The sustained effects of extending cardiac rehabilitation with a six-month telemonitoring and telecoaching programme on fitness, quality of life, cardiovascular risk factors and care utilisation in CAD patients: The TeleCaRe study

Abstract

Introduction The aim of this study was to assess the acute and sustained effects of a six-month heart-rate-based telerehabilitation programme, following the completion of cardiac rehabilitation (CR), on peak oxygen uptake (peakVO2), quality of life (QoL), cardiovascular risk factors and care utilisation in patients with coronary artery disease (CAD). Methods A total of 122 patients with CAD were randomised, after the completion of CR, to an intervention group with six months of telemonitoring and telecoaching (TELE) or a control group with a traditional six-month follow-up programme with monthly calls (CON). The primary outcome was peakVO2 at 12 months, to assess the sustained effects of TELE. The secondary outcomes included QoL, cardiovascular risk factors (lipid spectrum), major adverse cardiovascular events (MACE) and habitual physical activity. Results PeakVO2 increased significantly from baseline to 12 months in TELE (+2.5 mL·kg−1min−1 (95% CI 1.5–3.2)) and CON (+1.9 mL·kg−1min−1 (95% CI 1.0–2.5)), and did not differ between groups (P = 0.28). Similarly, QoL (P = 0.31), total cholesterol (P = 0.45), MACE (P = 0.86) did not differ between groups and in time. Discussion Extending CR with a heart-rate-based telerehabilitation programme did not yield additional sustainable health benefits compared with regular care with monthly telephone calls. These observations highlight that both telerehabilitation and regular care with monthly telephone calls may prevent the typically observed reductions in peakVO2 following the completion of a CR programme.Trial registration: Dutch Trial Register NL4140 (registered 6 December 2014)

Mobile Technologies to Promote Physical Activity during Cardiac Rehabilitation: A Scoping Review

“…In the remaining four studies [ 19 , 30 , 31 , 32 ], exercise capacity was a secondary outcome. Ten studies [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ] used peak oxygen consumption (⩒O 2peak ) as a measure for exercise capacity. Two studies [ 31 , 33 ] assessed the exercise capacity utilizing a six-minute walk test (6MWT).…”

“…Ten of the studies [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 32 , 33 ] compared a CG of outpatient CR without further CR to outpatient CR followed by mTechs during home-based CR (total n = 1659). Study duration ranged from 6 to 24 weeks.…”

“…Research-targeted devices were used in eight studies [ 12 , 15 , 16 , 19 , 20 , 21 , 30 , 33 ], custom devices in two studies [ 17 , 31 ] and off-the-shelf devices in four studies [ 13 , 14 , 20 , 32 ].…”

“…Thus, objective PA monitoring combined with BCTs facilitates meeting PA targets following CR. Several recent studies with CVD patients employed objective PA measurements [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ] in facility-based CR and home-based CR. Home-based CR is also referred to as telerehabilitation.…”

The scientific basis for secondary prevention of coronary artery disease: recent contributions from the Netherlands

“…In recent years, several studies have evaluated the effects of CTR. The FIT@Home study [26] was one of the first large RCTs investigating CTR versus centrebased cardiac rehabilitation [27,28]. In total, 90 patients with CAD with low to moderate risk of recurrent CVD events were randomised to a 12-week program of either centre-based or home-based exercise training.…”