Telemonitoring During Phase 2-3 Cardiac Rehabilitation
Condition: Ischemic Heart Disease
MeSH terms: Heart Diseases; Myocardial Ischemia; Coronary Artery Disease
Study type: Interventional
Phase: Phase 2

Summary: 
      In this study, 80 coronary artery disease patients with successful coronary revascularisation
      (by CABG or PCI) will be included. Patients are excluded in case of: congestive heart
      failure, ICD or pacemaker, any disability limiting exercise participation.

      These patients are attending phase 2-3 cardiac rehabilitation, and have completed 6 weeks of
      rehabilitation. Next, subjects are randomly assigned to a control group or an intervention
      group.

      Outcome parameters: physical activity, exercise capacity, blood glucose, insulin level and
      lipid profile, body weight and waist circumference, cardiovascular morbidity and mortality.

      Hypothesis: telemonitoring of physical activity will increase physical activity, and improve
      cardiovascular disease risk factors, in CAD patients attending phase 2-3 cardiac
      rehabilitation.
    

Detailed description: 
      We included patients that suffered from an acute coronary syndrome for which a percutaneous
      coronary intervention or coronary artery bypass graft was performed.

      All patients had access to a computer with internet connection.

      Patients that (i) were more than 80 years old, (ii) had an implantable cardioverter
      defibrillator or pacemaker, (iii) suffered from severe arrhythmias, or (iv) had persistent
      exertional ischaemia after revascularization therapy, were not invited to participate in this
      study. Patients with severe heart failure (NYHA class III and IV), or neurological or
      orthopaedic disability limiting their capability to exercise, were also excluded.

      The study was a prospective randomized controlled trial, including an 18-week intervention.
      All patients were included after week six of their conventional phase II cardiac
      rehabilitation (CR). During phase II of conventional CR, all patients (those in the
      intervention and control group) were educated about the core components of CR including
      healthy nutrition, risk factor management (lipids, hypertension, weight, diabetes, and
      smoking), psychosocial management and physical activity counseling.

      During the first six weeks of the intervention, patients in the intervention group continued
      exercising in the hospital's rehabilitation centre using an outpatient service, in
      combination with an exercise training program with telemonitoring support. Patients in the
      control group continued exercising in the hospital's rehabilitation centre using an
      out-patient service, without participating in the exercise training program with
      telemonitoring support. Starting from the seventh week in the study period, patients in the
      intervention group finished their phase II CR in the hospital's rehabilitation centre but
      continued their exercise training program with telemonitoring support; patients in the
      control group finished their phase II CR in the hospital's rehabilitation centre.

      All patients underwent a maximal cardiopulmonary exercise test (CPET) and a clinical
      examination (with determination of waist circumference, blood pressure, body mass index)
      after randomization, and also during the sixth and 18th week of the Telerehab II study
      period. A fasting blood sampling was taken from all patients during the first and 18th week
      of the Telerehab II study period.

      The hypothesis was that telemonitoring of physical activity will increase physical activity,
      and improve cardiovascular disease risk factors, in CAD patients attending phase 2-3 cardiac
      rehabilitation.
    

Intervention name(s): physical activity monitors; No physical activity monitors
Intervention type(s): Device; Other
Intervention description(s): physical activity monitors; No physical activity monitors
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: CAD, physical activity, rehabilitation, prevention