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Les maladies cardiovasculaires, et en premier lieu la maladie coronarienne, restent la première cause de mortalité en Suisse. La réadaptation cardiaque intégrée est une intervention multidisciplinaire validée représentant le meilleur moyen de mettre en place une stratégie de prévention cardiovasculaire secondaire efficace pour réduire l'impact des maladies cardiovasculaires. Pourtant, moins de la moitié des patients victimes d'un infarctus du myocarde et une proportion infime de patients atteints d'une insuffisance cardiaque participent à un programme de réadaptation cardiaque dans notre pays. Cet article résume l'état actuel de la réadaptation cardiaque en Suisse ainsi que les futurs développements de téléréadaptation cardiaque qui se sont accélérés dans le contexte de la pandémie de Covid-19. Cardiac rehabilitation : a multidisciplinary program of cardiovascular prevention of essential importanceCardiovascular diseases and especially coronary artery disease remain the first cause of mortality in Switzerland. Comprehensive cardiac rehabilitation is a validated multidisciplinary intervention, which represents the most appropriate strategy of implementing an effective secondary cardiovascular prevention to reduce the impact of cardiovascular diseases. However, less than half of patients after a myocardial infarction and a tiny proportion of patients with heart failure participate in a rehabilitation program in our country. This article summarizes the current state of cardiac rehabilitation in Switzerland, as well as future developments of cardiac tele-rehabilitation that have accelerated due to the COVID-19 pandemic.

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IntroductionThe aim of this study was to evaluate the effectiveness of a real-life clinical physical activity program (DIAfit) on improving physical fitness, body composition, and cardiometabolic health in an unselected population with type 2 diabetes mellitus, and to compare the effects of two variants a different exercise frequencies on the same outcomes.Research design and methodsThis was a cluster randomized-controlled assessor-blind trial conducted in 11 clinical centres in Switzerland. All participants in the clinical program with type 2 diabetes were eligible and were randomized to either standard (3 sessions/week for 12 weeks) or alternative (1 session/week for the first four weeks, then 2 sessions/week for the rest of 16 weeks) physical activity program each consisting of 36 sessions of combined aerobic and resistance exercise. Allocation was concealed by a central office unrelated to the study. The primary outcome was aerobic fitness. Secondary outcome measures included: body composition, BMI, HbA1c, muscle strength, walking speed, balance, flexibility, blood pressure, lipid profile.ResultsAll 185 patients with type 2 diabetes (mean age 59.7 +-10.2 years, 48% women) agreed to participate and were randomized in two groups: a standard group (n=88) and an alternative group (n=97)). There was an 11% increase in aerobic fitness after the program (12.5 Watts; 95% CI 6.76 to 18.25; p<0.001). Significant improvements in physical fitness, body composition, and cardiometabolic parameters were observed at the end of the DIAfit program (improvements between 2-29%) except for lean body mass, triglycerides and cholesterol. No differences were observed between both programs, except for a larger weight reduction of -0.97kg (95% CI -0.04 to -1.91; p=0.04) in the standard program.ConclusionsBoth frequency variants of the nation-wide DIAfit program had beneficial effects on physical fitness, HbA1c, body composition, and blood pressure in type 2 diabetes patients and differences were negligible.Clinical trial registrationclinicaltrials.gov, identifier NCT01289587.

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