Tang Jiamin, Ma Danni, Li Meng, Ding Yiqi, Zhou Xuemei, He Hong
School of Nursing and Rehabilitation, Nantong University, 226001, Nantong City, Jiangsu Province, China.
Affiliated Hospital of Nantong University, No. 20, Xisi Road, 226001, Nantong City, Jiangsu Province, China.
Herz. 2025 May 6. doi: 10.1007/s00059-025-05301-5.
The aim of this study was to compare the effectiveness of different types of tele-interventions in improving exercise capacity and cardiac function in patients with heart failure.
We searched five databases from inception to September 2024 for randomized controlled trials (RCTs) of telerehabilitation in people with heart failure. The primary outcomes were 6‑min walk distance (6MWD) and left ventricular ejection fraction (LVEF). The secondary outcome was patient adherence to rehabilitation. We used Review Manager (RevMan) 5.4 and Stata 16.0 for the analyses.
Overall, 17 studies with a total of four telerehabilitation interventions were included in the final analysis. Network meta-analysis showed that remote monitoring (mean difference [MD] = 29.03 [7.94, 50.13]) and combined interventions (MD = 28.86 [4.85, 53.86]) were more effective than usual rehabilitation in improving 6MWD. Remote monitoring (MD = 2.45 [0.14, 4.76]) was superior to usual rehabilitation in improving LVEF. The surface under the cumulative ranking curve (SUCRA) results showed that remote monitoring is the most effective way to improve the 6MWD (SUCRA = 71.7%) and LVEF (SUCRA = 76.3%) in patients with heart failure.
The results of this study indicate that remote cardiac rehabilitation is effective in improving heart function and enhancing exercise capacity in patients with heart failure. Based on our data and the accessibility of remote rehabilitation equipment, telemedicine may be a useful and significant way to increase patient participation in cardiac rehabilitation.
本研究旨在比较不同类型的远程干预措施在改善心力衰竭患者运动能力和心脏功能方面的有效性。
我们检索了从数据库建立至2024年9月的五个数据库，以查找心力衰竭患者远程康复的随机对照试验（RCT）。主要结局指标为6分钟步行距离（6MWD）和左心室射血分数（LVEF）。次要结局指标为患者对康复治疗的依从性。我们使用Review Manager（RevMan）5.4和Stata 16.0进行分析。
总体而言，最终分析纳入了17项研究，共涉及四种远程康复干预措施。网络荟萃分析表明，在改善6MWD方面，远程监测（平均差[MD]=29.03[7.94，50.13]）和联合干预（MD=28.86[4.85，53.86]）比常规康复更有效。在改善LVEF方面，远程监测（MD=2.45[0.14，4.76]）优于常规康复。累积排序曲线下面积（SUCRA）结果显示，远程监测是改善心力衰竭患者6MWD（SUCRA=71.7%）和LVEF（SUCRA=76.3%）的最有效方法。
本研究结果表明，远程心脏康复在改善心力衰竭患者心脏功能和增强运动能力方面是有效的。基于我们的数据以及远程康复设备的可及性，远程医疗可能是增加患者参与心脏康复的一种有用且重要的方式。
