Medium-Term Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial
Cardiac telerehabilitation has been introduced as an adjunct or alternative to conventional center-based cardiac rehabilitation to increase its long-term effectiveness. However, before large-scale implementation and reimbursement in current health care systems is possible, well-designed studies on t...
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| Veröffentlicht in: | Journal of medical Internet research 2015-07, Vol.17 (7), p.e185-e185 |
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| creator | Frederix, Ines Hansen, Dominique Coninx, Karin Vandervoort, Pieter Vandijck, Dominique Hens, Niel Van Craenenbroeck, Emeline Van Driessche, Niels Dendale, Paul |
| description | Cardiac telerehabilitation has been introduced as an adjunct or alternative to conventional center-based cardiac rehabilitation to increase its long-term effectiveness. However, before large-scale implementation and reimbursement in current health care systems is possible, well-designed studies on the effectiveness of this new additional treatment strategy are needed.
The aim of this trial was to assess the medium-term effectiveness of an Internet-based, comprehensive, and patient-tailored telerehabilitation program with short message service (SMS) texting support for cardiac patients.
This multicenter randomized controlled trial consisted of 140 cardiac rehabilitation patients randomized (1:1) to a 24-week telerehabilitation program in combination with conventional cardiac rehabilitation (intervention group; n=70) or to conventional cardiac rehabilitation alone (control group; n=70). In the telerehabilitation program, initiated 6 weeks after the start of ambulatory rehabilitation, patients were stimulated to increase physical activity levels. Based on registered activity data, they received semiautomatic telecoaching via email and SMS text message encouraging them to gradually achieve predefined exercise training goals. Patient-specific dietary and/or smoking cessation advice was also provided as part of the telecoaching. The primary endpoint was peak aerobic capacity (VO2 peak). Secondary endpoints included accelerometer-recorded daily step counts, self-assessed physical activities by International Physical Activity Questionnaire (IPAQ), and health-related quality of life (HRQL) assessed by the HeartQol questionnaire at baseline and at 6 and 24 weeks.
Mean VO2 peak increased significantly in intervention group patients (n=69) from baseline (mean 22.46, SD 0.78 mL/[min*kg]) to 24 weeks (mean 24.46, SD 1.00 mL/[min*kg], P |
| doi_str_mv | 10.2196/jmir.4799 |
| format | Article |
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The aim of this trial was to assess the medium-term effectiveness of an Internet-based, comprehensive, and patient-tailored telerehabilitation program with short message service (SMS) texting support for cardiac patients.
This multicenter randomized controlled trial consisted of 140 cardiac rehabilitation patients randomized (1:1) to a 24-week telerehabilitation program in combination with conventional cardiac rehabilitation (intervention group; n=70) or to conventional cardiac rehabilitation alone (control group; n=70). In the telerehabilitation program, initiated 6 weeks after the start of ambulatory rehabilitation, patients were stimulated to increase physical activity levels. Based on registered activity data, they received semiautomatic telecoaching via email and SMS text message encouraging them to gradually achieve predefined exercise training goals. Patient-specific dietary and/or smoking cessation advice was also provided as part of the telecoaching. The primary endpoint was peak aerobic capacity (VO2 peak). Secondary endpoints included accelerometer-recorded daily step counts, self-assessed physical activities by International Physical Activity Questionnaire (IPAQ), and health-related quality of life (HRQL) assessed by the HeartQol questionnaire at baseline and at 6 and 24 weeks.
Mean VO2 peak increased significantly in intervention group patients (n=69) from baseline (mean 22.46, SD 0.78 mL/[min*kg]) to 24 weeks (mean 24.46, SD 1.00 mL/[min*kg], P<.01) versus control group patients (n=70), who did not change significantly (baseline: mean 22.72, SD 0.74 mL/[min*kg]; 24 weeks: mean 22.15, SD 0.77 mL/[min*kg], P=.09). Between-group analysis of aerobic capacity confirmed a significant difference between the intervention group and control group in favor of the intervention group (P<.001). At 24 weeks, self-reported physical activity improved more in the intervention group compared to the control group (P=.01) as did the global HRQL score (P=.01).
