Feasibility of home-based cardiac rehabilitation using an integrated telerehabilitation platform in elderly patients with heart failure: A pilot study

Kikuchi, Atsushi; Taniguchi, Takao; Nakamoto, Kei; Sera, Fusako; Ohtani, Tomohito; Yamada, Takahisa; Sakata, Yasushi

doi:10.1016/j.jjcc.2021.01.010

Cited by 52 publications

(61 citation statements)

References 32 publications

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“…Most studies which used telerehabilitation as an add-on to center-based CR or an alternative for conventional CR suggested that it was a safe and well tolerated approach for patients ( Kraal et al, 2014 ; Taylor et al, 2015 ; Kikuchi et al, 2021 ). It was also the case in our study since all patients satisfactorily achieved this CR program and no adverse events were reported.…”

Section: Discussionmentioning

confidence: 99%

Effects of Cardiac Telerehabilitation During COVID-19 on Cardiorespiratory Capacities in Patients With Coronary Artery Disease

et al. 2022

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BackgroundThe COVID-19 pandemic led to the closure of most cardiac therapy centers. One of the solutions was to adapt the existing cardiac rehabilitation (CR) program in an institute to a remote approach offered by home-based telerehabilitation. The aim of this study was to measure the cardiorespiratory effects of telerehabilitation compared to conventional center-based CR.MethodsPatients were assigned to two 3-week CR programs: telerehabilitation and conventional center-based CR. The telerehabilitation group wore a connected watch to monitor heart rate (HR) and gave their perception of effort according to a modified Borg scale. The exercise training (four sessions/week) consisted of 1-h aerobic endurance and strength training session at the target HR zone determined by results based on cardiopulmonary exercise test (CPET) and perception of effort, respectively. The exercise protocol was the same for conventional CR participants except the duration of session that lasted 2 h instead of one. The week before and after the training program, peak oxygen uptake (VO2 peak), oxygen uptake at first ventilatory threshold (VO2 at VT1), peak workload, percent of predicted maximum HR, and the absolute differences in HR and systolic blood pressure between maximum and recovery at 1 and 3 min were measured using a CPET. A two-way ANOVA with one repeated measure and one independent factor was performed.ResultsFifty-four patients (mean age: 61.5 ± 8.6 years, 10 women) equally split in the two groups were included in this experiment. A significant increase was observed in both groups on VO2 peak (telerehabilitation: 8.1 ± 7.8% vs. conventional: 10.1 ± 9.7%, p < 0.001), VO2 at VT1 (telerehabilitation: 8.8 ± 4.4% vs. conventional: 7.3 ± 19.0%, p = 0.02) and peak workload (telerehabilitation: 16.6 ± 18.9% vs. conventional: 17.2 ± 7.0%, p < 0.001) after the 3-week telerehabilitation and conventional CR, respectively. No significant difference was noticed between both groups.ConclusionA 3-week exercise program improved patients’ cardiorespiratory fitness. Telerehabilitation was as effective and represents a safe alternative CR program during the COVID-19 period. In the future, this approach could facilitate the continuity of care for patients unable to participate in center-based CR.

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Section: Discussionmentioning

confidence: 99%

Effects of Cardiac Telerehabilitation During COVID-19 on Cardiorespiratory Capacities in Patients With Coronary Artery Disease

et al. 2022

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“…In a recent study, Kikuchi et al reported a real‐time home‐based cardiac rehabilitation session monitored by a video conferencing program installed in a tablet. After assessing the patient's condition via oral history taking, a study coordinator observes the electrocardiogram and vital signs during ergometer exercise (Kikuchi et al, 2021). The current COVID‐19 pandemic has forced many center‐based cardiac rehabilitation programs to end or limit their regular offerings.…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of a telemonitoring‐guided exercise program in patients receiving cardiac resynchronization therapy

Koike

Sobue

Kawai

et al. 2021

Noninvasive Electrocardiol

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Background Telerehabilitation is an alternative clinic‐based rehabilitation. A remote monitoring (RM) system attached to a cardiac rhythm device can collect physiological data and the device function. This study aimed to evaluate the safety and feasibility of telerehabilitation supervised by an RM in patients receiving cardiac resynchronization therapy (CRT). Methods A single group pre–post exercise program was implemented for 3 months in 18 CRT recipients. The exercise regimen consisted of walking a prescribed number of steps based on a 6‐min walk distance (6MWD) achieved at baseline. The patients were asked to exercise 3 to 5 times per week for up to 30 min per session, wearing an accelerometer to document the number of steps taken. The safety was assessed by the heart failure hospitalizations and all‐cause death. The feasibility was measured by the improvement in the quality of life (QOL) using the EuroQol 5 dimensions, and daily active time measured by the CRT, 6MWD, B‐type natriuretic peptide (BNP) level, and left ventricular ejection fraction (LVEF). Results No patients had heart failure hospitalizations or died. No patients had any ventricular tachyarrhythmias. One patient needed to suspend the exercise due to signs of exacerbated heart failure by the RM. Compared to baseline, there were significant improvements in the QOL (−0.037, p < .05), active time (1.12%/day, p < .05), and 6MWD (11 m, p < .001), but not the BNP (–32.4 pg/ml, p = .07) or LVEF (0.28%, p = .55). Conclusions Three months of RM‐guided walking exercise in patients with CRT significantly increased the QOL, active time, and exercise capacity without any adverse effects.

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“…With the development of mobile health and remote monitoring technology, smart systems for disease management have been generally used. A comprehensive support system of cardiac telerehabilitation allows the generation and saving of medical records which enable clinicians to objectively supervise and follow up the changes in patients' situations dynamically [83]. Online platforms connect patients and clinicians over a long distance, enabling patient consultations and health education, and prescription adjustment [23].…”

Section: Support Systems With Artificial Intelligencementioning

confidence: 99%

Mobilizing artificial intelligence to cardiac telerehabilitation

Jin¹,

Zhang²,

Ke³

et al. 2022

Rev. Cardiovasc. Med.

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Cardiac telerehabilitation is a method that uses digital technologies to deliver cardiac rehabilitation from a distance. It has been shown to have benefits to improve patients' disease outcomes and quality of life, and further reduce readmission and adverse cardiac events. The outbreak of the coronavirus pandemic has brought considerable new challenges to cardiac rehabilitation, which foster cardiac telerehabilitation to be broadly applied. This transformation is associated with some difficulties that urgently need some innovations to search for the right path. Artificial intelligence, which has a high level of data mining and interpretation, may provide a potential solution. This review evaluates the current application and limitations of artificial intelligence in cardiac telerehabilitation and offers prospects.

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Feasibility of home-based cardiac rehabilitation using an integrated telerehabilitation platform in elderly patients with heart failure: A pilot study

Cited by 52 publications

References 32 publications

Effects of Cardiac Telerehabilitation During COVID-19 on Cardiorespiratory Capacities in Patients With Coronary Artery Disease

Effects of Cardiac Telerehabilitation During COVID-19 on Cardiorespiratory Capacities in Patients With Coronary Artery Disease

Safety and feasibility of a telemonitoring‐guided exercise program in patients receiving cardiac resynchronization therapy

Mobilizing artificial intelligence to cardiac telerehabilitation

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