Supervised Exercise Compared to PAP in Patients With Permanent Atrial Fibrillation
Condition: Atrial Fibrillation
MeSH terms: Atrial Fibrillation
Study type: Interventional

Summary: 
      Atrial fibrillation is the most common arrhythmia, and physical activity and exercise are
      sometimes avoided due to symptoms such as palpitations, fatigue and anxiety.
      Physiotherapist-led group based exercise as part of cardiac rehabilitation is rare for this
      group of patients, the method physical activity on prescription is used to encourage the
      patient to increase their physical activity level in order to reduce the risk of premature
      morbidity and mortality. However, mostly in this method you do not know the patient's ability
      to perform the prescribed amount of physical activity, and its effect on physical fitness has
      not been studied in patients with heart disease, neither has the effect of physiotherapist
      led group-based exercise in patients with atrial fibrillation. The aim was to investigate the
      impact of physiotherapy led group-based exercise compared to physical activity on
      prescription in patients with atrial fibrillation regarding the level of physical fitness,
      physical activity, heart rate and health related quality of life (HR-QoL).
    

Detailed description: 
      Ninety consecutive patients aged 65-85 years, visiting the cardiology clinic at Alingsås
      Hospital, Sahlgrenska University Hospital and primary care in the western part of Sweden will
      be asked to participate in the study. Inclusion criteria are permanent atrial fibrillation
      verified with electrocardiogram (ECG), left ventricular ejection fraction (EF) ≥ 45% and no
      significant valvular lesions verified by ultrasound. Exclusion criteria: Coronary event or
      angina pectoris within 3 months prior to inclusion, stroke with residual symptoms, presence
      of pacemaker or not able to participate in functional tests due to other disabilities, or to
      read Swedish. Physical fitness will be measured by a symptom limited bicycle test and a
      muscle endurance test. Physical activity will be measured by accelerometer and the
      International Physical Activity Questionnaire (IPAQ),HR-QoL will be measured by Short form
      (SF-36).

      After the tests and return of accelerometer the patients will be randomized either to
      physiotherapist led group-based exercise or motivated interviewing and physical activity on
      prescription (PAP). The group-based exercise program consists of 60-minute sessions twice a
      week for 3 months, including central circulatory exercise performed on an ergometer cycle and
      muscle training, and two occasions of home-based exercise. The exercise program are designed
      after the patients requirements and with the intensity 13-17 on the Borg RPE 6-20 scale. The
      patients randomized to PAP will receive a PAP prescription and a physical activity diary. The
      PAP and physical activity diary will be followed up at 6 and 12 weeks after the inclusion.
      After three months all patients will perform the same tests as in baseline. A written
      informed consent will be obtained by the patients.
    

Intervention name(s): Exercise; Physical activity
Intervention type(s): Other; Other
Intervention description(s): The group-based exercise program consists of 60-minute sessions twice a week for 3 months, including central circulatory exercise performed on an ergometer cycle and muscle training, and one or two occasions of home-based exercise. The exercise program are designed after the patients requirements and with the intensity 13-17 on the Borg RPE 6-20 scale; The patients randomized PAP will receive a PAP prescription and a physical activity diary. The PAP and physical activity diary will be followed up at 6 and 12 weeks after the inclusion.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Physiotherapist led group-based exercise; Physical activity; Atrial fibrillation