Su Jing Jing, Wong Arkers Kwan Ching, He Xi-Fei, Zhang Li-Ping, Cheng Jie, Lu Li-Juan, Lan Lan, Wang Zhaozhao, Lin Rose S Y, Batalik Ladislav
School of Nursing, Tung Wah College, Hong Kong.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Contemp Clin Trials Commun. 2024 Sep 12;42:101365. doi: 10.1016/j.conctc.2024.101365. eCollection 2024 Dec.
Cardiac rehabilitation is a beneficial multidisciplinary treatment of exercise promotion, patient education, risk factor management, and psychosocial counseling for people with coronary heart disease (CHD) that is underutilized due to substantial disparities in access, referral, and participation. Empirical studies suggest that cardiac telerehabilitation (CTR) have safety and efficacy comparable to traditional in-person cardiac rehabilitation, however, older adults are under-reported with effectiveness, feasibility, and usability remains unclear.
The study randomized 43 older adults (84 % males) to the 12-week CTR intervention or standard of care. Guided by Social Cognitive Theory, participants received individualized in-person assessment and e-coaching sessions, followed by CTR usage at home. Data were collected at baseline (T0), six-week (T1), and 12-week (T2).
Participants in the CTR intervention group showed significant improvement in daily steps (T1: β = 4126.58, p = 0.001; T2: β = 5285, p = 0.01) and health-promoting lifestyle profile (T1: β = 23.26, < 0.001; T2: β = 12.18, = 0.008) across study endpoints. Twenty participants completed the intervention, with 40 % used the website for data-uploading or experiential learning, 90 % used the pedometer for tele-monitoring. Improving awareness of rehabilitation and an action focus were considered key facilitators while physical discomforts and difficulties in using the technology were described as the main barriers.
The CTR is feasible, safe and effective in improving physical activity and healthy behaviors in older adults with CHD. Considering the variation in individual cardiovascular risk factors, full-scale RCT with a larger sample is needed to determine the effect of CTR on psychological symptoms, body weight and blood pressure, and quality of life.
心脏康复是一种有益的多学科治疗方法，包括运动促进、患者教育、危险因素管理以及为冠心病（CHD）患者提供心理社会咨询，但由于在获得治疗、转诊和参与方面存在巨大差异，该疗法未得到充分利用。实证研究表明，心脏远程康复（CTR）的安全性和有效性与传统的面对面心脏康复相当，然而，关于老年人的有效性、可行性和可用性的报道较少，目前仍不清楚。
该研究将43名老年人（84%为男性）随机分为12周的CTR干预组或常规护理组。在社会认知理论的指导下，参与者接受个性化的面对面评估和电子辅导课程，随后在家中使用CTR。在基线（T0）、六周（T1）和12周（T2）时收集数据。
在整个研究终点，CTR干预组的参与者在每日步数（T1：β = 4126.58，p = 0.001；T2：β = 5285，p = 0.01）和促进健康的生活方式概况（T1：β = 23.26，< 0.001；T2：β = 12.18，= 0.008）方面有显著改善。20名参与者完成了干预，其中40%使用网站进行数据上传或体验式学习，90%使用计步器进行远程监测。提高康复意识和行动重点被认为是关键促进因素，而身体不适和技术使用困难被描述为主要障碍。
CTR在改善老年冠心病患者的身体活动和健康行为方面是可行、安全且有效的。考虑到个体心血管危险因素的差异，需要进行更大样本量的全面随机对照试验来确定CTR对心理症状、体重和血压以及生活质量的影响。
