open access

Vol 26, No 5 (2019)
STUDY PROTOCOL - CLINICAL CARDIOLOGY
Published online: 2018-12-13
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The use of modern telemedicine technologies in an innovative optimal cardiac rehabilitation program for patients after myocardial revascularization: Concept and design of RESTORE, a randomized clinical trial

Krzysztof Milewski, Andrzej Małecki, Dominika Orszulik-Baron, Mateusz Kachel, Piotr Hirnle, Marek Orczyk, Rafał Dunal, Grzegorz Mikołajowski, Adam Janas, Zbigniew Nowak, Karol Kozak, Wojciech Roskiewicz, Katarzyna Nierwińska, Andrzej Izworski, Adam Rybicki, Piotr P. Buszman, Ryszard Piotrowicz, Pawel E. Buszman
DOI: 10.5603/CJ.a2018.0157
·
Pubmed: 30566211
·
Cardiol J 2019;26(5):594-603.

open access

Vol 26, No 5 (2019)
STUDY PROTOCOL - CLINICAL CARDIOLOGY
Published online: 2018-12-13

Abstract

Despite proven efficacy of cardiac rehabilitation (CR) in reducing the all-cause mortality in patients after myocardial revascularization, the penetration of CR, due to patient-related factors and referral rates remains limited. To improve the outcomes, home-based tele-rehabilitation (TR) has been proposed recently. In theory TR enhances the effects of standard CR procedures due to implementation of an intelligent monitoring system designed to ensure optimal training through on-demand transmission of vital signs, aimed at motivating the patients through daily schedule reminders, setting daily goals and creating a platform for mutual feedback. Several meta-analyses assessing various studies comparing these two methods (CR and TR) have proven that they are at least equally effective, with some of the research showing superiority of TR. Although there was a small sample size, lack of long-term follow-up, reporting effects of TR itself, no integration with tools designed for coaching, motivating and promoting a healthy lifestyle constitutes an important limitation. The latter carries a hopeful prognosis for improvement when utilizing a broad-spectrum approach, especially with use of dedicated technological solutions exploiting the fact of a large and yet rapidly increasing penetration of smartphones, mobile PCs and tablets in the population. The above-mentioned findings worked as the basis and rationale for commencing the RESTORE project aimed at developing and delivering state-of-the-art, comprehensive TR for patients after myocardial revascularization and evaluating its molecular aspect in view of how it influences the atherosclerosis progression attenuation. This paper presents the current state and rationale behind the project based on up-to-date TR efficacy data.

Abstract

Despite proven efficacy of cardiac rehabilitation (CR) in reducing the all-cause mortality in patients after myocardial revascularization, the penetration of CR, due to patient-related factors and referral rates remains limited. To improve the outcomes, home-based tele-rehabilitation (TR) has been proposed recently. In theory TR enhances the effects of standard CR procedures due to implementation of an intelligent monitoring system designed to ensure optimal training through on-demand transmission of vital signs, aimed at motivating the patients through daily schedule reminders, setting daily goals and creating a platform for mutual feedback. Several meta-analyses assessing various studies comparing these two methods (CR and TR) have proven that they are at least equally effective, with some of the research showing superiority of TR. Although there was a small sample size, lack of long-term follow-up, reporting effects of TR itself, no integration with tools designed for coaching, motivating and promoting a healthy lifestyle constitutes an important limitation. The latter carries a hopeful prognosis for improvement when utilizing a broad-spectrum approach, especially with use of dedicated technological solutions exploiting the fact of a large and yet rapidly increasing penetration of smartphones, mobile PCs and tablets in the population. The above-mentioned findings worked as the basis and rationale for commencing the RESTORE project aimed at developing and delivering state-of-the-art, comprehensive TR for patients after myocardial revascularization and evaluating its molecular aspect in view of how it influences the atherosclerosis progression attenuation. This paper presents the current state and rationale behind the project based on up-to-date TR efficacy data.

Get Citation

Keywords

tele-rehabilitation; myocardial revascularization; optimal cardiac rehabilitation; reduced rehospitalization rate

About this article
Title

The use of modern telemedicine technologies in an innovative optimal cardiac rehabilitation program for patients after myocardial revascularization: Concept and design of RESTORE, a randomized clinical trial

Journal

Cardiology Journal

Issue

Vol 26, No 5 (2019)

Pages

594-603

Published online

2018-12-13

DOI

10.5603/CJ.a2018.0157

Pubmed

30566211

Bibliographic record

Cardiol J 2019;26(5):594-603.

Keywords

tele-rehabilitation
myocardial revascularization
optimal cardiac rehabilitation
reduced rehospitalization rate

Authors

Krzysztof Milewski
Andrzej Małecki
Dominika Orszulik-Baron
Mateusz Kachel
Piotr Hirnle
Marek Orczyk
Rafał Dunal
Grzegorz Mikołajowski
Adam Janas
Zbigniew Nowak
Karol Kozak
Wojciech Roskiewicz
Katarzyna Nierwińska
Andrzej Izworski
Adam Rybicki
Piotr P. Buszman
Ryszard Piotrowicz
Pawel E. Buszman

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