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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
Affiliations- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Poland
- The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
- Silvermedia, Krakow, Poland
- Universitätsklinikum Carl Gustav Carus Dresden
- Fraunhofer-Gesellschaft zur Förderung der Angewandten Forschung e.V., München, Germany
- AGH University of Science and Technology, Krakow, Poland
- Uzdrowisko Ustron Health Resort, Poland
- Andrzej Frycz Modrzewski Krakow University, Faculty of Medicine and Health Sciences, Krakow, Poland
- Head of Department of Cardiac Rehabilitation and Noninvasive Electrocardiology, National Institute of Cardiology, Warsaw, Poland
open access
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.
Keywords
tele-rehabilitation; myocardial revascularization; optimal cardiac rehabilitation; reduced rehospitalization rate
About this articleTitle
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
Issue
Pages
594-603
Published online
2018-12-13
Page views
2880
Article views/downloads
2348
DOI
Pubmed
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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