The aim was to evaluate feasibility, efficacy and safety of home-based telerehabilitation following shortened inpatient cardiac rehabilitation in comparison to a regular inpatient cardiac rehabilitation program in patients suffering uncomplicated coronary artery disease (CAD).
This prospective non-randomised parallel group study assigned 45 male patients for shortened 2 weeks inpatient rehabilitation followed by a 10 weeks telerehabilitation program (TRG) versus 47 patients who completed a conventional 4 weeks inpatient rehabilitation program (CG). Outcome measures were assessed after 12 months using cardiopulmonary function (Watt (W)peak, Wpeak/kgBW(Bodywight), WVAT1(ventilatory aerobic treshold1), VO2peak/kg, VO2VAT1/kg, With L(lactate)2mmol/l, With L(lactate)4mmol/l), laboratory parameters (total cholesterol (TC), high density lipoprotein (HDL)-C; low density lipoprotein (LDL)-C; TC/HDL-C quotient)), physical parameter (body weight (BW); body mass index (BMI), waste circumference (WC), body fat (BF)).
Baseline demographics were equally distributed between the groups, except age (CG younger).
No adverse events were observed in both groups during rehabilitation.
After 12 month in the TRG (n=41), Wpeak (+23,.1%; p<0.001), Wpeak/kgBW (+24.7%; p<0.001), WVAT1 (+11.2%; p=0.014), VO2peak/kg (+7.4%; p=0.008), and VO2VAT1/kg (+4.7%; p=ns) were increased.
In the CG (n=45) only Wpeak and Wpeak/kgBW increased by +3.5% (p=ns) and +3.2% (p=ns) respectively. In contrast WVAT1, VO2VAT1/kg and VO2peak/kg decreased by -15.1% (p= 0.002), -11.1% (p= 0.006), and -1.3%(p= ns) respectively. The difference between TRG and CG was highly significant for VO2VAT1/kg (p=0.016), Wpeak (p=0.019), Wpeak/kg (p=0.005), and WVAT1 (p=0.002). In TRG concentrations of LDL-C (-22.7%; p< 0.001), TC (-14.5%; p< 0.001), TG (-17.2%; p=ns), and TC/HDL-C (-16.9%; p= 0.001) decreased significantly during the twelve months. HDL-C (+1.2%; p=0.087) did not increase statistically significant. In CG non of the laboratory parameters statistically significant changed. After 12 months except HDL-C all parameters showed a statistically significant difference between the groups in favour of the TRG. Physical parameters showed no statistical significant difference within and between the two groups after twelve months.
Home-based telerehabilitation can be regarded as safe and feasible for patients with uncomplicated CAD. In addition we could show significant improvements due to physical fitness and change in risk factors in the TRG compared to regular four weeks inpatient rehabilitation.