No transport? No worries! Cardiac telerehabilitation is a feasible and effective alternative to centre-based programs

Abstract

Given the under-utilisation of cardiac rehabilitation despite its benefits, there has been a shift towards alternative delivery models. The recent coronavirus disease 2019 (COVID-19) pandemic has accelerated this shift, leading to a growing interest in home-based cardiac rehabilitation including telerehabilitation. There is increasing evidence to support cardiac telerehabilitation, with studies generally demonstrating comparable outcomes and potential cost-benefits. This review aims to provide a synopsis of the current evidence on home-based cardiac rehabilitation with a focus on telerehabilitation and practical considerations.

Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities

“…"Tele-health" refers to strategies that leverage telecommunications technologies such as telephone, email, text, and the internet to provide healthcare services to individuals in remote locations outside the clinic [57,[61][62][63][64][65]. Tele-health interventions can overcome many of the barriers related to facility access, scheduling, and transportation by offering a more convenient and economical solution that can be performed in one's home or in an accessible location of one's choosing [57,58,61,[66][67][68][69]. As highlighted in this section, rehabilitation and exercise professionals have also adopted tele-health strategies to specifically address the accessibility issues faced by people with disabilities.…”

“…In addition to measuring human movement and biomechanics, wearable devices are also commonly used to monitor heart rate, which may be useful when delivering telerehabilitation and tele-exercise programs. For example, wearable heart-rate monitors can allow clinicians to monitor cardiac activity during participation in tele-rehabilitation, which may be critical to maintaining safety and identifying problems in patients with cardiac irregularities/impairments [66,139,154,156,179]. Furthermore, evidence-based guidelines for exercise in people with disabilities have been established, based on research showing that the intensity of exercise should be optimized to generate a specific physiological stimulus that can safely and effectively drive improvements in physical function, fatigue, and cardiometabolic health [97,129,130,207].…”