TY - JOUR
T1 - Internet-based training of coronary artery patients
T2 - the Heart Cycle Trial
AU - Skobel, Erik
AU - Knackstedt, Christian
AU - Martinez-Romero, Alvaro
AU - Salvi, Dario
AU - Vera-Munoz, Cecilia
AU - Napp, Andreas
AU - Luprano, Jean
AU - Bover, Ramon
AU - Gloeggler, Sigrid
AU - Bjarnason-Wehrens, Birna
AU - Marx, Nikolaus
AU - Rigby, Alan
AU - Cleland, John
PY - 2017/4
Y1 - 2017/4
N2 - 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.
AB - 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.
KW - Exercise training
KW - Cardiac rehabilitation
KW - Monitoring
KW - INPATIENT CARDIAC REHABILITATION
KW - RANDOMIZED CONTROLLED-TRIAL
KW - CLINICAL-OUTCOMES
KW - PHYSICAL-ACTIVITY
KW - OXYGEN-UPTAKE
KW - WORK RATE
KW - EXERCISE
KW - FAILURE
KW - DISEASE
KW - METAANALYSIS
U2 - 10.1007/s00380-016-0897-8
DO - 10.1007/s00380-016-0897-8
M3 - Article
C2 - 27730298
SN - 0910-8327
VL - 32
SP - 408
EP - 418
JO - Heart and Vessels
JF - Heart and Vessels
IS - 4
ER -