Heart Failure Exercise And Resistance Training Camp (HEART Camp)
Condition: Heart Failure
MeSH terms: Heart Failure
Study type: Interventional

Summary: 
      The purpose of this feasibility study was to obtain pilot data, as the basis for a future,
      larger investigation, testing the impact of an innovative training camp intervention called
      HEART CAMP (Heart failure Exercise And Resistance Training CAMP) to teach HF patients how to
      exercise and self-manage exercise behavior over time. The study assessed the feasibility and
      adequacy of the intervention, the data collection plan, and the reliability and sensitivity
      of the outcome measures. The 6-month intervention was based on a training camp model to teach
      HF patients how to exercise in a fun, group-oriented atmosphere. Subjects interacted and
      exercised in small groups with an exercise physiologist and nurse to guide activities. The
      dosage of the intervention (frequency and amount of direct guidance from the exercise
      physiologist and nurse) decreased over the 6 months in order to increase subject's
      independence and promote long-term adherence to exercise. The intervention incorporated use
      of computerized data files to monitor exercise behavior, compare exercise performance to
      individualized goals and provide feedback as strategies to foster adherence and
      self-management of exercise behavior.
    

Detailed description: 
      This study uses an experimental repeated measures design with randomized comparison of the
      HEART CAMP intervention group and the attention control group. The purpose of this
      feasibility study is to obtain pilot data, as the basis for a future, larger investigation,
      testing the impact of an innovative 24-week (6-month) training camp intervention (HEART
      CAMP). HEART CAMP is designed to teach heart failure (HF) patients how to exercise (aerobic
      and resistance) and self-manage exercise behavior over time. Patients receiving care at the
      BryanLGH Heart Institute heart failure clinic will be eligible for the study.

      The HEART CAMP intervention is a multi-component intervention derived from Bandura's
      cognitive behavioral theory and consists of specific strategies to build self-efficacy for
      exercise. The subject, under the guidance of an exercise physiologist and nurse, will be
      taught how to exercise (aerobic and resistance). A baseline cardiopulmonary exercise test
      will be completed on all subjects. The first three weeks of HEART CAMP will be held in a
      hospital based cardiac rehabilitation department where subjects will be
      electrocardiographically monitored during the five-day per week training sessions. Training
      sessions will be delivered in cohort groups of eight subjects and will focus on exercise,
      self-evaluation of response to exercise, and group debriefing sessions for problem solving
      and relapse management. Weeks 4 through 12 subjects will complete three aerobic exercise
      sessions in the cardiac rehabilitation maintenance facility and two resistive training
      sessions at home with the exercise physiologist and nurse monitoring subject response and
      delivering group debriefing sessions each week. Weeks 12 through 24 subjects exercise
      independently with the exercise physiologist and nurse monitoring subject exercise data and
      available as needed.

      The attention control group will receive weekly cohort group education sessions during the
      first 3 months similar to the intervention groups' participation in weekly group sessions.
      One week an educational topic will be presented and the subsequent week the cohort group of
      eight subjects will discuss the topic. Six topics will be presented including: Eating Fruits,
      Vegetables, and Grains; Shopping Wisely; Cooking Healthy; Time Management; Communicating
      Assertively; and Learning to Relax.

      Outcome measures will be completed at baseline, 3 weeks, 3 and 6 months (end of study) for
      both groups. Primary outcomes are estimated energy expenditure, self-efficacy to exercise,
      and adherence to exercise. Secondary outcomes are symptoms, biomarker (BNP), physical and
      psychological functioning and quality of life
    

Intervention name(s): Heart Camp Group; Attention Control Group
Intervention type(s): Behavioral; Behavioral
Intervention description(s): In Week 1, 2, and 3 subjects will attend the HEART CAMP. Subjects will set specific exercise goals. Subjects will be taught how to record exercise data on the computer at the exercise facility. Specific activities will teach subjects aerobic and resistance training exercises and build self-efficacy to exercise. During the period from month 3 to the end of study subjects will continue the training program independently and no formal sessions will be scheduled.; Subjects will receive a 60 minute group session led by a specifically designated control group intervention nurse. Phone calls will be placed to the subject if they miss a Friday group session and attendance to meetings will be encouraged.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: heart failure; exercise; adherence to exercise