School of Medicine, University of St Andrews, St Andrews, Scotland.
J Telemed Telecare. 2024 May;30(4):631-646. doi: 10.1177/1357633X221085865. Epub 2022 Apr 4.
Cardiac rehabilitation (CR) is an effective, yet under-utilised, form of secondary prevention in cardiac patients. Telemedicine is one method of overcoming barriers to accessing CR. Previous systematic reviews highlight variation in the effectiveness of telerehabilitation programmes and current literature lacks identification of which telemedicine interventions are most effective, despite differences in the results of primary studies. The objectives of this literature review were to: evaluate the effectiveness of cardiac telerehabilitation compared to centre-based programmes for managing cardiac risk factors, satisfaction and adherence in cardiac patients; identify the technologies used to deliver CR; identify the key components of effective interventions.
A literature search was conducted using MEDLINE, EMBASE and Scopus. Randomised controlled trials (RCTs) involving an intervention group that received telerehabilitation and a control group that attended a CR centre were included.
Twelve RCTs met the inclusion criteria. There is evidence to suggest that telerehabilitation programmes have similar effectiveness to centre-based CR. Phones were the most commonly used technology. Most studies used a combination of technologies including personal computers and self-monitoring equipment. Phase III telerehabilitation programmes using self-monitoring, motivational feedback and education were more effective than centre-based CR for increasing physical activity and functional capacity.
Cardiac telerehabilitation is delivered by a range of technologies and has a similar effectiveness to centre-based programmes. While evidence suggests that additional health benefits are seen in patients who receive a telemedicine intervention in Phase III of CR, further evidence would be required to confidently draw this conclusion.
心脏康复（CR）是一种有效的、但未得到充分利用的心脏病患者二级预防形式。远程医疗是克服获得 CR 障碍的一种方法。先前的系统评价强调远程康复计划的有效性存在差异，尽管主要研究的结果不同，但目前的文献仍未能确定哪种远程医疗干预最有效。本文献回顾的目的是：评估与中心基础计划相比，远程心脏康复在管理心脏风险因素、患者满意度和坚持度方面的有效性；确定用于提供 CR 的技术；确定有效干预措施的关键组成部分。
使用 MEDLINE、EMBASE 和 Scopus 进行文献检索。纳入了涉及干预组接受远程康复和对照组参加 CR 中心的随机对照试验（RCT）。
有 12 项 RCT 符合纳入标准。有证据表明，远程康复计划与中心基础 CR 具有相似的效果。电话是最常用的技术。大多数研究使用了包括个人计算机和自我监测设备在内的多种技术组合。使用自我监测、激励反馈和教育的 III 期远程康复计划在增加身体活动和功能能力方面比中心基础 CR 更有效。
远程心脏康复通过一系列技术提供，与中心计划的效果相似。尽管有证据表明，在 CR 的第三阶段接受远程医疗干预的患者会获得额外的健康益处，但需要进一步的证据才能有信心得出这一结论。
