Telerehabilitation for Cardiac Patients: Systematic Review

Abstract Cardiovascular rehabilitation is one nonpharmacological intervention used to treat cardiovascular diseases. Despite the proven benefits of cardiovascular rehabilitation, the adherence of patients with heart disease is low. Thus, the alternative of telerehabilitation has gained importance, and many studies are being carried out to verify its efficacy. To review the literature and assess the efficacy of telerehabilitation for the cardiac population. This is a systematic review of the literature. The search was conducted in the electronic databases MEDLINE/PubMed (Medical Literature Analysis and Retrieval System Online), PubMed Central® (PMC), Cochrane Library, and Physiotherapy Evidence Database (PEDro), using the combination of descriptors, including terms of the Medical Subject Headings (MeSH) and its entry terms. The MeSH terms used in combination were: “telerehabilitation” AND “cardiac rehabilitation” (Table 1). Then, a manual search by use of the articles selected, as well as a search in the gray literature, was conducted. The search strategy collected 154 studies, of which 109 were excluded because of duplication in the databases and 29 for not being clinical studies. Sixteen clinical studies were included for full analysis, of which 2 were excluded for being prospective, 2 for being duplicate and 5 for not including any outcome. Thus, 7 studies were included. Cardiac rehabilitation using telerehabilitation is a feasible and safe alternative to conventional rehabilitation, and has high adherence of patients with heart disease. It can be added to conventional cardiovascular rehabilitation programs or used in isolation.

摘要 心血管康复（Cardiovascular rehabilitation）是用于治疗心血管疾病的非药物干预手段之一。尽管心血管康复已被证实具有明确的临床获益，但心脏病患者的治疗依从性普遍偏低。因此，远程康复（telerehabilitation）作为替代方案的重要性日益凸显，目前已有诸多研究旨在验证其临床疗效。本研究旨在系统梳理相关文献，并评估远程康复用于心脏疾病患者群体的临床疗效。本研究为文献系统综述。检索工作在MEDLINE/PubMed（医学文献分析与检索系统在线版，Medical Literature Analysis and Retrieval System Online）、PubMed Central®（PMC）、Cochrane图书馆以及物理治疗证据数据库（PEDro）中开展，检索策略采用主题词组合方式，涵盖医学主题词表（Medical Subject Headings, MeSH）及其入口术语。本次组合使用的医学主题词为：「远程康复（telerehabilitation）」AND「心血管康复（Cardiovascular rehabilitation）」（见表1）。随后，研究人员对筛选出的文献开展手工检索，并同步进行灰色文献检索。本次检索共获取154项研究，其中109项因数据库内重复而被排除，29项因非临床研究被剔除。初筛纳入16项临床研究进行完整分析，其中2项为前瞻性研究被排除，2项存在重复，另有5项未设置任何结局指标而被剔除，最终共纳入7项研究。采用远程康复模式开展的心脏康复，是常规康复方案可行且安全的替代选择，同时可提升心脏病患者的治疗依从性。该模式既可作为补充方案加入常规心血管康复项目，也可独立开展。