Conventional Rehabilitation Therapy Versus Telerehabilitation in Cardiac Patients: A Comparison of Motivation, Psychological Distress, and Quality of Life.

Helle Spindler,Birthe Dinesen,Gitte Nielsen,Katrine Joensson,Jan Andreasen,Kasper Leerskov

doi:10.3390/ijerph16030512

Abstract

Telerehabilitation (TR) has gained attention as a promising rehabilitation format. Our study examined how patients responded to TR and whether it provided adequate support for their lifestyle changes and self-care efforts when compared to conventional rehabilitation (CR). Cardiac patients (n = 136) were randomly assigned to a TR or CR group. The TR group was provided with relevant health care technology for a period of three months, and both groups filled in questionnaires on their motivation for lifestyle changes and self-care psychological distress, and quality of life at 0, 3, 6, and 12 months. Patients in both groups were found to be equally motivated for lifestyle changes and self-care (p < 0.05) and they experienced similar levels of psychological distress and quality of life. TR is comparable to conventional rehabilitation in motivating patients, preventing psychological distress and improving quality of life. Although we observed an initial increase in autonomous motivation in the telerehabilitation group, this positive difference in motivation does not last over time. As such, neither rehabilitation format seems able to ensure long-term motivation. Therefore, TR may serve as a viable replacement for conventional rehabilitation when considered relevant. Further research is needed to enhance long-term motivation, and maybe telerehabilitation can help to achieve this.

Highlights

Cardiovascular disease (CVD) is the leading cause of death across Europe today [1]
There were no significant differences between the two groups on any of our measures of psychological distress, a trend could be argued for a difference in depression and anxiety, as the study was underpowered to detect such differences (panxiety = 0.07, dCohen(anxiety) = 0.30, βanxiety = 0.40; pdepression = 0.07, dCohen(depression) = 0.32, βdepression = 0.44)
Our results suggest that there are no differences between conventional rehabilitation and telerehabilitation in terms of motivating patients to engage in rehabilitation activities

Summary

Introduction

Cardiovascular disease (CVD) is the leading cause of death across Europe today [1]. Developing rehabilitation programs to address lifestyle changes and improve self-care in CVD is a key factor in reducing mortality rates, as effective rehabilitation has been associated with a reduced symptom burden, improved quality of life, reduced psychological distress (anxiety and depression), Int. J. Res. Public Health 2019, 16, 512; doi:10.3390/ijerph16030512 www.mdpi.com/journal/ijerph

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