| Autor: |
Ensom, Emily, Albuquerque, Daniella, Erskine, Nathaniel, Peterson, Amy, Dickson, Emily, Ding, Eric Y, Piche, Jaclyn, Wang, Ziyue, Escobar, Jorge, Alonso, Alvaro A, Makam, Raghavendra, Botkin, Naomi, Stut, Wim, McManus, David D |
| Zdroj: |
Circulation (Ovid); November 2019, Vol. 140 Issue: Supplement 1 pA11873-A11873, 1p |
| Abstrakt: |
Introduction:Through supervised exercise training and disease management interventions, cardiac rehabilitation (CR) reduces morbidity and mortality among acute myocardial infarction (AMI) survivors. Data has shown CR improves outcomes; major cardiovascular disease (CVD); improves exercise performance; enhances medication compliance; reduces symptoms such as angina, dyspnea, and fatigue. In this pilot study, we developed and assessed the feasibility of delivering a smartwatch informed 12-week tele-rehabilitation program to AMI survivors.Methods:We enrolled hospitalized AMI survivors at an academic medical center who were medically cleared for CR post exercise stress test. Participants received a Philips Healthwatch monitoring heart rate (HR) and activity and a tablet with an application that displayed progress towards accomplishing weekly walking and exercise goals. Results were transmitted to a CR nurse via a secure cellular internet connection. For 12 weeks, participants exercised at home using HR and activity targets, and participated in weekly phone counseling sessions with the CR nurse who used a provider dashboard to provide personalized CR problem solving and standardized CR education (i.e. diet, weekly goals). We assessed use of the system, adherence to weekly activity goals, counseling session attendance, angina stability (Seattle Angina Questionnaire) and usability (System Usability Scale).Results:Twenty participants enrolled and 18 completed the 12-week tele-rehabilitation program; mean age was 59 (SD 7) years, 35% were women, and 35% had an ST-elevation myocardial infarction. Participants (n=18) wore the smartwatch for a median of 86% of days (IQR: 66%, 98%) for a median of 12.9 hours per day (IQR: 11.3, 14.2).The median percentage of completed walking goals for the entire study was 20% (IQR: 5%, 50%). Participants completed a median of 85% of exercise goals (IQR: 68%, 105%). Participants reported greater angina stability and showed higher adherence to exercise recommendations at 12 weeks compared to baseline (p=0.003).Conclusions:This pilot study established the feasibility of delivering CR at home to survivors of an AMI via an internet connected sensor-based tablet application and telephone counseling sessions. |
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