Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
ESC Heart Fail. 2022 Dec;9(6):3751-3760. doi: 10.1002/ehf2.14145. Epub 2022 Sep 9.
During the coronavirus disease 2019 (COVID-19) pandemic, it has become difficult to provide centre-based cardiac rehabilitation for heart failure patients. Digital therapeutics is a novel concept proposed in recent years that refers to the use of evidence-based therapeutic interventions driven by high-quality software programs to treat, manage, or prevent a medical condition. However, little is known about the use of this technology in heart failure patients. This study aims to explore the safety and efficacy of digital therapeutics-based cardiac rehabilitation in heart failure patients and to provide new insights into a new cardiac rehabilitation model during the COVID-19 era. To identify technologies related to digital therapeutics, such as the use of medical applications, wearable devices, and the Internet, all relevant studies published on PubMed, EMBASE, Cochrane database, and China National Knowledge Internet were searched from the time the database was established until October 2021. The PEDro was used to assess the quality of included studies. We ultimately identified five studies, which included 1119 patients. The mean age was 66.37, the mean BMI was 25.9, and the NYHA classification ranged from I to III (I = 232, II = 157, III = 209). The mean 6-min walk distance was 397.7 m. The PEDro scores included in the study ranged from 4 to 8, with a mean of 5.8. Exercise training was performed in four studies, and psychological interventions were conducted in three studies. No death or serious adverse events were observed. Adherence was reported in three studies, and all exceeded 85%. The results of most studies showed that digital therapeutics-based cardiac rehabilitation significantly increases exercise capacity and quality of life in heart failure patients. Overall, although this study suggests that digital therapeutics-based cardiac rehabilitation may be a viable intervention for heart failure patients during the COVID-19 era, the efficacy of this new model in routine clinical practice needs to be further validated in a large clinical trial.
在 2019 年冠状病毒病（COVID-19）大流行期间，为心力衰竭患者提供以中心为基础的心脏康复变得困难。数字治疗是近年来提出的新概念，是指使用基于高质量软件程序的循证治疗干预措施来治疗、管理或预防医疗状况。然而，对于这种技术在心力衰竭患者中的应用知之甚少。本研究旨在探讨基于数字治疗的心脏康复在心力衰竭患者中的安全性和有效性，并为 COVID-19 时代新的心脏康复模式提供新的见解。为了确定与数字治疗相关的技术，例如使用医疗应用程序、可穿戴设备和互联网，从数据库建立开始到 2021 年 10 月，在 PubMed、EMBASE、Cochrane 数据库和中国国家知识互联网上搜索了所有相关研究。使用 PEDro 评估纳入研究的质量。我们最终确定了五项研究，共纳入 1119 名患者。患者的平均年龄为 66.37 岁，平均 BMI 为 25.9，NYHA 分级为 I 至 III 级（I = 232，II = 157，III = 209）。平均 6 分钟步行距离为 397.7 米。研究中纳入的 PEDro 评分从 4 到 8 分，平均为 5.8 分。四项研究进行了运动训练，三项研究进行了心理干预。未观察到死亡或严重不良事件。三项研究报告了依从性，均超过 85%。大多数研究的结果表明，基于数字治疗的心脏康复可显著提高心力衰竭患者的运动能力和生活质量。总体而言，尽管本研究表明，基于数字治疗的心脏康复可能是 COVID-19 时代心力衰竭患者的可行干预措施，但这种新模式在常规临床实践中的疗效需要在大规模临床试验中进一步验证。
