使用基于遥测的生物信号测量设备的心脏康复运动管理对改善慢性心脏病患者运动耐量的影响:日本一项多中心随机对照试验方案(iCARE-MATE研究)
Impact of cardiac rehabilitation exercise management on improving exercise tolerance among patients with chronic heart disease using a telemetry-based biosignal measurement device: protocol for a multicentre randomised controlled trial in Japan (iCARE-MATE study).
作者信息
Yamagishi Junya, Watanabe Takatomo, Matsumoto-Miyazaki Jun, Sahashi Yuki, Watanabe Daichi, Asada Ryuta, Okura Hiroyuki
机构信息
Department of Rehabilitation, Gifu University Hospital, Gifu, Japan.
Department of Cardiology, Gifu University Graduate School of Medicine, Gifu, Japan
出版信息
BMJ Open. 2025 Aug 28;15(8):e098436. doi: 10.1136/bmjopen-2024-098436.
INTRODUCTION
Cardiac rehabilitation (CR) improves the outcomes of patients with chronic heart disease. However, participation in hospital-based programs is limited, partly because of accessibility issues. Notably, most CRs are performed unsupervised at home, making it challenging for healthcare providers and patients to monitor progress accurately or provide tailored feedback. Wearable devices are increasingly used to track physical activity; however, many require smartphone operations, which can be difficult for older adults. The purpose of this study is to evaluate whether a simple telemetry system for activity tracking and feedback could improve exercise tolerance in outpatients with chronic heart disease undergoing unsupervised CR at home.
METHODS AND ANALYSIS
This open-label, multicentre, randomised controlled trial will include 140 patients with cardiovascular diseases aged ≥20 years with percent of peak oxygen uptake (%peak VO2) <80%. Eligible patients will undergo a 2-4-week observation period followed by cardiopulmonary exercise testing. Participants with <3% peak VO2 change over 6 months will be randomised in a 1:1 ratio to either the intervention (device) or control (no device) group. The intervention group will use a wearable device to track daily activities and receive exercise guidance based on these data every 4 weeks. The control group will not use the device or receive feedback. The primary outcome is the 12-week change in peak VO from baseline between the groups.
ETHICS AND DISSEMINATION
This study was designed in accordance with the principles of the Declaration of Helsinki. Gifu University Graduate School of Medicine Ethics Committee approved this study (approval number: 2022-081), and all participants will sign an informed consent form.
TRIAL REGISTRATION
This study has been registered at the Japan Registry of Clinical Trials (jRCT; registration number, 1042220058; URL, https://jrct.mhlw.go.jp/en-latest-detail/jRCT1042220058; date of registration, 26 August 2022).
引言
心脏康复(CR)可改善慢性心脏病患者的预后。然而,参与医院心脏康复项目的人数有限,部分原因是可达性问题。值得注意的是,大多数心脏康复是患者在家中自行进行,缺乏监督,这使得医疗服务提供者和患者难以准确监测进展情况或提供个性化反馈。可穿戴设备越来越多地用于追踪身体活动;然而,许多设备需要智能手机操作,这对老年人来说可能有困难。本研究的目的是评估一种简单的用于活动追踪和反馈的遥测系统是否能改善在家中接受无监督心脏康复的慢性心脏病门诊患者的运动耐量。
方法与分析
这项开放标签、多中心、随机对照试验将纳入140名年龄≥20岁、峰值摄氧量百分比(%peak VO2)<80%的心血管疾病患者。符合条件的患者将接受2 - 4周的观察期,随后进行心肺运动测试。6个月内峰值VO2变化<3%的参与者将按1:1的比例随机分为干预组(使用设备)或对照组(不使用设备)。干预组将使用可穿戴设备追踪日常活动,并每4周根据这些数据接受运动指导。对照组将不使用该设备或接受反馈。主要结局是两组之间12周时峰值VO相对于基线的变化。
伦理与传播
本研究是根据《赫尔辛基宣言》的原则设计的。岐阜大学医学研究生院伦理委员会批准了本研究(批准号:2022 - 081),所有参与者都将签署知情同意书。
试验注册
本研究已在日本临床试验注册中心(jRCT;注册号,1042220058;网址,https://jrct.mhlw.go.jp/en-latest-detail/jRCT1042220058;注册日期,2022年8月26日)注册。