Internet-based training of coronary artery patients: the Heart Cycle Trial

Skobel, E. et al. (2017) Internet-based training of coronary artery patients: the Heart Cycle Trial. Heart and Vessels, 32(4), pp. 408-418. (doi: 10.1007/s00380-016-0897-8) (PMID:27730298)

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Abstract

Low adherence to cardiac rehabilitation (CR) might be improved by remote monitoring systems that can be used to motivate and supervise patients and tailor CR safely and effectively to their needs. The main objective of this study was to evaluate the feasibility of a smartphone-guided training system (GEX) and whether it could improve exercise capacity compared to CR delivered by conventional methods for patients with coronary artery disease (CAD). A prospective, randomized, international, multi-center study comparing CR delivered by conventional means (CG) or by remote monitoring (IG) using a new training steering/feedback tool (GEx System). This consisted of a sensor monitoring breathing rate and the electrocardiogram that transmitted information on training intensity, arrhythmias and adherence to training prescriptions, wirelessly via the internet, to a medical team that provided feedback and adjusted training prescriptions. Exercise capacity was evaluated prior to and 6 months after intervention. 118 patients (58 ± 10 years, 105 men) with CAD referred for CR were randomized (IG: n = 55, CG: n = 63). However, 15 patients (27 %) in the IG and 18 (29 %) in the CG withdrew participation and technical problems prevented a further 21 patients (38 %) in the IG from participating. No training-related complications occurred. For those who completed the study, peak VO2 improved more (p = 0.005) in the IG (1.76 ± 4.1 ml/min/kg) compared to CG (−0.4 ± 2.7 ml/min/kg). A newly designed system for home-based CR appears feasible, safe and improves exercise capacity compared to national CR. Technical problems reflected the complexity of applying remote monitoring solutions at an international level.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Skobel, E., Knackstedt, C., Martinez-Romero, A., Salvi, D., Vera-Munoz, C., Napp, A., Luprano, J., Bover, R., Glöggler, S., Bjarnason-Wehrens, B., Marx, N., Rigby, A., and Cleland, J. G.F.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Heart and Vessels
Publisher:Springer
ISSN:0910-8327
ISSN (Online):1615-2573
Published Online:11 October 2016
Copyright Holders:Copyright © 2016 Springer Japan
First Published:First published in Heart and Vessels 32(4):408-418
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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