European Journal of Physical and Rehabilitation Medicine 2021 Feb 23

DOI: 10.23736/S1973-9087.21.06653-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Long-term exercise effects after cardiac telerehabilitation in patients with coronary artery disease: 1-year follow-up results of the randomized study

Ladislav BATALIK ^{1, 2} ✉, Filip DOSBABA ¹, Martin HARTMAN ¹, Vladimir KONECNY ², Katerina BATALIKOVA ¹, Jindrich SPINAR ³

¹ Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic; ² Non-Government Health Facility, Cardiovascular Rehabilitation, Brno, Czech Republic; ³ First Department of Internal Medicine, Cardioangiology, Institutions shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic

BACKGROUND: Home-based cardiac telerehabilitation (HBCT) is a feasible and effective alternative to traditional center-based cardiac rehabilitation (CBCR). Currently, there are only limited studies focusing on a long-term effect of HBCT, which means it is essential to do more research in this study field.
AIM: This study aimed at investigating a 1-year effect of a randomized controlled study using Cardiac Rehabilitation through the Global Position System (CR-GPS) compared to outpatient cardiac rehabilitation. Study focused on cardiorespiratory fitness (CRF) and health-related quality of life (HRQL) in patients with coronary heart disease (CAD).
DESIGN: A long-term follow-up of a randomized study.
SETTING: Patients were enrolled, and the intervention was performed in an outpatient or homebased model. The results were obtained and evaluated in a hospital.
POPULATION: Patients who participated in the CR-GPS study were diagnosed with CAD with low to moderate cardiovascular risk.
METHODS: Patients enrolled in the study were eligible participants who had previously completed a 12-week HBCT program using a wrist heart rate (HR) monitor or attended a traditional CBCR. Primary outcome was the change in CRF expressed in peak oxygen uptake (pVO2), and the secondary outcomes were self-reported HRQL, objectively measured anthropometric characteristics, and mortality and hospitalization rates.
RESULTS: 44 patients (76%) completed the long-term follow-up. The average peak of pVO2 was higher after 1-year follow-up in the telerehabilitation group (HBCT 25.5 ml / kg / min compared to the active control group CBCR 23.6 ml / kg / min p = 0.047). No statistically significant difference between the two groups was found after long-term follow-up for the parameter HRQL. For both groups, there was a significant improvement in the range of perceptions of general health. There was no death case and no difference in hospitalization rate between the groups.
CONCLUSIONS: This study supports the HBCT model. It has been demonstrated that it induces satisfactory long-term effects in pVO2, exercise performance, and perceived general health in CAD patients with low to moderate cardiovascular risk.
CLINICAL REHABILITATION IMPACT: Cardiovascular telerehabilitation using wrist HR monitors is a feasible and effective rehabilitation method that can help patients eliminate barriers that prevent them from using CBCR programs. Especially in the current global situation with the COVID-19 pandemic, this topic is becoming increasingly important.

KEY WORDS: Cardiac telerehabilitation; Cardiac rehabilitation; Physical exercise; Wrist heart rate monitor; Coronary artery disease; Cardiorespiratory fitness