Feasibility of telerehabilitation for heart failure patients inaccessible for outpatient rehabilitation.
Autor: | Lundgren KM; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway., Langlo KAR; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Department of Nephrology, Clinic of Medicine, St. Olavs University Hospital, Trondheim, Norway., Salvesen Ø; Unit of Applied Clinical Research, Institute of Cancer and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway., Zanaboni P; Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway., Cittanti E; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway., Mo R; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Ellingsen Ø; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway., Dalen H; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Clinic of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.; Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway., Aksetøy IA; Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.; Clinic of Clinical Services, St. Olavs University Hospital, Trondheim, Norway. |
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Jazyk: | angličtina |
Zdroj: | ESC heart failure [ESC Heart Fail] 2023 Aug; Vol. 10 (4), pp. 2406-2417. Date of Electronic Publication: 2023 May 23. |
DOI: | 10.1002/ehf2.14405 |
Abstrakt: | Aims: Despite strong recommendations, outpatient cardiac rehabilitation is underused in chronic heart failure (CHF) patients. Possible barriers are frailty, accessibility, and rural living, which may be overcome by telerehabilitation. We designed a randomized, controlled trial to evaluate the feasibility of a 3-month real-time, home-based telerehabilitation, high-intensity exercise programme for CHF patients who are either unable or unwilling to participate in standard outpatient cardiac rehabilitation and to explore outcomes of self-efficacy and physical fitness at 3 months post-intervention. Methods and Results: CHF patients with reduced (≤40%), mildly reduced (41-49%), or preserved ejection fraction (≥50%) (n = 61) were randomized 1:1 to telerehabilitation or control in a prospective controlled trial. The telerehabilitation group (n = 31) received real-time, home-based, high-intensity exercise for 3 months. Inclusion criteria were (i) ≥18 years, (ii) New York Heart Association class II-III, stable on optimized medical therapy for >4 weeks, and (iii) N-terminal pro-brain natriuretic peptide >300 ng/L. All participants participated in a 2-day 'Living with heart failure' course. No other intervention beyond standard care was provided for controls. Outcome measures were adherence, adverse events, self-reported outcome measures, the general perceived self-efficacy scale, peak oxygen uptake (VO Conclusions: Home-based telerehabilitation was feasible in chronic heart failure patients inaccessible for outpatient cardiac rehabilitation. Most participants were adherent when given more time and felt safe exercising at home under supervision, and no adverse events occurred. The trial suggests that telerehabilitation can increase the use of cardiac rehabilitation, but the clinical benefit of telerehabilitation must be evaluated in larger trials. (© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.) |
Databáze: | MEDLINE |
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