Promotion of Home-Based Exercise Training as Secondary Prevention of Coronary Heart Disease: A PILOT WEB-BASED INTERVENTION.

Abstract

BACKGROUND:

Although cardiac rehabilitation (CR) is cost- effective in improving the health of patients with coronary heart disease (CHD), less than half of eligible CHD patients attend a CR program. Innovative web-based technologies might improve CR delivery and utilization. We assessed the feasibility and impact on functional capacity and secondary prevention targets of a long-term web-monitored exercise-based CR maintenance program.

METHODS:

Low- to moderate-risk CHD patients were recruited at discharge from inpatient CR after a coronary event or revascularization. We developed an interactive web-based platform for secure home individual access control, monitoring, and validation of exercise training. Of 86 eligible patients, 26 consented to participate in the study intervention (IG). Using a quasi-experimental design, we recruited in parallel 27 eligible patients, unavailable for regular web monitoring, who consented to a follow-up visit as usual care (UC).

RESULTS:

Among IG, active daily data transmission was 100% during month 1, 88% at month 3, and 81% at 6 months, with sustained improvement in self-reported physical activity beginning with the first week after discharge from inpatient CR (2467 [1854-3554] MET-min/wk) to month 3 (3411 [1981-5347] MET-min/wk, P = .019). Both groups showed favorable changes over time in lipid profile, ventricular function, distance walked in 6 min, and quality of life. At 6 mo, IG achieved a significantly higher proportion of cardiovascular risk factor targets than UC (75 ± 20% vs 59 ± 30%, P = .029).

CONCLUSIONS:

Our web-based home CR maintenance program was feasible, well-accepted, and effective in improving physical activity during 6 mo and achieved higher overall adherence to cardiovascular risk targets than UC.

• Authors: Anna Torri, Claudia Panzarino, Anna Scaglione, Maddalena Modica, Bruno Bordoni, Raffaella Redaelli, Renata De Maria, Maurizio Ferratini
• Journal: Journal of cardiopulmonary rehabilitation and prevention (J Cardiopulm Rehabil Prev) Vol. 38 Issue 4 Pg. 253-258 (07 2018) ISSN: 1932-751X [Electronic] United States
• PMID: 29738378 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Lipids

Topics

• Aged
• Cardiac Rehabilitation (methods)
• Coronary Disease (physiopathology, prevention & control, rehabilitation)
• Exercise
• Feasibility Studies
• Female
• Humans
• Internet
• Lipids (blood)
• Male
• Middle Aged
• Patient Compliance
• Pilot Projects
• Quality of Life
• Secondary Prevention (methods)
• Self Care
• Ventricular Function
• Walk Test