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Project

PRIORITY -PeRsonalIzed remOtely guided preventive exeRcIse therapy for a healThY heart

PRIORITY aims to generate the scientific evidence for the use of remotely guided exercise therapy as an accessible, clinical and cost-effective treatment to prevent the deleterious effects of sedentary aging on the heart and forestall progression towards heart failure (HF). In Belgium, an epidemic of HF exists, with 200 000 HF patients and 40 new cases every day. Mortality approaches 50% within 5 yrs of diagnosis. The best treatment of HF is prevention. Exercise is one of the most efficacious ways to improve health outcome of HF patients stage A-C. Yet, despite a Class I recommendation for exercise, only one third of HF patients stage A-C receives an adequate dose of physical activity. As such, a huge treatment gap exists. Our pilot study in 20 patients showed that a hybrid exercise intervention which combines supervised exercise with remotely guided home-based exercise increases uptake and compliance to properly dosed exercise. A wide-spread utilization strategy is now needed to ensure maximal translation of the results to the benefit of Flemish patients and the health ecosystem. PRIORITY will validate the clinical and cost-effectiveness of our hybrid exercise intervention by means of a multi-center single blind randomized controlled trial in 450 HF patients (i.e. 150 stage A, 150 stage B, 150 stage C). Patients will be randomized (1:1) to usual care or hybrid exercise intervention. Outcomes will be assessed at baseline, 4 months, one and two-years. Primary outcome is the proportion of patients with a clinically relevant improvement in peak oxygen uptake, the most important predictor of premature CV morbidity in this population. Further, big data of physical activity collected during the trial will be used to develop models using machine-learning algorithms which can predict physical activity uptake and changes in fitness to facilitate the creation of more personalized interventions and better tailored exercise prescription.

Date:1 Mar 2021 →  29 Feb 2024
Keywords:Exercise therapy, Cardiovascular Health, Prevention heart failure
Disciplines:Health economy, Exercise physiology, Preventive medicine, Rehabilitation, Physiotherapy
Project type:PhD project