Telemonitored exercise-based cardiac rehabilitation improves physical capacity and health-related quality of life

Introduction: Cardiac rehabilitation improves physical capacity, health-related quality of life, and reduces morbidity and mortality among cardiac patients. Telemonitored exercise-based cardiac rehabilitation may innovate existing programmes and increase participation rates.

Objective: The purpose of this study was to investigate if telemonitored exercise-based cardiac rehabilitation improves physical capacity, muscle endurance, muscle power, muscle strength and health-related quality of life in cardiac patients.

Methods: A follow-up study on moderate risk patients with ischaemic heart and heart valve disease referred to a 12-week telemonitored exercise-based cardiac rehabilitation intervention at Aarhus University Hospital (Denmark). Participants were encouraged to exercise 60 min three times weekly with moderate/high intensity for 20 min per session. Intensity and duration of training sessions were visualised on a smartphone and uploaded to a website. Participants received individual feedback from physiotherapists on their training efforts by telephone/email. Outcome measures were changes in physical capacity (peak oxygen uptake), muscle endurance, power, and strength, and health-related quality of life between baseline end of telemonitored exercise-based cardiac rehabilitation intervention, and at six and 12 months after end of telemonitored exercise-based cardiac rehabilitation.

Results: Thirty-four participants completed telemonitored exercise-based cardiac rehabilitation. We identified a significant increase in peak oxygen uptake of 10%, in muscle endurance of 17%, in muscle power of 7%, and in muscle strength of 10% after the telemonitored exercise-based cardiac rehabilitation programme. Health-related quality of life was significantly improved by 19% in the physical and 17% in the mental component scores. We found no significant improvement in peak oxygen uptake between baseline and 12 months follow-up, but a significant improvement in muscle endurance (0.3 watts/kg, 95% confidence interval; 0.2-0.4), muscle power (0.4 watts/kg; 0.2-0.5), muscle strength (0.5 N/m/kg; 0.1-0.9), physical health-related quality of life (five points; 2-8) and mental health-related quality of life (six points; 3-9).

Discussion: This study demonstrated that the self-elected type of physical exercise in cardiac rehabilitation with telemonitoring improved all outcome measures both on the short and long-term, except for peak oxygen uptake at 12 months follow-up.