Exergaming i hemmet- vårt nästa steg för förbättrad fysisk aktivitet hos hjärtsviktspatienter. En randomiserad multicenterstudie.

Background:

The number of heart failure patients is increasing, and patients are living longer at home. As part of the medical treatment patients are advised to be physically active. Even a 10-minute decrease in sedentary time could have beneficial effects for a growing group of inactive patients with heart failure.

However, less than half of the patients are regularly physically active, due to lack of motivation, symptoms or practical issues. Home based interventions to increase physical activity for patients with HF are needed. The use of exergames (games to improve physical activity) is promising for people who are home bound and physically inactive.

In the recent COVID-19 pandemic it became even more clear that getting help to be active at home is important. Our group used previous results in exergaming to design a gaming activity that is attractive, tailored to preferences and to capacity. Goal:

The overall purpose is to determine the effect of tailored exergaming for inactive patients with heart failure to reduce their sedentary time, improve their daily physical activity, exercise capacity, decrease frailty and improve health-related quality of life and well-being. Method:

After a pilot study we will conduct a multicentre, randomised controlled study including 600 inactive patients with symptomatic heart failure (NYHA II-IV). Patients will be randomised into activity advice (control) or the Heart-Exergame intervention. In the Heart-Exergame intervention patients will receive an exergame, get feedback and tailoring of the gaming advice.

The active intervention will lasts 3 months. Patients will also be able to play with a person in their own network or to play virtually with a volunteer from our exergame group of the Heart and Lung patient organisation.

Main study parameters/endpoints: Primary endpoint is decrease in sedentary time at 3 months, measured by objective accelerometer. To achieve a power to detect a clinically significant difference in reduction of sedentary time, 80% power, 5% significance, and to anticipate drop out, 300 patients in both groups are needed. Secondary outcomes are exercise capacity (six-minute walking test). We also will measure frailty and quality of life and ask patients how they experienced playing an exergame.

Significance:

This study will gain an insight into the effects of using a serious game application that is easily applicable and affordable to increase physical activity in patients with heart failure.