A new model of home-based telemonitored cardiac rehabilitation in patients with heart failure: effectiveness, quality of life, and adherence.
OBJECTIVE
Despite proven benefits of cardiac rehabilitation (CR), currently proposed CR models are not acceptable for many heart failure (HF) patients. The purpose of this study was to evaluate a new model of home-based telemonitored cardiac rehabilitation (HTCR) using walking training compared with an outpatient-based standard cardiac rehabilitation (SCR) using interval training on a cycle ergometer.


RESULTS
The study included 152 HF patients (aged 58.1 + or - 10.2 years, NYHA class II and III, ejection fraction < or = 40%) who were randomized to HTCR (n = 77) or SCR (n = 75). All patients underwent 8 weeks of CR. Both groups were comparable in terms of demographic and clinical characteristics and medical therapy. The effectiveness of CR was assessed by changes in NYHA class, peak oxygen consumption, 6-min walking test distance, and SF-36 score. Cardiac rehabilitation resulted in a significant improvement of all parameters in both groups. All patients in the HTCR group completed the 8 weeks of CR, whereas 15 patients in the SCR group (20%) discontinued CR.


CONCLUSIONS
In patients with HF, HTCR is equally as effective as SCR and provides a similar improvement in quality of life. Adherence to CR seems to be better for HTCR. Home-based telemonitored cardiac rehabilitation may be a useful alternative form of CR in patients with HF.
Piotrowicz
Ewa
E
Department of Cardiac Rehabilitation and Noninvasive Electrocardiology, Institute of Cardiology, Alpejska 42, Warsaw 04-628, Poland. epiotrowicz@ikard.pl
Baranowski
Rafal
R
Bilinska
Maria
M
Stepnowska
Monika
M
Piotrowska
Malgorzata
M
Wójcik
Anna
A
Korewicki
Jerzy
J
Chojnowska
Lidia
L
Malek
Lukasz A
LA
Klopotowski
Mariusz
M
Piotrowski
Walerian
W
Piotrowicz
Ryszard
R
D005080:Exercise Test; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000534:rehabilitation*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010349:Patient Compliance; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D016138:Walking