This study showed that an additional 6-month patient-specific, comprehensive telerehabilitation program can lead to a bigger improvement in both physical fitness (VO2 peak) and associated HRQL compared to center-based cardiac rehabilitation alone. These results are supportive in view of possible future implementation in standard cardiac care.</description><identifier>ISSN: 1438-8871</identifier><identifier>ISSN: 1439-4456</identifier><identifier>EISSN: 1438-8871</identifier><identifier>DOI: 10.2196/jmir.4799</identifier><identifier>PMID: 26206311</identifier><language>eng</language><publisher>Canada: Journal of Medical Internet Research</publisher><subject>Adult ; Cardiac patients ; Cardiology ; Clinical trials ; Coronary Artery Disease - rehabilitation ; Coronary heart disease ; Exercise ; Female ; Humans ; Internet ; Male ; Middle Aged ; Original Paper ; Prospective Studies ; Quality of Life ; Rehabilitation Centers ; Surveys and Questionnaires ; Telerehabilitation - methods ; Text Messaging</subject><ispartof>Journal of medical Internet research, 2015-07, Vol.17 (7), p.e185-e185</ispartof><rights>COPYRIGHT 2015 Journal of Medical Internet Research</rights><rights>Ines Frederix, Dominique Hansen, Karin Coninx, Pieter Vandervoort, Dominique Vandijck, Niel Hens, Emeline Van Craenenbroeck, Niels Van Driessche, Paul Dendale. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.07.2015. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-52da303261b991f2f627f3f43b9843b756d4a84785780bc21dd400913fd8f5c93</citedby><cites>FETCH-LOGICAL-c476t-52da303261b991f2f627f3f43b9843b756d4a84785780bc21dd400913fd8f5c93</cites><orcidid>0000-0001-6730-3426 ; 0000-0003-3118-7560 ; 0000-0001-8636-5972 ; 0000-0003-3074-2737 ; 0000-0003-0821-4559 ; 0000-0002-6276-6445 ; 0000-0003-2209-088X ; 0000-0002-6094-2548 ; 0000-0001-7686-2668</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,724,777,781,861,882,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26206311$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Frederix, Ines</creatorcontrib><creatorcontrib>Hansen, Dominique</creatorcontrib><creatorcontrib>Coninx, Karin</creatorcontrib><creatorcontrib>Vandervoort, Pieter</creatorcontrib><creatorcontrib>Vandijck, Dominique</creatorcontrib><creatorcontrib>Hens, Niel</creatorcontrib><creatorcontrib>Van Craenenbroeck, Emeline</creatorcontrib><creatorcontrib>Van Driessche, Niels</creatorcontrib><creatorcontrib>Dendale, Paul</creatorcontrib><title>Medium-Term Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial</title><title>Journal of medical Internet research</title><addtitle>J Med Internet Res</addtitle><description>Cardiac telerehabilitation has been introduced as an adjunct or alternative to conventional center-based cardiac rehabilitation to increase its long-term effectiveness. However, before large-scale implementation and reimbursement in current health care systems is possible, well-designed studies on the effectiveness of this new additional treatment strategy are needed.
The aim of this trial was to assess the medium-term effectiveness of an Internet-based, comprehensive, and patient-tailored telerehabilitation program with short message service (SMS) texting support for cardiac patients.
This multicenter randomized controlled trial consisted of 140 cardiac rehabilitation patients randomized (1:1) to a 24-week telerehabilitation program in combination with conventional cardiac rehabilitation (intervention group; n=70) or to conventional cardiac rehabilitation alone (control group; n=70). In the telerehabilitation program, initiated 6 weeks after the start of ambulatory rehabilitation, patients were stimulated to increase physical activity levels. Based on registered activity data, they received semiautomatic telecoaching via email and SMS text message encouraging them to gradually achieve predefined exercise training goals. Patient-specific dietary and/or smoking cessation advice was also provided as part of the telecoaching. The primary endpoint was peak aerobic capacity (VO2 peak). Secondary endpoints included accelerometer-recorded daily step counts, self-assessed physical activities by International Physical Activity Questionnaire (IPAQ), and health-related quality of life (HRQL) assessed by the HeartQol questionnaire at baseline and at 6 and 24 weeks.
Mean VO2 peak increased significantly in intervention group patients (n=69) from baseline (mean 22.46, SD 0.78 mL/[min*kg]) to 24 weeks (mean 24.46, SD 1.00 mL/[min*kg], P<.01) versus control group patients (n=70), who did not change significantly (baseline: mean 22.72, SD 0.74 mL/[min*kg]; 24 weeks: mean 22.15, SD 0.77 mL/[min*kg], P=.09). Between-group analysis of aerobic capacity confirmed a significant difference between the intervention group and control group in favor of the intervention group (P<.001). At 24 weeks, self-reported physical activity improved more in the intervention group compared to the control group (P=.01) as did the global HRQL score (P=.01).
