Kizilkilic Sevda Ece, Ramakers Wim, Falter Maarten, Scherrenberg Martijn, Bonneux Cindel, Pieters Zoë, Milani Mauricio, Hansen Dominique, De Pauw Michel, Coninx Karin, Dendale Paul
Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium.
Heart Centre Hasselt, Jessa Hospital, Stadsomvaart 11, 3500 Hasselt, Belgium.
Eur J Prev Cardiol. 2025 Aug 28. doi: 10.1093/eurjpc/zwaf537.
The aim of the study is to evaluate the effectiveness of combining center-based cardiac rehabilitation (CR) with shared decision making (SDM) based telerehabilitation (TR) on patients' quality of life, cardiorespiratory fitness, and physical activity level.
A randomized controlled trial (NCT05026957) was conducted with 80 patients with heart disease recruited from Jessa Hospital, Hasselt. Patients were randomized to either a control group receiving standard CR or an intervention group receiving standard CR with additional SDM-based TR via the SharedHeart smartphone application. Primary outcome was quality of life (HeartQoL), while secondary outcomes included cardiorespiratory fitness (VO2peak) and physical activity levels. Data were analyzed using a linear mixed model.
The intervention group showed a greater improvement in quality of life (4.15 points, 95% CI: 0.7-7.6; p = 0.02), peak oxygen uptake (VO₂peak) (1.1 ml/kg/min, 95% CI: 0.04-2.1; p = 0.04), and number of step count (14 788 more steps/7 days (95% CI: 4,2-25,3; p < 0.01)) over a 12-week intervention, compared to the control group.
This study demonstrated that the addition of SDM-based TR program to center-based CR significantly improved patients' quality of life, cardiorespiratory fitness, physical activity levels compared to center-based CR alone. The SharedHeart study stands out as one of the first to integrate a digitally-supported SDM approach in CR, empowering patients to take an active role in their rehabilitation. Future research should focus on the long-term impact of digital interventions, particularly in reducing adverse cardiovascular events and enhancing patient self-management.
本研究旨在评估基于中心的心脏康复（CR）与基于共同决策（SDM）的远程康复（TR）相结合对患者生活质量、心肺适能和身体活动水平的有效性。
进行了一项随机对照试验（NCT05026957），从哈瑟尔特的耶萨医院招募了80名心脏病患者。患者被随机分为接受标准CR的对照组或通过SharedHeart智能手机应用程序接受标准CR并附加基于SDM的TR的干预组。主要结局是生活质量（HeartQoL），次要结局包括心肺适能（VO2peak）和身体活动水平。使用线性混合模型分析数据。
与对照组相比，干预组在12周的干预期间，生活质量改善更大（4.15分，95%CI：0.7 - 7.6；p = 0.02），峰值摄氧量（VO₂peak）（1.1 ml/kg/min，95%CI：0.04 - 2.1；p = 0.04），以及步数（每周多14788步（95%CI：42 - 253；p < 0.01））。
本研究表明，与单独的基于中心的CR相比，在基于中心的CR中添加基于SDM的TR计划可显著改善患者的生活质量、心肺适能和身体活动水平。SharedHeart研究是最早将数字支持的SDM方法整合到CR中的研究之一，使患者能够在康复中发挥积极作用。未来的研究应关注数字干预的长期影响，特别是在减少心血管不良事件和增强患者自我管理方面。
