Authors (including presenting author) :
Tsui LN(1), Yau TY(1), Leung HY(1), So SY(1), Lau KM(1), Leung KC(2)
Affiliation :
(1)Physiotherapy Department, Tung Wah Eastern Hospital, (2)Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital
Introduction :
Under the influence of the COVID-19 epidemic, ambulatory cardiac rehabilitation (CR) service in Hospital Authority was restricted resulting in reduced patients’ uptake with decreased training opportunities.
Advancement in telecommunication technology made remote patient care possible. Physiotherapy Tele-Care service is introduced in TWEH to enhance patients’ service access during the epidemic and to explore future development of protocol-driven Tele-Care model in CR.
Objectives :
To explore the feasibility, efficacy and acceptability on the application of physiotherapy Tele-Care in CR.
Methodology :
A hybrid model of centre and home-based Tele-Care CR was introduced to patients with stable heart condition, consented and were able to receive service by using electronic devices. For patients who refused or unable to receive Tele-Care, 8-session usual centre-based ambulatory training with home exercise advice and education were given.
In addition to usual training, Tele-Care group received Tele-support throughout the program with individualized home exercise prescribed by physiotherapist through “Rehab” app under HA Go Mobile Application and exercise diary. Exercise intensity, precautions and patient’s feedback were evaluated periodically. CR group education was conducted via Zoom. Patients’ post-discharge exercise adherence was monitored using telephone or WhatsApp at one-month follow-up.
6-minute Walk Test (6MWT), exercise volume (duration x frequency) and Cardiac Exercise Self-Efficacy Instrument Chinese Version (CESEI-C) were measured at baseline and upon completion of ambulatory training for both Tele-Care and usual care patients. Patients’ exercise adherence (exercise volume) and satisfaction to service were collected at one-month follow-up.
Result & Outcome :
33 patients under Tele-Care (n=18) and usual care (n=15) with comparable baseline demographic data were recruited. Paired T-Test was applied to compare within group difference. Repeated measures ANOVA was applied to compare the between-group difference. Both groups showed increases in 6MWT (p< 0.01) though no significant difference was detected between groups. Significant difference in change of exercise volume was found between groups upon discharge (p=0.001); while Tele-Care group was able to maintain exercise adherence after one-month follow-up. CESEI-C was significantly increased (p< 0.05) in Tele-Care group only. All Tele-Care participants are satisfied with the Tele-Care service.
The hybrid model of physiotherapy Tele-Care in CR was well accepted by patients and shown to be effective in promoting patients’ exercise capacity, improving exercise self-efficacy as well as maintaining exercise adherence.
