Key result
Remote cardiac rehabilitation using wearable devices and telenursing improves exercise tolerance, though its effects on preventing cardiac events and mortality remain controversial.
Why the study?
Despite the benefits of cardiac rehabilitation in patients with cardiovascular diseases, outpatient participation remains low, prompting exploration of remote cardiac rehabilitation with wearable devices.
Remote cardiac rehabilitation using wearable devices offers a potential solution to low outpatient CR participation, though its effects on hard clinical outcomes remain controversial and require careful risk stratification.
Supports wearable remote CR to address low participation; leaves open hard-outcome benefits and optimal risk stratification pending RCTs.
Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients' busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as cost-effectiveness and insurance coverage still persist.
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Nakayama et al. (2023) conducted a review in Cardiovascular diseases. Remote cardiac rehabilitation vs. Standard care or outpatient cardiac rehabilitation was evaluated. Remote cardiac rehabilitation using wearable devices and telenursing improves exercise tolerance, though its effects on preventing cardiac events and mortality remain controversial.
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