Unit:
Κατεύθυνση Καρδιοπνευμονική Αποκατάσταση και Αποκατάσταση Πασχόντων ΜΕΘLibrary of the School of Health Sciences
Author:
Tsoukatos Michail
Supervisors info:
Κωνσταντίνος Δάβος, Ερευνητής Β΄, Ίδρυμα Ιατροβιολογικών Ερευνών Ακαδημίας Αθηνών, Επιβλέπων
Παρασκευή Κατσαούνου, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Καλομενίδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Telerehabilitation σε χρόνια καρδιακή ανεπάρκεια και στεφανιαία νόσο.
Translated title:
Telerehabilitation in heart failure and coronary heart disease.
Summary:
Coronary heart disease (CHD) is one of the top causes of death in the developed countries, the top cause of years of life lost globally and it was responsible for ≈1 of every 7 deaths in the United States in 2013. The prevalence of heart failure (HF) is estimated at 1–2% in the western world and the incidence approaches 5–10 per 1000 persons per year. Cardiac rehabilitation (CR) has proven beneficial effects on prevention of CHD, and is highly recommended in clinical guidelines for patients with coronary artery disease(CAD). The benefits of exercise training are well documented and unquestionable therefore, exercise training is strongly recommended in HF patients. Even though CR is highly recommended it is poorly implemented in everyday clinical practice. According to a European survey fewer than half of eligible cardiovascular patients benefit from CR in most European countries. Deficits include absent or inadequate legislation, funding, professional guidelines and information systems in many countries. There are different categories of barriers for exercise in HF such as patient related, social and economic, healthcare system/team, condition related and therapy related. Enabling a comprehensive CR at patients’ homes and the introduction of simple training modality could eliminate those adherence hindering factors and increase patient participation in rehabilitation programs. The key to solve the problem of safety and monitoring of homebased physical training of cardiovascular patients and to make this rehabilitation modality theoretically possible is the latest technological advancements in the field of telemedicine which was the reason for the European Society of Cardiology to mention this form of rehabilitation in its current guidelines.
Telerehabilitation is the supervision and performance of a comprehensive CR programme at a distance. The components of telerehabilitation are telemonitoring, teleassessment, telesupport, teletherapy, telecoaching, teleconsulting, and telesupervision of exercise training. Systematic reviews including primary studies comparing cardiac telerehabilitation with centre-based CR have shown that the former to be non-inferior to the latter. Published randomized controlled trials (RCTs) showed that home-based telerehabilitation is well accepted, safe, and effective and has high adherence among HF patients. In this context we can understand that telerehabilitation for cardiopulmonary patients may be helpful to the furthering and popularization of CR and moreover increase the compliance to the recommended guidelines.
Main subject category:
Health Sciences
Keywords:
Telerehabilitation, Coronary heart disease, Heart failure, Rehabilitation
