Authors (including presenting author) :
Li SM(1), Choi WM(1), Lau CK David(1), Cheung YW(1), Leung CY Gary(2)
Affiliation :
(1) Physiotherapy Department, Tseung Kwan O Hospital, Hong Kong, (2) Department of Medicine, Tseung Kwan O Hospital, Hong Kong
Introduction :
Cardiac rehabilitation plays a crucial role in optimizing physical function of cardiac patients, reducing their cardiovascular risks and mortality. However, the outbreak of coronavirus disease 2019 (COVID-19) has interrupted the delivery of routine cardiac services and restrained patients’ participation in rehabilitation. In order to boost patient’s adherence and compliance to exercise training for secondary prevention, the Cardiac Society of Australia and New Zealand (CSANZ) recommended that health care professionals should continue to deliver evidenced-based training with the adoption of electronic health platforms to fulfill the general recommendation of at least 150-minutes of moderate intensity exercise per week as they are more accessible during the pandemic.
Objectives :
This study sought to examine the safety and effectiveness of physiotherapy tele-rehabilitation in cardiac rehabilitation during COVID-19.
Methodology :
Cardiac patients were recruited from the Cardiac Rehabilitation Program Phase II (CRP) in Tseung Kwan O Hospital between December 2019 and November 2020. Patients who attended the CRP received usual care of 1.5-hour center-based training 1-2 times per week, with 12 sessions in total. In addition, tele-rehabilitation was implemented in the form of home virtual exercise via QR code, introducing circuit training including stretching, punching, squatting and lunging etc. Patients’ safety, 6 Minutes Walk Test (6MWT) distance, Five Times Sit To Stand (FTSTS) and Cardiac Exercise Self-Efficacy Instrument (CESEI) were measured at baseline and at end of the 12th session. Patient satisfaction survey was conducted before discharge.
Result & Outcome :
Fifty patients with a mean age of 59.54 (SD=8.74) were recruited. No adverse events were reported in relation to home virtual exercise. There were significant improvements in 6MWT distance (404.80±84.11 vs 497.12±86.85; p< 0.001), FTSTS (10.26±3.57 vs 8.20±3.11; p< 0.001) and CESEI (59.68±11.13 vs 64.18±8.58; p=0.001). All patients reported satisfied and very satisfied on improvement in functional capacity, managing daily lives and self-management on cardiovascular disease. Tele-rehabilitation via home virtual exercise appears to be safe and effective for patients to exercise at home during COVID-19. Improvements in functional capacity and self-efficacy were observed, therefore, suggesting that home virtual exercise could be used as an adjunct to center-based training to reduce cardiovascular risk. Cardiac rehabilitation specialists should consider employing electronic platforms during the pandemic to deliver exercise regimes. Future study is needed to explore the long-term effects of tele-rehabilitation after program completion.
