Limonti Francesco, Gigliotti Andrea, Cecere Luciano, Varvaro Angelo, Bosco Vincenzo, Mazzotta Rocco, Gravante Francesco, Ramacciati Nicola
Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
Department of Health and Exercise Science, The University of Oklahoma, Norman, OK 73019, USA.
J Clin Med. 2025 Jul 14;14(14):4971. doi: 10.3390/jcm14144971.
Home-based cardiac telerehabilitation (HBCTR) is a multidisciplinary intervention aimed at optimizing functional, psychological, and social recovery in patients undergoing percutaneous coronary intervention (PCI). This rehabilitation model serves as an effective alternative to traditional center-based rehabilitation, providing a cost-effective and clinically advantageous approach. Following PRISMA guidelines, we conducted a systematic literature search across multiple databases (PubMed, CINAHL, Cochrane, Scopus, Web of Science). We included randomized controlled trials (RCTs), cohort, and observational studies assessing telerehabilitation in post-PCI patients. Primary outcomes focused on health-related quality of life (HRQoL) and adherence, while secondary outcomes included functional capacity (6 min walk test, VOmax), cardiovascular risk factor control, and psychological well-being. Risk of bias was assessed using the Cochrane RoB 2.0 and ROBINS-I tools. A total of 3575 articles were identified after removing duplicates, of which 877 were selected based on title and abstract, and 17 met the inclusion criteria, with strong RCT representation ensuring robust evidence synthesis. HBCTR was associated with significant improvements in exercise capacity, with increases in VOmax ranging from +1.6 to +3.5 mL/kg/min and in 6 min walk distance from +34.7 to +116.6 m. HRQoL scores improved significantly, with physical and mental component scores increasing by +6.75 to +14.18 and +4.27 to +11.39 points, respectively. Adherence to telerehabilitation programs was consistently high, often exceeding 80%, and some studies reported reductions in hospital readmissions of up to 40%. Wearable devices and smartphone applications facilitated self-monitoring, enhancing adherence and reducing readmissions. Several studies also highlighted improvements in anxiety and depression scores ranging from 10% to 35%. HBCTR is a promising strategy for rehabilitation and quality-of-life improvement after PCI. It offers a patient-centered solution that leverages technology to enhance long-term outcomes. By integrating structured telerehabilitation programs, healthcare systems can expand accessibility, promote adherence, and improve equity in cardiovascular care.
家庭心脏远程康复（HBCTR）是一种多学科干预措施，旨在优化接受经皮冠状动脉介入治疗（PCI）患者的功能、心理和社会恢复情况。这种康复模式是传统的基于中心的康复的有效替代方案，提供了一种具有成本效益且在临床上具有优势的方法。遵循PRISMA指南，我们在多个数据库（PubMed、CINAHL、Cochrane、Scopus、Web of Science）中进行了系统的文献检索。我们纳入了评估PCI术后患者远程康复的随机对照试验（RCT）、队列研究和观察性研究。主要结局集中在健康相关生活质量（HRQoL）和依从性，而次要结局包括功能能力（6分钟步行试验、最大摄氧量）、心血管危险因素控制和心理健康。使用Cochrane RoB 2.0和ROBINS-I工具评估偏倚风险。去除重复项后共识别出3575篇文章，其中877篇根据标题和摘要被选中，17篇符合纳入标准，强大的RCT代表性确保了有力的证据综合。HBCTR与运动能力的显著改善相关，最大摄氧量增加范围为+1.6至+3.5 mL/kg/min，6分钟步行距离增加范围为+34.7至+116.6米。HRQoL评分显著改善，身体和心理成分评分分别增加+6.75至+14.18分和+4.27至+11.39分。对远程康复计划的依从性一直很高，通常超过80%，一些研究报告医院再入院率降低高达40%。可穿戴设备和智能手机应用程序促进了自我监测，提高了依从性并减少了再入院率。几项研究还强调焦虑和抑郁评分改善了10%至35%。HBCTR是PCI术后康复和改善生活质量的一种有前景的策略。它提供了一种以患者为中心的解决方案，利用技术来改善长期结局。通过整合结构化的远程康复计划，医疗系统可以扩大可及性、促进依从性并提高心血管护理的公平性。
