SPC365

Home-based Cardiac Rehabilitation - the real barriers of programs at distance

Session: CO 12 - Cardiologia preventiva/reabilitação
Speaker: Ana Margarida Martins

Congress: CPC 2021
Topic: J. Preventive Cardiology
Theme: 29. Rehabilitation and Sports Cardiology
Subtheme: 29.2 Cardiovascular Rehabilitation
Session Type: Comunicações Orais
FP Number: ---
Authors: Margarida Martins; Inês Aguiar-Ricardo; Nelson Cunha; Tiago Rodrigues; Pedro Silvério António; Sara Couto Pereira; Joana Brito; Pedro Alves da Silva; Beatriz Valente Silva; Beatriz Garcia; Catarina Oliveira; Rita Pinto; Madalena Lemos Pires; Olga Santos; Paula Sousa; Fausto j. Pinto; Ana Abreu

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Introduction&nbsp;</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">Despite established benefits of cardiac rehabilitation (CR), it remains significantly underutilized. Home-based CR (CR-HB) programs should offer the same core CR components as Centre-based programs (CR-CB) but several aspects need to be adapted, communication and supervision involves several important issues.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">Although CR-HB has been successfully deployed and is a valuable alternative to CR-CB,&nbsp;there is less structured experience with these&nbsp;programs and further studies are needed to understand which patients (pts) are indicated to this type of program.&nbsp;</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Aim&nbsp;</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">To investigate patient-perceived facilitators and barriers to CR-HB.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Methods&nbsp;</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">Prospective cohort study of&nbsp;pts&nbsp;who were participating in a CR-CB program and accepted to participate in a CR-HB program after CR-CB closure due to COVID-19. The CR-HB consisted in a multidisciplinary digital program, including pt risk evaluation and regular assessment, exercise, educational and psychological sessions. The online exercise training sessions consisted of recorded videos and real time online supervised exercise&nbsp;sessions. It was recommended to do each session 3 times per week, during 60 min. A pictorial exercise training guidebook was available to all pts including instructions regarding safety, clothing and warm-up, and a detailed illustrated description of each&nbsp;exercise sessions. Also, for questions or difficulties regarding the exercises, an e-mail and telephone was provided. Once a month, real time CR exercise sessions through a device with internet access was provided.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Results</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">&nbsp;116 cardiovascular disease (CVD) pts&nbsp;(62.6&plusmn;8.9 years, 95 males) who were attending a face-to-face CR program were included in a CR-HB program. The majority of the pts&nbsp;had coronary artery disease (89%) and 5% valvular disease. Regarding risk factors, obesity was the most common (75%) followed by hypertension (60%), family history (42%), dyslipidaemia (38%), diabetes (18%), and smoking (13%).&nbsp;</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">47%&nbsp;of the participants did at least 1 online exercise training session (ETS) per week: 58% did 2-3 times per week, 27% once per week and 15% more than 4 times per week.&nbsp;</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">Participants who did less than 1&nbsp;ETS&nbsp;per week reported as cause: lack of motivation to train alone (38%), preference of a different mode of exercise training in the exterior space (26%), other reasons (19%), technology barrier such as impossibility to stream online videos (11%), fear of performing exercise without supervision (4%), and limited space at home to perform the exercise training sessions (4%).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Conclusion&nbsp;</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial"><span style="color:#000000"><span style="background-color:#ffffff">Our study based on real-life results of a CR-HB program shows a sub-optimal rate of participation in exercise sessions mainly for the lack of motivation to exercise alone or preference for walking/jogging in exterior space. The knowledge of the CR-HB program barriers will facilitate to find out strategies to increase the participation rate and to select the best candidates.&nbsp;</span></span></span></span></p>