Cardiac Rehabilitation Based on the Walking Test and Telerehabilitation Improved Cardiorespiratory Fitness in People Diagnosed with Coronary Heart Disease during the COVID-19 Pandemic

Abstract

This study investigated an alternative home-based cardiac telerehabilitation model in consideration of the recommendations for the COVID-19 quarantine of people diagnosed with coronary heart disease (CHD). We hypothesized that using a 200 m fast walking test (200 mFWT) and telerehabilitation would create an effective alternative cardiac rehabilitation (CR) intervention that could improve cardiorespiratory fitness. Participants (n = 19, mean age 60.4 ± 9.6) of the 8-week intervention performed regular physical exercise at the target heart rate zone determined by calculations based on the 200 mFWT results. In our study, the participants were supervised using telerehabilitation. A total of 84% of participants completed the 8-week intervention. No adverse events were reported during telerehabilitation. The study participants noted a significant improvement (p < 0.001) in cardiorespiratory fitness expressed by an 8% reduction in the walking test time (Δ 8.8 ± 5.9 s). Home-based telerehabilitation based on 200 mFWT effectively increased the cardiorespiratory fitness in people with CHD with a low to moderate cardiovascular risk. This was a novel approach in CR during the COVID-19 pandemic. As research in this area is justified, this paper may serve as an alternative method of providing healthcare during the COVID-19 pandemic and as a basis for further upcoming randomized controlled trials.

Effectiveness of Physical Therapy Services Through Telemedicine During the Covid-19 Pandemic: Systematic Review

“…From the eight articles reviewed, it is known that physical therapy services through telemedicine or telerehabilitation have produced good results for their users during the Covid-19 pandemic. This method has been successfully applied to patients with cardiorespiratory disorders, patients with musculoskeletal disorders (Patellofemoral Pain Syndrome and breast cancer), as well as patients with neurological disorders (Stroke, and Amyotrophic Lateral Sclerosis) (Albornoz-Cabello et al, 2021;Batalik et al, 2021;De Marchi et al, 2021;Hameed et al, 2021;Lewis et al, 2021;Mella-Abarca et al, 2020;Miao et al, 2021;Turcinovic et…”

“…In addition, it turns out that this method has other advantages. One of them is cost-effective (Batalik et al, 2021;Miao et al, 2021). Telerehabilitation showed to be at least as cost-effective as traditional cardiac rehabilitation programs (Kraal et al, 2014).…”

“…The question is what should the patient do at home to recover his condition? Telemedicine is an alternative approach that can ease some of these obstacles (Batalik et al, 2021). There are several types of telemedicine such as telerehabilitation, telemonitoring, and teleconsultation.…”

“…Telerehabilitation can be defined as the use of telecommunications, either with live video or audio, to provide rehabilitative interventions (Appleby et al, 2019). In a previous study with physical therapy intervention through telerehabilitation services to reduce pain and disability in patients with Patellofemoral Pain Syndrome (PFPS), it was proven successful in 12 physical therapy sessions over 4 weeks (Albornoz-Cabello et al, 2021) (Batalik et al, 2021). However, in other studies, it was found that the results of evaluating the effectiveness of telerehabilitation were contradictory.…”

Current role and future perspectives of cardiac rehabilitation in coronary heart disease

“…While this point has been comprehensively reviewed in a position statement by the EAPC, novel insights (as discussed above) could also add interesting data[ 11 , 42 , 120 , 121 ]. While exercise testing (namely cardiopulmonary exercise stress testing) has a central role, other methods have also been described as of potential interest[ 11 , 42 , 90 , 123 , 124 ]. In this regard, the use of the 6-min walk test in assessing exercise progression has been proposed, whereas another recent study (albeit in a small number of individuals) reported on the use of the 200-m fast walking test in tailoring exercise in low to moderate risk CHD patients undergoing HBCR[ 123 , 124 ].…”