Key result
Remote CR matches center-based rehab for maintaining functional status in older patients.
Why the study?
Most patients find it difficult to maintain healthy lifestyle behavior after ambulatory cardiac rehabilitation programs, and the feasibility of remote cardiac rehabilitation support in older patients was unknown.
Does remote cardiac rehabilitation improve adherence and maintain functional status compared to center-based cardiac rehabilitation in older patients with cardiac disease?
RCT (n=11)
Open-label
1:1, based on a computer-generated list of random numbers
No
Does remote cardiac rehabilitation improve adherence and maintain functional status compared to center-based cardiac rehabilitation in older patients with cardiac disease?
p-value: p=0.892
Remote cardiac rehabilitation using information and communication technology is a feasible and safe alternative to center-based rehabilitation for maintaining functional status in older patients.
Supports remote cardiac rehabilitation as a viable alternative for older patients; extends RCT evidence for telehealth equivalence in cardiac rehab.
BACKGROUND: Cardiac rehabilitation (CR) in the long term is fundamental to achieve better outcomes. However, most patients may find it difficult to maintain healthy lifestyle behavior after ambulatory CR program. We aimed to investigate the feasibility on remote CR support program (Remote-CR) in older patients with cardiac disease. METHODS: Between October 2020 and February 2021, we enrolled older patients with cardiac disease after at least over 5 months of ambulatory CR program. The study was conducted as a randomized controlled case series to compare Remote-CR vs. center-based CR (CB-CR) after ambulatory CR in older patients with cardiac disease. The core component of Remote-CR is a web application, which evaluates vital sign and receives feedback through real-time video consultation once a week. We evaluated the satisfaction of Remote-CR, and impact of Remote-CR on adherence to exercise and physical activity management. Moreover, we assessed the change in functional status using handgrip strength, usual gait speed, short physical performance battery (SPPB), and Kihon checklist (KCL) before the intervention, at the end of the 4-week intervention, and cardiovascular-related hospital discharge within 6 months after completion of ambulatory CR. RESULTS: Eleven patients were enrolled (six for Remote-CR and five for CB-CR). All participants completed the intervention without serious adverse event in each group. After the on-site initial remote system set up, all the patients completed the Remote-CR session without on-site assistance. Patients' satisfaction with Remote-CR was generally high. Remote-CR helps to maintain healthy lifestyle behavior. In addition, Remote-CR and CB-CR seem to be equally successful in maintaining functional status and preventing cardiovascular-related hospital readmission. CONCLUSIONS: This trial suggested the Remote-CR comprising a hybrid of information and communication technology and strategy for health behavior change may be a feasible and safe intervention option in selected older patients with cardiac disease after completion of ambulatory CR.
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Saitoh et al. (2022) conducted an RCT in Stable cardiac disease after completion of ambulatory cardiac rehabilitation (n=11). Remote cardiac rehabilitation support program (Remote-CR) vs. Center-based cardiac rehabilitation (CB-CR) was evaluated on Change in Short Physical Performance Battery (SPPB) score at 4 weeks (p=0.892). A 4-week remote cardiac rehabilitation support program was feasible, safe, and resulted in comparable functional status maintenance and 0% 6-month cardiovascular-related hospital readmission compared to center-based rehabilitation in older patients.
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