Hybrid comprehensive telerehabilitation in heart failure patients (TELEREH-HF): A randomized, multicenter, prospective, open-label, parallel group controlled trial—Study design and description of the intervention

Piotrowicz, Ewa; Piotrowicz, Ryszard; Opolski, Grzegorz; Pencina, Michael J.; Banach, Maciej; Zaręba, Wojciech

doi:10.1016/j.ahj.2019.08.015

Cited by 41 publications

(94 citation statements)

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“…Initial psychological assessment and consultation, along with clinical evaluation, allowed Table I. TELEREH-HF inclusion and exclusion criteria [22,23]…”

Section: Assessment Of Health-related Qolmentioning

confidence: 99%

“…Table II. TELEREH-HF methods -telerehabilitation set, telesupervised exercise training, education [22,23] Telerehabilitation set The EHO mini device was able to record ECG and transmit them via a mobile phone network to the monitoring center. An EHO mini device has training sessions preprogrammed for each patient (defined exercise duration, breaks, timing of ECG recording).…”

Section: Esc -European Society Of Cardiology Lvef -Left Ventricular mentioning

confidence: 99%

“…The planned training sessions were executed with the device indicating what needed to be done with sound (bleeps) and light signals (colors emitting diodes). The timing of automatic ECG recordings corresponded to peak exercise [22,23] Telesupervised exercise training Before beginning a training session, patients answer a series of questions regarding their present condition: fatigue, dyspnea, blood pressure, body mass, and medication taken. Patients then transmitted resting ECG data to the monitoring center.…”

Section: Esc -European Society Of Cardiology Lvef -Left Ventricular mentioning

confidence: 99%

“…Telephone contact was also used for psychological support [22,23] Education Patients were taught how to self-evaluate, how to measure HR, blood pressure, body mass, how to performed exercise training, how to evaluate the level of perceived exertion according to the Borg scale and how to operate a TR set. Education also encompassed smoking cessation, lipid management, nutritional counselling, vocational and psychosocial support [22,23] The number of phone calls and its length were discussed with the patient during initial psychological assessment and qualification for psychological counseling sessions Patients from the UC group received standard care appropriate for each center. Some of them could participate in a rehabilitation program which (apart from exercise training) encompassed psychosocial assessment focused on cardiovascular risk factors, psychological support, and counselling regarding adjustment to treatment and enhancing health-related QoL.…”

Section: Esc -European Society Of Cardiology Lvef -Left Ventricular mentioning

confidence: 99%

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Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care – results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial

et al. 2020

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Introduction: Hybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation and remote monitoring of implantable devices might be an innovative option improving heart failure (HF) patients' quality of life (QoL) and emotional health. The aim of the study was to investigate the influence of HCTR on various facets of QoL in HF patients in comparison with usual care (UC) alone. Material and methods: The present analysis formed part of a multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III, LVEF ≤ 40%). Patients were randomized 1 : 1 to HCTR plus UC or UC only. Patients underwent either an HCTR program or UC with observation. The psychological intervention in the HCTR group included supportive psychological counseling via mobile phone. The Medical Outcome Survey Short Form 36 Questionnaire was used to assess QoL. Measurements were made before and after a 9-week intervention (HCTR group)/observation (UC group). Results: After the intervention, the HCTR group showed significant improvement in overall QoL, physical domain (PD) of QoL, and 4 areas of QoL (physical functioning (PhF), role functioning related to physical state (RF), general health (GH), vitality (VI)). A significant positive change in QoL in

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“…Initial psychological assessment and consultation, along with clinical evaluation, allowed Table I. TELEREH-HF inclusion and exclusion criteria [22,23]…”

Section: Assessment Of Health-related Qolmentioning

confidence: 99%

Section: Esc -European Society Of Cardiology Lvef -Left Ventricular mentioning

confidence: 99%

Section: Esc -European Society Of Cardiology Lvef -Left Ventricular mentioning

confidence: 99%

Section: Esc -European Society Of Cardiology Lvef -Left Ventricular mentioning

confidence: 99%

See 2 more Smart Citations

Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care – results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial

et al. 2020

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“…[21][22][23] Telerehabilitation has begun to be implemented in other rehabilitation fields, such as cardiac rehabilitation, cancer rehabilitation, neurological rehabilitation, and spinal cord injuries. [24][25][26] Some studies have pointed out the effectiveness of these methods; [27,28] however the last systematic reviews and meta-analyzes highlight the limited evidence, mainly due to the lack of high quality research studies. [29,30] In general terms, telerehabilitation methods have been reported as positive experiences by patients [31], and can represent an important way to reduce associated healthcare costs [29].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Pulmonary Telerehabilitation Protocol in patients affected by COVID-19, confined in their homes: Study Protocol for a Randomized Control Trial

