title: Exercise Telemonitoring and Telerehabilitation Compared with Traditional Cardiac and Pulmonary Rehabilitation: A Systematic Review and Meta-Analysis.
abstract: Background:Despite exercise capacity and quality-of-life benefits, pulmonary rehabilitation (PR) and cardiac rehabilitation (CR) programmes are not easily accessed because of several barriers. A solution may be telerehabilitation (TR), in which patients exercise in their communities while they are monitored via teletechnology. However, the benefits of TR for the purposes of PR and CR have not been systematically reviewed.Objective:To determine whether the benefits of the exercise component of PR and CR using TR are comparable to usual-care (UC) programmes.Methods:A comprehensive literature search was performed of the Medline, Embase, and CINAHL databases up to July 13, 2015. Meta-analyses were performed for peak oxygen consumption, peak workload, exercise test duration, and 6-minute walk test (6MWT) distance using theI2statistic and forest plots displaying standardized mean difference (SMD).Results:Of 1,431 citations found, 8 CR studies met the inclusion criteria. No differences were found in exercise outcomes between UC and TR groups for CR studies, except in exercise test duration, which slightly favoured UC (SMD 0.268, 95% CI: 0.002, 0.534,p<0.05). Only 1 PR study was included, and it showed similar improvements on the 6MWT between the UC and TR groups.Conclusion:TR for patients with cardiac conditions provided benefits similar to UC with no adverse effects reported. Similar studies of TR for patients with pulmonary conditions need to be conducted.
authors.affiliation: Centre for Heart Lung Innovation, University of British Columbia.
authors.forename: Christen
authors.initials: C
authors.lastname: Chan
authors.affiliation: Centre for Heart Lung Innovation, University of British Columbia; Alberta Health Services - Rockyview General Hospital, Calgary.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Yamabayashi
authors.affiliation: Centre for Heart Lung Innovation, University of British Columbia; School of Allied Health Sciences, Manipal University, Manipal, India.
authors.forename: Nafeez
authors.initials: N
authors.lastname: Syed
authors.affiliation: Centre for Heart Lung Innovation, University of British Columbia.
authors.forename: Ashley
authors.initials: A
authors.lastname: Kirkham
authors.affiliation: Centre for Heart Lung Innovation, University of British Columbia; Department of Physical Therapy, University of British Columbia, Vancouver.
authors.forename: Pat G
authors.initials: PG
authors.lastname: Camp
keywords: chronic obstructive pulmonary disease; heart diseases; rehabilitation; systematic review; telemedicine; telerehabilitation