Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
J Cardiol. 2021 Jul;78(1):66-71. doi: 10.1016/j.jjcc.2021.01.010. Epub 2021 Feb 10.
Cardiac rehabilitation (CR) is a widely recommended evidence-based intervention for patients with cardiovascular disease. However, the participation rate in CR has been reported to be low globally, mainly due to barriers in access to the CR center. We evaluated the feasibility and safety of a new remote real-time monitoring system for supervising home-based CR among elderly patients with heart failure (HF).
Hospitalized patients or outpatients followed for HF were enrolled. Patients received 12-week home-based CR under remote supervision using an integrated platform for telerehabilitation. Feasibility was evaluated by the participation and completion rates of the home-based CR sessions. Safety was assessed by adverse events during the sessions. All patients underwent baseline and 12-week assessment of exercise tolerance and lower extremity muscle strength.
All 10 patients (mean age 76 ± 7 years; 60% male) who participated in the study completed the program without withdrawal during the study period. Median participation rate in the exercise sessions was 94.4% (interquartile range: 88.9-97.9%). While fatigue, common cold, and palpitation were observed, no serious cardiovascular events were reported. Six-minute walk distance significantly improved from 383 ± 94 m to 432 ± 83 m (p=0.003).
Home-based CR under real-time supervision was feasible and safe among elderly HF patients. Our study suggests that home-based CR using an integrated telerehabilitation platform may be a potential option for patients who are unable to participate in center-based CR due to geographic or social accessibility and physical barrier issues.
心脏康复(CR)是一种广泛推荐的基于证据的心血管疾病患者干预措施。然而,全球范围内 CR 的参与率一直很低,主要是由于获得 CR 中心的障碍。我们评估了一种新的远程实时监测系统用于监督老年心力衰竭(HF)患者家庭为基础的 CR 的可行性和安全性。
招募住院或随访 HF 的患者。患者接受为期 12 周的家庭为基础的 CR,远程监督使用远程康复综合平台。通过家庭为基础的 CR 课程的参与率和完成率评估可行性。通过课程期间的不良事件评估安全性。所有患者在基线和 12 周时评估运动耐量和下肢肌肉力量。
所有 10 名参与研究的患者(平均年龄 76 ± 7 岁;60%为男性)在研究期间无退出,完成了该计划。锻炼课程的参与率中位数为 94.4%(四分位距:88.9-97.9%)。虽然观察到疲劳、普通感冒和心悸,但没有报告严重的心血管事件。6 分钟步行距离从 383 ± 94 m 显著改善至 432 ± 83 m(p=0.003)。
实时监督下的家庭为基础的 CR 在老年 HF 患者中是可行和安全的。我们的研究表明,使用综合远程康复平台的家庭为基础的 CR 可能是由于地理或社会可达性以及身体障碍问题而无法参加中心为基础的 CR 的患者的潜在选择。