Brief Title
A pragmatiC sTrategy to Promote actIVity and Enhance Quality of Life AFTER Transcatheter Aortic Valve Replacement
Official Title
A pragmatiC sTrategy to Promote actIVity and Enhance Quality of Life AFTER Transcatheter Aortic Valve Replacement (ACTIVE AFTER TAVR): A Pilot Study
Brief Summary
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.
Detailed Description
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.
Study Type
Interventional
Primary Outcome
Average Daily Steps
Secondary Outcome
5 meter gait time at the end of the intervention period
Condition
Aortic Valve Stenosis
Intervention
Daily Activity Goal
Study Arms / Comparison Groups
No Resistance Exercise and No Activity Goal Arm
Description: Blinded use of Fitbit with no daily activity goal and no resistance exercises
Publications
* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
Recruitment Information
Recruitment Status
Behavioral
Estimated Enrollment
85
Start Date
November 7, 2017
Completion Date
March 25, 2020
Primary Completion Date
March 24, 2020
Eligibility Criteria
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 - All exclusion criteria from Phase 1 apply - 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)
Gender
All
Ages
18 Years - N/A
Accepts Healthy Volunteers
No
Contacts
Brian R Lindman, MD, ,
Location Countries
United States
Location Countries
United States
Administrative Informations
NCT ID
NCT03270124
Organization ID
ACTIVE AFTER TAVR
Responsible Party
Principal Investigator
Study Sponsor
Vanderbilt University Medical Center
Collaborators
Edwards Lifesciences
Study Sponsor
Brian R Lindman, MD, Principal Investigator, Vanderbilt University Medical Center
Verification Date
October 2020