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Internet-based training of coronary artery patients: the Heart Cycle Trial

Skobel, Erik; Knackstedt, Christian; Martinez-Romero, Alvaro; Salvi, Dario; Vera-Munoz, Cecilia; Napp, Andreas; Luprano, Jean; Bover, Ramon; Glöggler, Sigrid; Bjarnason-Wehrens, Birna; Marx, Nikolaus; Rigby, Alan; Cleland, John

Authors

Erik Skobel

Christian Knackstedt

Alvaro Martinez-Romero

Dario Salvi

Cecilia Vera-Munoz

Andreas Napp

Jean Luprano

Ramon Bover

Sigrid Glöggler

Birna Bjarnason-Wehrens

Nikolaus Marx

John Cleland



Abstract

© 2016, Springer Japan. Low adherence to cardiac rehabilitation (CR) might be improved by remote monitoring systems that can be used to motivate and supervise patients and tailor CR safely and effectively to their needs. The main objective of this study was to evaluate the feasibility of a smartphone-guided training system (GEX) and whether it could improve exercise capacity compared to CR delivered by conventional methods for patients with coronary artery disease (CAD). A prospective, randomized, international, multi-center study comparing CR delivered by conventional means (CG) or by remote monitoring (IG) using a new training steering/feedback tool (GEx System). This consisted of a sensor monitoring breathing rate and the electrocardiogram that transmitted information on training intensity, arrhythmias and adherence to training prescriptions, wirelessly via the internet, to a medical team that provided feedback and adjusted training prescriptions. Exercise capacity was evaluated prior to and 6 months after intervention. 118 patients (58 ± 10 years, 105 men) with CAD referred for CR were randomized (IG: n = 55, CG: n = 63). However, 15 patients (27 %) in the IG and 18 (29 %) in the CG withdrew participation and technical problems prevented a further 21 patients (38 %) in the IG from participating. No training-related complications occurred. For those who completed the study, peak VO 2 improved more (p = 0.005) in the IG (1.76 ± 4.1 ml/min/kg) compared to CG (−0.4 ± 2.7 ml/min/kg). A newly designed system for home-based CR appears feasible, safe and improves exercise capacity compared to national CR. Technical problems reflected the complexity of applying remote monitoring solutions at an international level.

Citation

Skobel, E., Knackstedt, C., Martinez-Romero, A., Salvi, D., Vera-Munoz, C., Napp, A., …Cleland, J. (2017). Internet-based training of coronary artery patients: the Heart Cycle Trial. Heart and vessels, 32(4), 408-418. https://doi.org/10.1007/s00380-016-0897-8

Journal Article Type Article
Acceptance Date Sep 30, 2016
Online Publication Date Oct 11, 2016
Publication Date Apr 1, 2017
Deposit Date Mar 3, 2018
Publicly Available Date Mar 28, 2024
Journal Heart and Vessels
Print ISSN 0910-8327
Electronic ISSN 1615-2573
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 32
Issue 4
Pages 408-418
DOI https://doi.org/10.1007/s00380-016-0897-8
Keywords Exercise training; Cardiac rehabilitation; Monitoring
Public URL https://hull-repository.worktribe.com/output/706471
Publisher URL https://link.springer.com/article/10.1007%2Fs00380-016-0897-8
Related Public URLs http://eprints.gla.ac.uk/130083/

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