title: Effects of home-based training with telemonitoring guidance in low to moderate risk patients entering cardiac rehabilitation: short-term results of the FIT@Home study.
abstract: BACKGROUND
  Home-based exercise training in cardiac rehabilitation (CR) has the potential to improve CR uptake, decrease costs and increase self-management skills. The FIT@Home study evaluates home-based CR with telemonitoring guidance using coaching interventions including strategies for behavioural changes with the aim to maintain adherence to a healthy lifestyle and to improve long-term effects. In this interim analysis we provide short-term results on exercise capacity, quality of life and training adherence of the first 50 patients included in the FIT@Home study.
  
  
  METHODS
  The study design was a randomised controlled trial.
  
  
  METHODS
  Low to moderate risk CR patients were randomised to a 12-week home-based training (HT) programme or a 12-week centre-based training (CT) programme. In both groups, training was performed at 70-85% of maximal heart rate (HRmax) for 45-60 min, 2-3 times per week. The HT group received three supervised training sessions, before commencing training with a heart rate monitor in their home environment. These patients received individual coaching by telephone weekly, based on training data uploaded on the Internet. The CT programme was performed under the direct supervision of a physical therapist. Exercise capacity and health-related quality of life were assessed at baseline and at 12 weeks.
  
  
  RESULTS
  CT (n = 25) and HT (n = 25) both showed a significant improvement in peak oxygen uptake (peak VO2) (10% and 14% respectively) and quality of life after 12 weeks of training, without significant between-group differences. The average training intensity of the HT group was 73.3 ± 3.5% of HRmax. Training adherence was similar between groups.
  
  
  CONCLUSIONS
  This analysis shows that HT with telemonitoring guidance has similar short-term effects on exercise capacity and quality of life as CT in CR patients.
authors.affiliation: Department of Medical Informatics, University of Amsterdam, the Netherlands j.j.kraal@amc.uva.nl.
authors.forename: Jos J
authors.initials: JJ
authors.lastname: Kraal
authors.affiliation: Department of Medical Informatics, University of Amsterdam, the Netherlands Health eResearch Centre, University of Manchester, UK.
authors.forename: Niels
authors.initials: N
authors.lastname: Peek
authors.affiliation: Department of Medical Decision Making, Leiden University Medical Center, the Netherlands.
authors.forename: M Elske
authors.initials: ME
authors.lastname: Van den Akker-Van Marle
authors.affiliation: Department of Medical Informatics, University of Amsterdam, the Netherlands Department of Cardiology, Máxima Medical Center Veldhoven, the Netherlands.
authors.forename: Hareld Mc
authors.initials: HM
authors.lastname: Kemps
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006339:Heart Rate; D018575:Home Care Services, Hospital-Based; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D009426:Netherlands; D010101:Oxygen Consumption; D010349:Patient Compliance; D011237:Predictive Value of Tests; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D013686:Telemetry / Q000295:instrumentation; D013813:Therapy, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome
keywords: Home-based training; cardiac rehabilitation; e-coaching; exercise training; self management; telemedicine; telemonitoring