Activity Counselling Early post-Percutaneous Coronary Intervention: the ACE-PCI trial.

INTERVENTION: Physiotherapist‐led physical activity counselling: Participants that are allocated to the intervention group will receive a once‐only 30‐minute physical activity counselling session from a physiotherapist anytime prior to discharge following their PCI. The average length‐of‐stay in hospital following a PCI has been reported as 1–2 days. This session will be recorded in the patients medical record. Physiotherapists are well‐placed to promote physical activity, with evidence that physiotherapists can counsel effectively for physical activity behaviour change, treating and considering any underlying conditions that may impair someone’s physical capacity to be physically active. Within the counselling session the physiotherapist will provide general physical activity advice, explain the benefits of physical activity, the physical activity guidelines post‐PCI according to the FITT principle (frequency, intensity, time and type), barriers and enablers of physical activity, and safety measures including the warning signs of a heart attack. Exercise‐based cardiac rehabilitation will also be discussed in more detail, outlining that exercise screening will be performed at the start of the program allowing a more individually tailored exercise prescription. The main purpose of this counselling session is to encourage participants to start being physically active immediately after discharge, according to their medical status, recommending light‐to‐moderate physical activity which is gradually progressed and motivating them to attend exercise‐based cardiac rehabilitation. The total duration of the study is 3‐weeks. CONDITION: Cardiovascular ‐ Coronary heart disease coronary heart disease;physical inactivity; ; coronary heart disease ; physical inactivity Public Health ‐ Health promotion/education PRIMARY OUTCOME: Physical activity (min/day). A triaxial commercial accelerometer (ActiGraph GT3X) will be used to objectively assess physical activity. Participants will wear the monitor on their right hip during waking hours for 7‐consecutive days. The triaxial accelerometer captures movement around three axes; vertical (y‐axis), horizontal (x‐axis) and perpendicular (z‐axis). [Baseline and 3‐weeks post‐intervention commencement.] INCLUSION CRITERIA: Eligible participants will be aged greater than or equal to 18 years and included if they have stable coronary heart disease and received a PCI +/‐ myocardial infarction. Eligible participants must have adequate English language and cognitive skills. Nursing staff will use clinical judgement to determine if potential participants have adequate language and cognitive skills. SECONDARY OUTCOME: Anxiety. The Hospital Anxiety and Depression Scale will be used for the assessment of anxiety. This questionnaire is a 14‐item self‐reporting questionnaire comprised of 4‐point Likert‐scaled items covering the occurrence of symptoms of anxiety (HADS‐A) over the past 2 weeks.[Baseline and 3‐weeks post‐intervention commencement. .] Depression. The Hospital Anxiety and Depression Scale will be used for the assessment of depression. This questionnaire is a 14‐item self‐reporting questionnaire comprised of 4‐point Likert‐scaled items covering the occurrence of symptoms of depression (HADS‐D) over the past 2 weeks.[Baseline and 3‐weeks post‐intervention commencement..] Quality‐of‐life, The MacNew Heart Disease Health‐related Quality of Life Questionnaire (MacNew) will be used for the assessment of heart disease specific health‐related quality of life. The MacNew is self‐administered and consists of 27 items which fall into three domains (a 13‐item physical limitations domain scale, a 14‐item emotional function domain scale, and a 13‐item social function domain scale). There are 5 items that inquire about symptoms: angina/chest pain, shortness of breath, fatigue, dizziness, and aching legs. The time frame for the MacNew is the previous two weeks, and it has good reliability and validity internationally.[Baseline and 3‐weeks post‐intervention commencement..] Sedentary behaviour (min/day). A triaxial commercial accelerometer (ActiGraph GT3X) will be used to objectively assess sedentary behaviour. Participants will wear the monitor on their right hip during waking hours for 7‐consecutive days. The triaxial accelerometer captures movement around three axes; vertical (y‐axis), horizontal (x‐axis) and perpendicular (z‐axis). [Baseline and 3‐weeks post‐intervention commencement..]