Feasibility and effectiveness of cardiac telerehabilitation for older adults with coronary heart disease: A pilot randomized controlled trial

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Jing Jing Su , Arkers Kwan Ching Wong , Xi-Fei He , Li-ping Zhang , Jie Cheng , Li-Juan Lu , Lan Lan , Zhaozhao Wang , Rose S.Y. Lin , Ladislav Batalik
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引用次数: 0

Abstract

Background

Cardiac rehabilitation is a beneficial multidisciplinary treatment of exercise promotion, patient education, risk factor management, and psychosocial counseling for people with coronary heart disease (CHD) that is underutilized due to substantial disparities in access, referral, and participation. Empirical studies suggest that cardiac telerehabilitation (CTR) have safety and efficacy comparable to traditional in-person cardiac rehabilitation, however, older adults are under-reported with effectiveness, feasibility, and usability remains unclear.

Methods

The study randomized 43 older adults (84 % males) to the 12-week CTR intervention or standard of care. Guided by Social Cognitive Theory, participants received individualized in-person assessment and e-coaching sessions, followed by CTR usage at home. Data were collected at baseline (T0), six-week (T1), and 12-week (T2).

Results

Participants in the CTR intervention group showed significant improvement in daily steps (T1: β = 4126.58, p = 0.001; T2: β = 5285, p = 0.01) and health-promoting lifestyle profile (T1: β = 23.26, p < 0.001; T2: β = 12.18, p = 0.008) across study endpoints. Twenty participants completed the intervention, with 40 % used the website for data-uploading or experiential learning, 90 % used the pedometer for tele-monitoring. Improving awareness of rehabilitation and an action focus were considered key facilitators while physical discomforts and difficulties in using the technology were described as the main barriers.

Conclusions

The CTR is feasible, safe and effective in improving physical activity and healthy behaviors in older adults with CHD. Considering the variation in individual cardiovascular risk factors, full-scale RCT with a larger sample is needed to determine the effect of CTR on psychological symptoms, body weight and blood pressure, and quality of life.

为患有冠心病的老年人提供心脏远程康复服务的可行性和有效性:随机对照试验
背景心脏康复是一种有益的多学科治疗方法,包括运动促进、患者教育、危险因素管理和冠心病患者的心理咨询,但由于在获取、转诊和参与方面存在巨大差异,因此未得到充分利用。经验性研究表明,心脏远程康复(CTR)的安全性和有效性可与传统的面对面心脏康复相媲美,但是,老年人对其有效性、可行性和可用性的报告不足,目前仍不清楚。方法该研究将 43 名老年人(84% 为男性)随机分配到为期 12 周的 CTR 干预或标准护理中。在社会认知理论的指导下,参与者接受了个性化的面对面评估和电子辅导课程,随后在家中使用 CTR。在基线(T0)、6 周(T1)和 12 周(T2)收集数据。结果CTR 干预组的参与者在各研究终点的每日步数(T1:β = 4126.58,p = 0.001;T2:β = 5285,p = 0.01)和促进健康的生活方式(T1:β = 23.26,p < 0.001;T2:β = 12.18,p = 0.008)方面均有显著改善。20名参与者完成了干预,其中40%的人使用网站上传数据或进行体验式学习,90%的人使用计步器进行远程监测。提高康复意识和行动重点被认为是主要的促进因素,而身体不适和使用技术的困难被认为是主要障碍。考虑到个体心血管风险因素的差异,需要进行更大规模的样本研究,以确定 CTR 对心理症状、体重和血压以及生活质量的影响。
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来源期刊
Contemporary Clinical Trials Communications
Contemporary Clinical Trials Communications Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
2.70
自引率
6.70%
发文量
146
审稿时长
20 weeks
期刊介绍: Contemporary Clinical Trials Communications is an international peer reviewed open access journal that publishes articles pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from a wide range of disciplines including medicine, life science, pharmaceutical science, biostatistics, epidemiology, computer science, management science, behavioral science, and bioethics. Contemporary Clinical Trials Communications is unique in that it is outside the confines of disease specifications, and it strives to increase the transparency of medical research and reduce publication bias by publishing scientifically valid original research findings irrespective of their perceived importance, significance or impact. Both randomized and non-randomized trials are within the scope of the Journal. Some common topics include trial design rationale and methods, operational methodologies and challenges, and positive and negative trial results. In addition to original research, the Journal also welcomes other types of communications including, but are not limited to, methodology reviews, perspectives and discussions. Through timely dissemination of advances in clinical trials, the goal of Contemporary Clinical Trials Communications is to serve as a platform to enhance the communication and collaboration within the global clinical trials community that ultimately advances this field of research for the benefit of patients.
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