González-Gerez

Bernal‐Utrera

Anarte‐Lazo

et al. 2020

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Abstract Background: In December 2019, 27 cases of pneumonia, of unknown cause, were identified in the province of Hubei (China). The WHO declared the situation as a Public Health emergency of International Concern and it was finally declared a global pandemic on March 11, 2020. Spanish Government obliges the entire population to remain confined to their homes, with exception of essential basic services, to stop the spread of COVID-19. Home isolation implies a notable physical deconditioning. Telerehabilitation methods have reported positive experiences and we propose to study in affected patients of COVID-19, due to the general house confinement of the entire Spanish population. Methods: Patients will be recruited in the regions of Andalusia, Murcia and Valencia (Spain). Patients will remain confined to their homes, and there they will carry out their assigned exercise program, which will be controlled telematically. Evaluators will attend to carry out all measurements at the beginning, during, and end of the study, telematically controlled. The patients will be randomly divided into three groups, two of them will perform a home exercise program (breathing exercises or non-specific exercises for muscle toning) and the third group will perform sedentary activities, using mental activation techniques, and will act as a sham group. We will evaluate respiratory variables and other variables of physical state through physical tests, effort and perceived fatigue. The data will be statistically analyzed, and the hypotheses will be tested between the groups, using the SPSS software, v.20, considering a 95% confidence interval. Discussion: We will analyze the results, in terms of level of fatigue and perceived exertion, physical health, and maintenance of respiratory activity of two types of exercise programs, toning and respiratory, applied in patients affected by COVID19 during the period of home confinement. We intend to investigate a field not previously studied, such as the repercussion of carrying out a toning and respiratory exercise program in these patients, in historical circumstances that no one had previously observed in Spain, since the general population has never been forced to remain confined in their homes, due to a pandemic infection, by coronavirus (COVID19). Observing the effects that these two home exercise programs could produce in patients infected with COVID19, we will try to better analyze and understand the mechanisms that are associated with worsening of breathing in this type of patient.

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Effects of a 9-Week Hybrid Comprehensive Telerehabilitation Program on Long-term Outcomes in Patients With Heart Failure

et al. 2020

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IMPORTANCE Guidelines recommend exercise training as a component of heart failure management. There are large disparities in access to rehabilitation, and introducing hybrid comprehensive telerehabilitation (HCTR) consisting of remote monitoring of training at patients' homes might be an appealing alternative.OBJECTIVE To assess whether potential improvements in quality-of-life outcomes after a 9-week HCTR intervention in patients with heart failure translate into improvement in clinical outcomes during extended 12 to 24 months of follow-up, compared with usual care. DESIGN, SETTING, AND PARTICIPANTSThe Telerehabilitation in Heart Failure Patients (TELEREH-HF) trial is a multicenter, prospective, open-label, parallel-group randomized clinical trial that enrolled 850 patients with heart failure up to 6 months after a cardiovascular hospitalization with New York Heart Association levels I, II, or III and left ventricular ejection fraction of 40% or less. Patients from 5 centers in Poland were randomized 1:1 to HCTR plus usual care or usual care only and followed up for 14 to 26 months after randomization.INTERVENTIONS During the first 9 weeks, patients underwent either an HCTR program (1 week in hospital and 8 weeks at home) or usual care with observation. The HCTR intervention encompassed telecare, telerehabilitation, and remote monitoring of implantable devices. No intervention occurred in the remaining study period. MAIN OUTCOMES AND MEASURESThe percentage of days alive and out of the hospital from randomization through the end of follow-up at 14 to 26 months.RESULTS A total of 850 patients were enrolled, with 425 randomized to the HCTR group (377 male patients [88.7%]; mean [SD] age, 62.6 [10.8] years) and 425 randomized to usual care (376 male patients [88.5%]; mean [SD] age, 62.2 [10.2] years). The HCTR intervention did not extend the percentage of days alive and out of the hospital. The mean (SD) days were 91.9 (19.3) days in the HCTR group vs 92.8 (18.3) days in the usual-care group, with the probability that HCTR extends days alive and out of the hospital equal to 0.49 (95% CI, 0.46-0.53; P = .74) vs usual care. During follow-up, 54 patients died in the HCTR arm and 52 in the usual-care arm, with mortality rates at 26 months of 12.5% vs 12.4%, respectively (hazard ratio, 1.03 [95% CI, 0.70-1.51]). There were also no differences in hospitalization rates (hazard ratio, 0.94 [95% CI, 0.79-1.13]). The HCTR intervention was effective at 9 weeks, significantly improving peak oxygen consumption (0.95 [95% CI, 0.65-1.26] mL/kg/min vs 0.00 [95% CI, −0.31 to 0.30] mL/kg/min; P < .001) and quality of life (Medical Outcome Survey Short Form-36 questionnaire score, 1.58 [95% CI, 0.74-2.42] vs 0.00 [95% CI, −0.84 to 0.84]; P = .008), and it was well tolerated, with no serious adverse events during exercise. CONCLUSIONS AND RELEVANCEIn this trial, the positive effects of a 9-week program of HCTR in patients with heart failure did not lead to the increase in percentage of days alive and out of the hospital and did not red...

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Hybrid comprehensive telerehabilitation in heart failure patients (TELEREH-HF): A randomized, multicenter, prospective, open-label, parallel group controlled trial—Study design and description of the intervention

Cited by 41 publications

References 45 publications

Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care – results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial

Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care – results of the Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized Clinical Trial

Therapeutic Pulmonary Telerehabilitation Protocol in patients affected by COVID-19, confined in their homes: Study Protocol for a Randomized Control Trial

Effects of a 9-Week Hybrid Comprehensive Telerehabilitation Program on Long-term Outcomes in Patients With Heart Failure

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