Key result
A remote cardiac rehabilitation program yielded similar 12-week walking distance test distances compared to an in-person program for stable coronary artery disease patients after percutaneous coronary intervention.
Why the study?
The COVID-19 pandemic restricted in-person cardiac rehabilitation delivery for CAD patients undergoing PCI, prompting investigation of exercise capacity, quality of life, mental health, and family burden outcomes across in-person versus remote delivery models.
Does a remote cardiac rehabilitation program improve exercise capacity, HRQL, mental health, and family burden in stable CAD patients undergoing PCI compared to an in-person program?
Cohort (n=92)
No
Does a remote cardiac rehabilitation program improve exercise capacity, HRQL, mental health, and family burden in stable CAD patients undergoing PCI compared to an in-person program?
Remote cardiac rehabilitation is a feasible, safe, and effective alternative to in-person rehabilitation for low-to-moderate risk CAD patients after PCI, offering additional benefits in mental health and family burden.
Answers are grounded in this paper and cite their sources.
Remote CR may improve mental health and family burden versus in-person programs post-PCI; hypothesis-generating and requires RCTs before practice change.
Objective The coronavirus disease-19 (COVID-19) pandemic restricts rapid implementation of in-person delivery of cardiac rehabilitation (CR) at the center for coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI), thus enabling a cohort comparison of in-person vs. remote CR program. This study aims to investigate outcomes of exercise capacity, health-related quality of life (HRQL), mental health, and family burden of stable CAD patients undergoing PCI in low-to-moderate risk after different delivery models of CR program. Methods The study included a cohort of stable CAD patients undergoing PCI who had experienced two naturally occurring modes of CR program after hospital discharge at two time periods, January 2019 to December 2019 (in-person CR program) and May 2020 to May 2021 (remote CR program). The exercise capacity was assessed by means of 6-min walk test (6MWT), maximal oxygen uptake (VO 2 max) and the respiratory anaerobic threshold (VO 2AT ) before discharge, at the end of the 8-week and 12-week in-person or remote CR program after discharge. Results No adverse events occurred during the CR period. CAD patients had a longer distance walked in 6 min with a higher VO 2max after 8-week and 12-week CR program whether in-person or remote model (p < 0.05). The distance walked in 6 min was longer and the maximal oxygen uptake (VO 2 max) was higher at the end of the 12-week in-person or remote CR program than 8-week in-person or remote CR program (p < 0.05). The respiratory anaerobic threshold (VO 2AT ) of CAD patients was decreased after 8-week CR program whether in-person or remote model (p < 0.05). CAD patients receiving remote CR program exhibited higher HRQL scores in domains of vitality (p = 0.048), role emotional (p = 0.039), mental health (p = 0.014), and the summary score of the mental composite (p = 0.048) compared to in-person CR program after 8 weeks. The anxiety and depression scores of CAD patients undergoing PCI were decreased after 8-week CR program whether in-person or remote model (p < 0.05). The CAD patients receiving remote delivery showed lower anxiety and depression scores compared to those receiving in-person delivery at the end of the 8-week CR program (p < 0.05). It was found that the family burden scores of CAD patients undergoing PCI were reduced after 8-week and 12-week CR program whether in-person or remote model (p < 0.05). The CAD patients receiving remote CR program showed lower family burden scores than those receiving in-person CR program after whether 8 weeks or 12 weeks (p < 0.05). Conclusion These data indicate that a properly designed and monitored remote delivery represents a feasible and safe model for low-to-moderate-risk, stable CAD patients undergoing PCI inaccessible to in-person CR during the COVID-19 pandemic.
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Gu et al. (2023) conducted a cohort in Stable coronary artery disease after percutaneous coronary intervention (n=92). Remote cardiac rehabilitation program vs. In-person cardiac rehabilitation program was evaluated on Exercise capacity (6-minute walk test distance at 12 weeks) (p=ns). A remote cardiac rehabilitation program yielded similar 12-week walking distance test distances compared to an in-person program for stable coronary artery disease patients after percutaneous coronary intervention.
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