Care Group - Bendigo Hospital - Bendigo
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Recruitment hospital [2]
22473
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St John of God Hospital - Bendigo - Bendigo
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Recruitment postcode(s) [1]
37706
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3550 - Bendigo
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Recruitment postcode(s) [2]
37746
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3450 - Castlemaine
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Recruitment postcode(s) [3]
37747
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3551 - Axedale
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Recruitment postcode(s) [4]
37748
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3463 - Maldon
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Holsworth Research Initiative
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Address [1]
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La Trobe University
Edwards Road, Flora Hill
Victoria 3550
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Country [1]
311546
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Australia
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Primary sponsor type
University
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Name
La Trobe University
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Address
La Trobe University
Edwards Road
Flora Hill, VIC, 3550
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Bendigo Health
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Address [1]
312961
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100 Bernard Street,
Bendigo, VIC, 3550
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Country [1]
312961
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310999
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Bendigo Health HREC
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Ethics committee address [1]
310999
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100 Bernard Street, Bendigo, VIC, 3550
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Ethics committee country [1]
310999
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Australia
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Date submitted for ethics approval [1]
310999
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23/12/2021
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Approval date [1]
310999
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01/07/2022
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Ethics approval number [1]
310999
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81083
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Summary
Brief summary
Exercise training has conventionally been considered a key factor in the multi-disciplinary approach to cardiac rehabilitation. However, recent systematic review and meta-analyses have reported a reduced effectiveness, particularly in regional areas with limited resources for exercising testing and delivery. More specifically, exercise training at a workload corresponding to the ventilatory anaerobic threshold has previously demonstrated significant improvements in cardiovascular health outcomes. However identifying such workloads requires specialized equipment including cardiopulmonary testing. Therefore, the proposed project is designed to identify submaximal field tests that can be used to prescribe exercise workloads at an individual’s ventilatory anaerobic threshold without the need for specialized equipment or expertise. It is hypothesized that the addition of participant heart rate and rating of perceived exertion will improve the accuracy of linear regression models based on field test protocols.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Blake Collins
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Address
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La Trobe University
Edwards Road, Flora Hill
Bendigo, VIC, 3550
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Country
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Australia
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Phone
119642
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+61 3 5444 7144
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Fax
119642
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Email
119642
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[email protected]
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Contact person for public queries
Name
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Blake Collins
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Address
119643
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La Trobe University
Edwards Road, Flora Hill
Bendigo, VIC, 3550
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Country
119643
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Australia
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Phone
119643
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+61 3 5444 7144
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Fax
119643
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Email
119643
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[email protected]
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Contact person for scientific queries
Name
119644
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Blake Collins
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Address
119644
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La Trobe University
Edwards Road, Flora Hill
Bendigo, VIC, 3550
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Country
119644
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Australia
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Phone
119644
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+61 3 5444 7144
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Fax
119644
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Email
119644
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Non-identifiable participant demographic data , pre- and post-data and training intervention data will be made available
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When will data be available (start and end dates)?
Within 12-months of publication with no end-date
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Available to whom?
Data will be made publicly available, members of the public and those within research communities will have access to both published and unpublished data which will not be identifiable.
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Available for what types of analyses?
Any purpose. There is potential for follow-up research including re-analyses, systematic review and meta analyses however this will not be apparent until the data is collected and analyses
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How or where can data be obtained?
Published on OPAL (La Trobe institutional repository): https://opal.latrobe.edu.au
Or made available to researchers upon reasonable request with contact directed to
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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