Effects of Cardiac Telerehabilitation During COVID-19 on Cardiorespiratory Capacities in Coronary Artery Disease Patients.

Study Overview
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Brief Summary
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After an acute coronary syndrome, an adapted cardiac rehabilitation program is necessary to restore or increase physical capacities and decrease cardiovascular risk. This multidisciplinary care combines physical training sessions and therapeutic education workshops. The COVID-19 pandemic imposed restrictions such as the closure of rehabilitation centres. To remedy this problem, one solution was to adapt the existing program to a remote cardiac telerehabilitation, i.e., medical and paramedical supervision of rehabilitation sessions and therapeutic patient education meetings via digital tools. Recent studies have shown that it was a safe (no reported adverse effects), effective (similar gains in peak oxygen consumption compared to traditional cardiac rehabilitation and patient-adherence alternative.

Detailed Description
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The hypothesis of this study is that telerehabilitation was more effective on cardiorespiratory functions.

Official Title
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Effects of Cardiac Telerehabilitation During COVID-19 on Cardiorespiratory Capacities in Coronary Artery Disease Patients.

Conditions
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Cardiac Disease

Intervention / Treatment
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* Other: cardiac telerehabilitation program by videoconference


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both groups: Acute Coronary Syndrome treated in the last 6 months Medical revascularization (angioplasty ± stenting) or surgical (coronary artery bypass) For Telerehabilitation group: Internet connexion (computer or digital tablet) Equipped with an exercise bike Exclusion Criteria: Both groups: Pulmonary hypertension Aortic pathway anomaly Uncontrolled ventricular rhythm disorders For Telerehabilitation group: Important muscular deconditioning Patient requiring medical supervision in institute

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Home-based cardiac telerehabilitation (interventional group)<br>Patients followed the cardiac rehabilitation program at home. | Other: cardiac telerehabilitation program by videoconference<br>* A video conference interview with an Adapted Physical Activity (APA) teacher before starting physical training Exercise training for 3 weeks via distance coaching Therapeutic patient education (TPE) workshops conducted remotely with 1 workshop per week. Medical follow-up via teleconsultation Psychological and/or dietetic follow-up if necessary. Final assessment at 1 month with evaluation of aerobic metabolism, functional evaluation and final shared educational assessment (BEP). Appointment with an association Cœur et Santé and Sport-Santé 42 or setting up of an individual physical activity<br>|
| Traditional centre-based cardiac rehabilitation (control group)<br>Patients participates in the cardiac rehabilitation program in hospital. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Baseline oxygen (VO2) (ml/min/kg) at the first ventilatory threshold (VT1) at 2 months | Variation of oxygen (VO2) (ml/min/kg) at the first ventilatory threshold (VT1) during a cardio-pulmonary exercise test (CPET) before and after 15 training sessions performed | Months: 0, 2 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| oxygen (VO2) peak | Variation of oxygen (VO2) peak before and after 15 training sessions performed | Months: 0, 2 | 
| maximum power workload | Variation of maximum power workload before and after 15 training sessions performed | Months: 0, 2 | 
| power at the first ventilatory threshold (VT1) | Variation of power at the first ventilatory threshold (VT1) before and after 15 training sessions performed | Months: 0, 2 | 
| maximum heart rate | Variation of maximum heart rate before and after 15 training sessions performed. | Months: 0, 2 | 
| recovery heart rate | Variation of recovery heart rate before and after 15 training sessions performed. | Months: 0, 2 | 
| obstructive ventilatory disorder | Variation of obstructive ventilatory disorder before and after 15 training sessions performed. | Months: 0, 2 | 
| autonomic nervous system | Variation of autonomic nervous system before and after 15 training sessions performed. | Months: 0, 2 | 
| muscular strength | Variation of muscular strength before and after 15 training sessions performed. | Months: 0, 2 | 
| muscular endurance | Variation of muscular endurance before and after 15 training sessions performed. | Months: 0, 2 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cardiac telerehabilitation, acute coronary syndrome, rehabilitation therapeutic, rehabilitation sessions, cardiorespiratory functions