Cardiovascular telerehabilitation improves functional capacity, cardiorespiratory fitness and quality of life in older adults: A systematic review and meta-analysis

Diego Nacarato; Amanda V Sardeli; Lilian O Mariano; Mara Patrícia T Chacon-Mikahil

doi:10.1177/1357633X221137626

Cardiovascular telerehabilitation improves functional capacity, cardiorespiratory fitness and quality of life in older adults: A systematic review and meta-analysis

J Telemed Telecare. 2022 Dec 5:1357633X221137626. doi: 10.1177/1357633X221137626. Online ahead of print.

Authors

Diego Nacarato^{1

2}, Amanda V Sardeli^{1

2

3}, Lilian O Mariano^{1

2}, Mara Patrícia T Chacon-Mikahil^{1

2}

Affiliations

¹ Laboratory of Exercise Physiology, School of Physical Education, State University of Campinas, Campinas, SP, Brazil.
² Gerontology Program - School of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.
³ Institute of Inflammation and Ageing, 1724University of Birmingham, Birmingham, UK.

PMID: 36469017
DOI: 10.1177/1357633X221137626

Abstract

Introduction: The aim was to identify whether cardiovascular telerehabilitation programs (CV-T-REHAB) can improve functional capacity, cardiorespiratory fitness and quality of life (QoL) to the same extent of presential rehabilitation (CV-P-REHAB) in older adults, by meta-analysis of previous studies.

Methods: Literature search was conducted in October 2020 in four databases to select controlled trials of CV-T-REHAB effects on functional capacity (six-minute walk test [6MWT]), cardiorespiratory fitness (maximal oxygen consumption [ $\dot{V}$ O_2max]), and QoL in older adults (> 50 years) and included new articles in April 2022.

Results: CV-T-REHAB improved 6MWT (11.14 m [CI95% = 8.03; 14.26], p < 0.001), $\dot{V}$ O_2max (1.18 ml/kg/min [CI95% = 0.70; 1.66], p < 0.001), and QoL (standardized mean difference [SMD] = 0.36 [CI95% = 0.05; 0.67], p = 0.02). CV-T-REHAB increased $\dot{V}$ O_2max to a greater extent than CV-P-REHAB (1.08 ml/kg/min [0.39; 1.76], p = 0.002). Although the 6MWT and $\dot{V}$ O_2max analyses proved consistent and homogeneous, the QoL analysis showed considerable inconsistency (I² = 92.90%), suggesting the need for studies exploring the effect of CV-T-REHAB on QoL in this population. Part of the heterogeneity was explained by age differences, as CV-T-REHAB improved QoL in adults >65 years, but not in adults <64 years.

Conclusion: CV-T-REHAB improved cardiorespiratory fitness to a level equal to or higher than CV-P-REHAB and improved functional capacity and QoL; being mainly effective for QoL in older adults >65 years. Thus, CV-T-REHAB can be a good alternative, when not the best option and might be considered especially for individuals with limited access to participate in face-to-face programs.

Keywords: Telerehabilitation; cardiac rehabilitation; exercise therapy; physical and rehabilitation medicine; physical fitness; quality of life.