Algorithm for managing the safety of remote cardiac rehabilitation in the integrated telemedicine system "IS-Cardio"
https://doi.org/10.15829/1560-4071-2024-5678
EDN: UJUGMO
Abstract
Aim. To testing the safety algorithm of remote cardiac rehabilitation (RCR) programs performed on the basis of the integrated telemedicine system (TMS) "IS-Cardio".
Material and methods. The object of a single-center pilot study was the safety algorithm for home physical training (PT) programs embedded in the TMS "ISCardio" cardiac rehabilitation module. Its functionality ensured the implementation of 12-week aerobic PT programs with an intensity of 55-70%, duration 90-300 min/week and a target level of individual exercise tolerance of 8-12 on the 6-20 Borg scale. The number of adverse events was assessed, defined as an individual exercise tolerance level of ³13.
Results. The study included 33 patients (men, 75%; mean age, 56±8 years). The activity of patients in the RCR was 2,4±0,7 РT per week with a total duration of 56,5±29,8 min/week. Twelve patients (39,6%) fully completed the PT program, exercising at least 3 times/week for at least 30 min/session. One adverse event was recorded, which required extraordinary transmission of blood pressure, heart rate, ECG recording and remote consultation.
Conclusion. The use of TMS with a computerized module for monitoring PT parameters makes it possible to safely perform RCR in patients with cardiovascular disease. The safety of РT programs using an algorithm providing stopping the program with subsequent remote consultation should be ensured. The necessary components of TMS that determine the safety of RCR are the initial stratification of patients, remote monitoring based on self-monitoring devices, and a feedback function.
About the Authors
E. V. KotelnikovaRussian Federation
Saratov
O. M. Posnenkova
Russian Federation
Saratov
T. M. Bogdanova
Russian Federation
Saratov
V. N. Senchikhin
Russian Federation
Saratov
V. I. Gridnev
Russian Federation
Saratov
References
1. Richardson CR, Franklin B, Moy ML, et al. Advances in rehabilitation for chronic diseases: improving health outcomes and function. BMJ. 2019;365:l2191. doi:10.1136/bmj.l2191.
2. Sandesara PB, Lambert CT, Gordon NF, et al. Cardiac rehabilitation and risk reduction: time to "rebrand and reinvigorate". J Am Coll Cardiol. 2015;65:389-95. doi:10.1016/j.jacc.2014.10.059.
3. Ades PA, Keteyian SJ, Wright JS, et al. Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clin Proc. 2017;92:234-42. doi:10.1016/j.mayocp.2016.10.014.
4. Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J. 2016;37:2315-81. doi:10.1093/eurheartj/ehw106.
5. Hannan AL, Harders MP, Hing W, et al. Impact of wearable physical activity monitoring devices with exercise prescription or advice in the maintenance phase of cardiac rehabilitation: systematic review and meta-analysis. BMC Sports Sci Med Rehabil. 2019; 11:14. doi:10.1186/s13102-019-0126-8.
6. Taylor RS, Dalal H, Jolly K, et al. Home-based vs centre-based cardiac rehabilitation. Cochrane Database Syst Rev. 2015;18:(8):CD007130. doi:10.1002/14651858.CD007130.pub3.
7. Thompson PD, Franklin BA, Balady GJ, et al. Exercise and Acute Cardiovascular Events Placing the Risks Into Perspective: A Scientific Statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circ. 2007;115:2358-68. doi:10.1161/CIRCULATIONAHA.107.181485.
8. Acute myocardial infarction with ST segment elevation of the electrocardiogram: rehabilitation and secondary prevention. Russian clinical guidelines. CardioSomatika. 2014; Suppl. 1:5-42. (In Russ.) EDN: UOWIRX.
9. Stefanakis M, Batalik L, Antoniou V, et al. Safety of home-based cardiac rehabilitation: A systematic review. Heart Lung. 2022;55:117-26. doi:10.1016/j.hrtlng.2022.04.016.
10. Buys R, Claes J, Walsh D, et al. Cardiac patients show high interest in technology enabled cardiovascular rehabilitation. BMC Med Inform Decis Mak. 2016;16:95. doi:10.1186/s12911-016-0329-9.
11. Attkisson CC, Greenfield TK. The UCSF Client Satisfaction Scales: I.The Client Satisfaction Questionnaire-8. In: Maruish M., ed. The Use of Psychological Testing for Treatment Planning and Outcome Assessment. Mahwah N. J.: Lawrence Erlbaum Associates, 2004:402-20.
12. Trevlaki E, Trevlakis E, Xrysos G, et al. The safety of exercise-based cardiac rehabilitation program in patients after Myocardial Infarction. Intern J Scie Res Arch. 2022;06(01): 288-93. doi:10.30574/ijsra.2022.6.1.0140.
13. Liu S, Zhao H, Fu J, et al. Current status and influencing factors of digital health literacy among community-dwelling older adults in Southwest China: a cross-sectional study. BMC Public Health. 2022;22:996. doi:10.1186/s12889-022-13378-4.
14. Abdrakhmanova GI, Vasilkovskii SA, Vishnevskii KO, et al. Digital Economy: 2023: A Brief Statistical Collection. Nats issled un-t Vysshaia shkola ekonomiki M.: NIU VSHE, 2023. 332 p. (In Russ.) ISBN: 978-5-7598-2697-2.
15. Dinesen B, Nielsen G, Andreasen JJ, et al. Integration of Rehabilitation Activities In to Everyday Life. Through Telerehabilitation: Qualitative Study of Cardiac Patients and Their Partners. J Med Internet Res. 2019;21(4):e13281. doi:10.2196/13281.
16. Kotelnikova EV, Senchikhin VN, Lipchanskaya TP. Remote cardiology rehabilitation in the strategy implementation of the secondary prevention in patients with cardiovascular diseases. Rus J Prev Med. 2021;24(5):15-21. (In Russ.) doi:10.17116/profmed20212405115.
Supplementary files
- Cardiac rehabilitation (CR) is a comprehensive preventive intervention with Class I and Level A evidence level.
- The proportion of patient participation in outpatient CR programs everywhere does not exceed 20% of the number of patients in need of them.
- Remote CR, including home PT programs, remote monitoring of cardiac parameters, counseling and patient education, has effectiveness comparable to traditional CR.
- The use of integrated telemedicine systems with a computerized algorithm for monitoring the safety of physical training can ensure the full implementation of remote CR programs.
Review
For citations:
Kotelnikova E.V., Posnenkova O.M., Bogdanova T.M., Senchikhin V.N., Gridnev V.I. Algorithm for managing the safety of remote cardiac rehabilitation in the integrated telemedicine system "IS-Cardio". Russian Journal of Cardiology. 2024;29(9):5678. (In Russ.) https://doi.org/10.15829/1560-4071-2024-5678. EDN: UJUGMO