This study showed that an additional 6-month patient-specific, comprehensive telerehabilitation program can lead to a bigger improvement in both physical fitness (VO2 peak) and associated HRQL compared to center-based cardiac rehabilitation alone. These results are supportive in view of possible future implementation in standard cardiac care.</description><subject>Adult</subject><subject>Cardiac patients</subject><subject>Cardiology</subject><subject>Clinical trials</subject><subject>Coronary Artery Disease - rehabilitation</subject><subject>Coronary heart disease</subject><subject>Exercise</subject><subject>Female</subject><subject>Humans</subject><subject>Internet</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Paper</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Rehabilitation Centers</subject><subject>Surveys and Questionnaires</subject><subject>Telerehabilitation - methods</subject><subject>Text Messaging</subject><issn>1438-8871</issn><issn>1439-4456</issn><issn>1438-8871</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkt9rFDEQxxdRbK0--A9IwBd92DPZZH_EB6EeVQ9aLd6JjyGXTLYpu8maZIv6n_nfmaM_6EEJJMPMZ74zSaYoXhK8qAhv3l2ONixYy_mj4pAw2pVd15LH9-yD4lmMlxhXmHHytDiomgo3lJDD4t8ZaDuP5QbCiE6MAZXsFTiIEXmDJFr6cQpwAS5mN1q5BMFBKj_KCBpJp9G5TBZcKtcTKGusQhsYIGfIrR1sykHv0HnwfZAj-mnTRY7_TugsF5C9dT1az9PkQ0LGB7SUQVupbjXje_Q9l_Cj_ZuLLb1LwQ9DNjfByuF58cTIIcKLm_Oo-PHpZLP8Up5--7xaHp-WirVNKutKS4pp1ZAt58RUpqlaQw2jW97lra0bzWTH2q5uO7xVFdGaYcwJNbozteL0qPhwrTvN2xG0yo0FOYgp2FGGP8JLK_Yjzl6I3l8JVlcd7uos8OZGIPhfM8QkRhsVDIN04OcoSMM547lFltHX12gvBxDWGZ8V1Q4Xx23DaV3XdCe4eIDKS8NolXdgbPbvJbzdS8hMyr_QyzlGsVp_fZBVwccYwNzdlGCxmzaxmzaxm7bMvrr_NHfk7XjR_ydW0q8</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Frederix, Ines</creator><creator>Hansen, Dominique</creator><creator>Coninx, Karin</creator><creator>Vandervoort, Pieter</creator><creator>Vandijck, Dominique</creator><creator>Hens, Niel</creator><creator>Van Craenenbroeck, Emeline</creator><creator>Van Driessche, Niels</creator><creator>Dendale, Paul</creator><general>Journal of Medical Internet Research</general><general>JMIR Publications Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISN</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6730-3426</orcidid><orcidid>https://orcid.org/0000-0003-3118-7560</orcidid><orcidid>https://orcid.org/0000-0001-8636-5972</orcidid><orcidid>https://orcid.org/0000-0003-3074-2737</orcidid><orcidid>https://orcid.org/0000-0003-0821-4559</orcidid><orcidid>https://orcid.org/0000-0002-6276-6445</orcidid><orcidid>https://orcid.org/0000-0003-2209-088X</orcidid><orcidid>https://orcid.org/0000-0002-6094-2548</orcidid><orcidid>https://orcid.org/0000-0001-7686-2668</orcidid></search><sort><creationdate>20150701</creationdate><title>Medium-Term Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial</title><author>Frederix, Ines ; Hansen, Dominique ; Coninx, Karin ; Vandervoort, Pieter ; Vandijck, Dominique ; Hens, Niel ; Van Craenenbroeck, Emeline ; Van Driessche, Niels ; Dendale, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-52da303261b991f2f627f3f43b9843b756d4a84785780bc21dd400913fd8f5c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Cardiac patients</topic><topic>Cardiology</topic><topic>Clinical trials</topic><topic>Coronary Artery Disease - rehabilitation</topic><topic>Coronary heart disease</topic><topic>Exercise</topic><topic>Female</topic><topic>Humans</topic><topic>Internet</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Paper</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Rehabilitation Centers</topic><topic>Surveys and Questionnaires</topic><topic>Telerehabilitation - methods</topic><topic>Text Messaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Frederix, Ines</creatorcontrib><creatorcontrib>Hansen, Dominique</creatorcontrib><creatorcontrib>Coninx, Karin</creatorcontrib><creatorcontrib>Vandervoort, Pieter</creatorcontrib><creatorcontrib>Vandijck, Dominique</creatorcontrib><creatorcontrib>Hens, Niel</creatorcontrib><creatorcontrib>Van Craenenbroeck, Emeline</creatorcontrib><creatorcontrib>Van Driessche, Niels</creatorcontrib><creatorcontrib>Dendale, Paul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Canada</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of medical Internet research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Frederix, Ines</au><au>Hansen, Dominique</au><au>Coninx, Karin</au><au>Vandervoort, Pieter</au><au>Vandijck, Dominique</au><au>Hens, Niel</au><au>Van Craenenbroeck, Emeline</au><au>Van Driessche, Niels</au><au>Dendale, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medium-Term Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial</atitle><jtitle>Journal of medical Internet research</jtitle><addtitle>J Med Internet Res</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>17</volume><issue>7</issue><spage>e185</spage><epage>e185</epage><pages>e185-e185</pages><issn>1438-8871</issn><issn>1439-4456</issn><eissn>1438-8871</eissn><abstract>Cardiac telerehabilitation has been introduced as an adjunct or alternative to conventional center-based cardiac rehabilitation to increase its long-term effectiveness. However, before large-scale implementation and reimbursement in current health care systems is possible, well-designed studies on the effectiveness of this new additional treatment strategy are needed.
