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Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty

AIMS: Cardiac rehabilitation (CR) is an evidence‐based, secondary preventive strategy that improves mortality and morbidity rates in patients with heart failure (HF). However, the implementation and continuation of CR remains unsatisfactory, particularly for outpatients with physical frailty. This s...

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Autores principales: Nagatomi, Yuta, Ide, Tomomi, Higuchi, Tae, Nezu, Tomoyuki, Fujino, Takeo, Tohyama, Takeshi, Nagata, Takuya, Higo, Taiki, Hashimoto, Toru, Matsushima, Shouji, Shinohara, Keisuke, Yokoyama, Tomiko, Eguchi, Aika, Ogusu, Ayumi, Ikeda, Masataka, Ishikawa, Yusuke, Yamashita, Fumika, Kinugawa, Shintaro, Tsutsui, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9288767/
https://www.ncbi.nlm.nih.gov/pubmed/35534907
http://dx.doi.org/10.1002/ehf2.13934
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author Nagatomi, Yuta
Ide, Tomomi
Higuchi, Tae
Nezu, Tomoyuki
Fujino, Takeo
Tohyama, Takeshi
Nagata, Takuya
Higo, Taiki
Hashimoto, Toru
Matsushima, Shouji
Shinohara, Keisuke
Yokoyama, Tomiko
Eguchi, Aika
Ogusu, Ayumi
Ikeda, Masataka
Ishikawa, Yusuke
Yamashita, Fumika
Kinugawa, Shintaro
Tsutsui, Hiroyuki
author_facet Nagatomi, Yuta
Ide, Tomomi
Higuchi, Tae
Nezu, Tomoyuki
Fujino, Takeo
Tohyama, Takeshi
Nagata, Takuya
Higo, Taiki
Hashimoto, Toru
Matsushima, Shouji
Shinohara, Keisuke
Yokoyama, Tomiko
Eguchi, Aika
Ogusu, Ayumi
Ikeda, Masataka
Ishikawa, Yusuke
Yamashita, Fumika
Kinugawa, Shintaro
Tsutsui, Hiroyuki
author_sort Nagatomi, Yuta
collection PubMed
description AIMS: Cardiac rehabilitation (CR) is an evidence‐based, secondary preventive strategy that improves mortality and morbidity rates in patients with heart failure (HF). However, the implementation and continuation of CR remains unsatisfactory, particularly for outpatients with physical frailty. This study investigated the efficacy and safety of a comprehensive home‐based cardiac rehabilitation (HBCR) programme that combines patient education, exercise guidance, and nutritional guidance using information and communication technology (ICT). METHODS AND RESULTS: This study was a single‐centre, open‐label, randomized, controlled trial. Between April 2020 and November 2020, 30 outpatients with chronic HF (New York Heart Association II–III) and physical frailty were enrolled. The control group (n = 15) continued with standard care, while the HBCR group (n = 15) also received comprehensive, individualized CR, including ICT‐based exercise and nutrition guidance using ICT via a Fitbit® device for 3 months. The CR team communicated with each patient in HBCR group once a week via the application messaging tool and planned the training frequency and intensity of training individually for the next week according to each patient's symptoms and recorded pulse data during exercise. Dietitians conducted a nutritional assessment and then provided individual nutritional advice using the picture‐posting function of the application. The primary outcome was the change in the 6 min walking distance (6MWD). The participants' mean age was 63.7 ± 10.1 years, 53% were male, and 87% had non‐ischaemic heart disease. The observed change in the 6MWD was significantly greater in the HBCR group (52.1 ± 43.9 m vs. −4.3 ± 38.8 m; P < 0.001) at a 73% of adherence rate. There was no significant change in adverse events in either group. CONCLUSIONS: Our comprehensive HBCR programme using ICT for HF patients with physical frailty improved exercise tolerance and improved lower extremity muscle strength in our sample, suggesting management with individualized ICT‐based programmes as a safe and effective approach. Considering the increasing number of HF patients with frailty worldwide, our approach provides an efficient method to keep patients engaged in physical activity in their daily life.
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spelling pubmed-92887672022-07-19 Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty Nagatomi, Yuta Ide, Tomomi Higuchi, Tae Nezu, Tomoyuki Fujino, Takeo Tohyama, Takeshi Nagata, Takuya Higo, Taiki Hashimoto, Toru Matsushima, Shouji Shinohara, Keisuke Yokoyama, Tomiko Eguchi, Aika Ogusu, Ayumi Ikeda, Masataka Ishikawa, Yusuke Yamashita, Fumika Kinugawa, Shintaro Tsutsui, Hiroyuki ESC Heart Fail Original Articles AIMS: Cardiac rehabilitation (CR) is an evidence‐based, secondary preventive strategy that improves mortality and morbidity rates in patients with heart failure (HF). However, the implementation and continuation of CR remains unsatisfactory, particularly for outpatients with physical frailty. This study investigated the efficacy and safety of a comprehensive home‐based cardiac rehabilitation (HBCR) programme that combines patient education, exercise guidance, and nutritional guidance using information and communication technology (ICT). METHODS AND RESULTS: This study was a single‐centre, open‐label, randomized, controlled trial. Between April 2020 and November 2020, 30 outpatients with chronic HF (New York Heart Association II–III) and physical frailty were enrolled. The control group (n = 15) continued with standard care, while the HBCR group (n = 15) also received comprehensive, individualized CR, including ICT‐based exercise and nutrition guidance using ICT via a Fitbit® device for 3 months. The CR team communicated with each patient in HBCR group once a week via the application messaging tool and planned the training frequency and intensity of training individually for the next week according to each patient's symptoms and recorded pulse data during exercise. Dietitians conducted a nutritional assessment and then provided individual nutritional advice using the picture‐posting function of the application. The primary outcome was the change in the 6 min walking distance (6MWD). The participants' mean age was 63.7 ± 10.1 years, 53% were male, and 87% had non‐ischaemic heart disease. The observed change in the 6MWD was significantly greater in the HBCR group (52.1 ± 43.9 m vs. −4.3 ± 38.8 m; P < 0.001) at a 73% of adherence rate. There was no significant change in adverse events in either group. CONCLUSIONS: Our comprehensive HBCR programme using ICT for HF patients with physical frailty improved exercise tolerance and improved lower extremity muscle strength in our sample, suggesting management with individualized ICT‐based programmes as a safe and effective approach. Considering the increasing number of HF patients with frailty worldwide, our approach provides an efficient method to keep patients engaged in physical activity in their daily life. John Wiley and Sons Inc. 2022-05-09 /pmc/articles/PMC9288767/ /pubmed/35534907 http://dx.doi.org/10.1002/ehf2.13934 Text en © 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Nagatomi, Yuta
Ide, Tomomi
Higuchi, Tae
Nezu, Tomoyuki
Fujino, Takeo
Tohyama, Takeshi
Nagata, Takuya
Higo, Taiki
Hashimoto, Toru
Matsushima, Shouji
Shinohara, Keisuke
Yokoyama, Tomiko
Eguchi, Aika
Ogusu, Ayumi
Ikeda, Masataka
Ishikawa, Yusuke
Yamashita, Fumika
Kinugawa, Shintaro
Tsutsui, Hiroyuki
Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty
title Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty
title_full Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty
title_fullStr Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty
title_full_unstemmed Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty
title_short Home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty
title_sort home‐based cardiac rehabilitation using information and communication technology for heart failure patients with frailty
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9288767/
https://www.ncbi.nlm.nih.gov/pubmed/35534907
http://dx.doi.org/10.1002/ehf2.13934
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