Telemedicine-assisted cardiac rehabilitation: A controlled cohort clinical trial

Abstract

Introduction. The traditional method of cardiac rehabilitation (CR) recommends continuing physical training at home, but many patients do not follow these instructions and the effectiveness of the rehabilitation program decreases. Thanks to the use of telemedicine technologies, the doctor can remotely monitor the patient’s condition, ensuring the safety and effectiveness of training.Aim. To test the method of organizing telemedicine support for CR of patients who have suffered a myocardial infarction.Materials and methods. During the study, 27 patients underwent CR with telemedicine support, and 26 patients underwent traditional CR. To assess the effectiveness of using telemedicine technologies in CR, the results of the six-minute walk test under the control of an electrocardiogram were assessed using the Accordix telemedicine system (Neurosoft LLC, Ivanovo) before and after the rehabilitation program.Results. After the end of the CR, in the group of patients with telemedicine support, during the six-minute walk test, reliable indicators of an increase in the distance covered were revealed compared to the results of patients in the control group (72 [52; 99.5] m vs. 45 [0.75; 51] m, p < 0.05), restoration of tolerance to physical activity (the ratio of the distance covered to the expected 15 [11.5; 18.5]% vs. 3 [-1.75; 8.75]%, p < 0.05), as well as an increase in the time the pulse stays in the training corridor (15% vs. 0.04%, p < 0.05). Also, in patients in the telemedicine CR group, the number of workouts was significantly higher (14.5 [12.5; 17] vs. 8.5 [4.5; 11.5], p < 0.05).Conclusion. The presented method of conducting CR using telemedicine technologies has shown greater efficiency compared to the traditional approach. Changes recorded using ECG are analyzed by the telemedicine system, ensuring control and safety of physical activity. The use of telemedicine technologies allows the patient to reduce the fear of repeated myocardial infarction and increase adherence to CR.