The aim of this trial was to assess the medium-term effectiveness of an Internet-based, comprehensive, and patient-tailored telerehabilitation program with short message service (SMS) texting support for cardiac patients.
This multicenter randomized controlled trial consisted of 140 cardiac rehabilitation patients randomized (1:1) to a 24-week telerehabilitation program in combination with conventional cardiac rehabilitation (intervention group; n=70) or to conventional cardiac rehabilitation alone (control group; n=70). In the telerehabilitation program, initiated 6 weeks after the start of ambulatory rehabilitation, patients were stimulated to increase physical activity levels. Based on registered activity data, they received semiautomatic telecoaching via email and SMS text message encouraging them to gradually achieve predefined exercise training goals. Patient-specific dietary and/or smoking cessation advice was also provided as part of the telecoaching. The primary endpoint was peak aerobic capacity (VO2 peak). Secondary endpoints included accelerometer-recorded daily step counts, self-assessed physical activities by International Physical Activity Questionnaire (IPAQ), and health-related quality of life (HRQL) assessed by the HeartQol questionnaire at baseline and at 6 and 24 weeks.
Mean VO2 peak increased significantly in intervention group patients (n=69) from baseline (mean 22.46, SD 0.78 mL/[min*kg]) to 24 weeks (mean 24.46, SD 1.00 mL/[min*kg], P<.01) versus control group patients (n=70), who did not change significantly (baseline: mean 22.72, SD 0.74 mL/[min*kg]; 24 weeks: mean 22.15, SD 0.77 mL/[min*kg], P=.09). Between-group analysis of aerobic capacity confirmed a significant difference between the intervention group and control group in favor of the intervention group (P<.001). At 24 weeks, self-reported physical activity improved more in the intervention group compared to the control group (P=.01) as did the global HRQL score (P=.01).
This study showed that an additional 6-month patient-specific, comprehensive telerehabilitation program can lead to a bigger improvement in both physical fitness (VO2 peak) and associated HRQL compared to center-based cardiac rehabilitation alone. These results are supportive in view of possible future implementation in standard cardiac care.</abstract><cop>Canada</cop><pub>Journal of Medical Internet Research</pub><pmid>26206311</pmid><doi>10.2196/jmir.4799</doi><orcidid>https://orcid.org/0000-0001-6730-3426</orcidid><orcidid>https://orcid.org/0000-0003-3118-7560</orcidid><orcidid>https://orcid.org/0000-0001-8636-5972</orcidid><orcidid>https://orcid.org/0000-0003-3074-2737</orcidid><orcidid>https://orcid.org/0000-0003-0821-4559</orcidid><orcidid>https://orcid.org/0000-0002-6276-6445</orcidid><orcidid>https://orcid.org/0000-0003-2209-088X</orcidid><orcidid>https://orcid.org/0000-0002-6094-2548</orcidid><orcidid>https://orcid.org/0000-0001-7686-2668</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; PubMed Central |
| subjects | Adult Cardiac patients Cardiology Clinical trials Coronary Artery Disease - rehabilitation Coronary heart disease Exercise Female Humans Internet Male Middle Aged Original Paper Prospective Studies Quality of Life Rehabilitation Centers Surveys and Questionnaires Telerehabilitation - methods Text Messaging |
| title | Medium-Term Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial |
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