Cardiac telerehabilitation improves physical function in frail older adults after acute decompensated heart failure: a randomised controlled trial (Tele-ADHF)
M Van Leunen, I De Lathauwer, V Van Es, R Brouwers, R Tio, R Spee, Y Lu, H KempsAbstract
Aims
Clinical admission due to acute decompensated heart failure (ADHF) leads to substantial physical deconditioning. This randomised controlled trial aims to assess the effectiveness of cardiac telerehabilitation (CTR) on physical function in frail, older adults after admission for ADHF.
Methods and Results
A total of 87 patients entering remote patient management (RPM) after admission for ADHF were included. Sixty-four (74%) reached stable heart failure, defined as two weeks of stable symptoms and achievement of maximally tolerated guideline-directed medical therapy, after a median of 55 days (IQR: 32.5-106.5), and were subsequently randomised to intervention (RPM and CTR; n=31) or control group (RPM only; n=31). The 18-week CTR intervention consisted of three in-hospital training sessions with a physical and/or occupational therapist, followed by weekly video coaching, and video consultations with a dietician and psychologist. The primary outcome, physical function (Short Physical Performance Battery (SPPB)), and secondary outcome, quality of life (QoL) (KCCQ-12 and MLHFQ), were measured at randomisation, 18 and 26 weeks. At 26 weeks, the proportion of participants with a ‘good’ SPPB score increased from 70 to 83% in the intervention group, compared to 48 to 46% in the control group (p <0.01). No significant between-group differences were found for QoL. Adherence to the intervention was 90%, with 76% reporting high satisfaction.
Conclusion
Multidisciplinary cardiac telerehabilitation combined with RPM resulted in a significantly greater and clinically relevant improvement in physical function compared to RPM only in older, frail patients recently admitted for ADHF.For image description, please refer to the figure legend and surrounding text.For image description, please refer to the figure legend and surrounding text.