Effects of 6-Week Home-based Online-Supervised Exercise Program (HOSEP) on Frailty in People after percutaneous Coronary Intervention: A Randomized Controlled Trial

Guilin Zhao, Kunli Jiao, Tingting Zhang, Jia Han, Shu Meng, Wenqing Xu, Jiajia Li, Jianhua Yan
Purpose:

To investigate whether a 6-week HOSEP is effective in reducing frailty in people after PCI.

Methods:

Eighty people completed the 6-minute walking test and 30-s sit-to-stand test for an exercise program at the baseline, which included walking for 30-60 mins, and STS exercise for 2-3 sets every day, with scoring at 4-5 on RPE 0-10 or at 60-80% of maximum heart rate calculated for intensity. The exercise program was given to all participants before discharge, and then participants were randomly allocated into a control group (CG) and a supervision group (SG). SG had additional online supervision to complete their exercise program. Frailty was assessed at the baseline and re-assessed after 6-weeks, using the essential frailty toolset (EFT), which is scored 0-5 points as a function of time to complete five times sit-to-stand (2 points if unable to complete, 1 point if 15 seconds), Mini-Mental Status Examination score (1 point if 24), hemoglobin (1 point if 13.0 g/dL in men or 12.0 g/dL in women), and serum albumin (1 point if 3.5 g/dL). Participants were classified into 1 of 3 frailty status groups: robust (EFT score of 0), prefrail (EFT score of 1-2), or frail (EFT score of 3-5). All participants were treated with dual antiplatelet therapy, β-Blocker, and Stain. The intragroup comparison was conducted via paired-sample t-test. The intergroup comparison and the intragroup changes in EFT score (baseline EFT score minus 6-week EFT score) were analyzed using the independent-sample t-test. 

Results:

After the 6-week follow-up, three participants in SG and one in CG dropped out due to family reasons. There were no adverse events reported during the intervention period. There were no significant intergroup differences in the demographic (for SG, male: female=27:11; age=65.38.7; BMI=24.63.5; for CG: male: female=29:10; age=67.77.6; BMI=24.62.8) and the mean EFT score (SG: 0.59 0.76, CG: 0.54  0.76, p=0.75). After 6 weeks intervention, the intragroup comparison in SG showed EFT scores decreased significantly (p0.01), and no significant change in CG (p=0.60). In addition, after intervention the percentage of prefrail and frail participants dropped significantly from 44.7% to 12.2% for the SG, while this figure increased slightly for the CG (41% to 48.7%). 

Conclusion(s):

This randomized controlled study demonstrated that the 6-week HOSEP was safe and clinically effective in reducing frailty for people after PCI.

Implications:

Combined aerobic and resistance training is needed to improve frailty in people after PCI.

Funding acknowledgements:
Supported by the 2021 Curriculum Construction Project of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine.
Keywords:
home-based exercise
percutaneous coronary intervention
frailty
Primary topic:
Cardiorespiratory
Second topic:
Health promotion and wellbeing/healthy ageing/physical activity
Third topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Human Subjects Committee of Xinhua Hospital Affiliated to Shanghai Jiao Tong University school of Medicine.
Provide the ethics approval number:
No. XHEC-C-2020-078-1
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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