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

Marie Fanget; Manon Bayle; Pierre Labeix; Frédéric Roche; David Hupin

doi:10.3389/fphys.2022.837482

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

Front Physiol. 2022 Mar 17:13:837482. doi: 10.3389/fphys.2022.837482. eCollection 2022.

Authors

Marie Fanget¹, Manon Bayle², Pierre Labeix^{1

2}, Frédéric Roche^{1

2}, David Hupin^{1

2

3}

Affiliations

¹ INSERM, U1059, SAINBIOSE, DVH, University of Lyon, Jean Monnet University, Saint-Etienne, France.
² Department of Clinical and Exercise Physiology, University Hospital Center of Saint-Etienne, Saint-Etienne, France.
³ Department of Medicine, K2, Solna, Karolinska Institutet, Stockholm, Sweden.

Abstract

Background: The COVID-19 pandemic led to the closure of most cardiac therapy centers. One of the solutions was to adapt the existing cardiac rehabilitation (CR) program in an institute to a remote approach offered by home-based telerehabilitation. The aim of this study was to measure the cardiorespiratory effects of telerehabilitation compared to conventional center-based CR.

Methods: Patients were assigned to two 3-week CR programs: telerehabilitation and conventional center-based CR. The telerehabilitation group wore a connected watch to monitor heart rate (HR) and gave their perception of effort according to a modified Borg scale. The exercise training (four sessions/week) consisted of 1-h aerobic endurance and strength training session at the target HR zone determined by results based on cardiopulmonary exercise test (CPET) and perception of effort, respectively. The exercise protocol was the same for conventional CR participants except the duration of session that lasted 2 h instead of one. The week before and after the training program, peak oxygen uptake (VO₂ peak), oxygen uptake at first ventilatory threshold (VO₂ at VT₁), peak workload, percent of predicted maximum HR, and the absolute differences in HR and systolic blood pressure between maximum and recovery at 1 and 3 min were measured using a CPET. A two-way ANOVA with one repeated measure and one independent factor was performed.

Results: Fifty-four patients (mean age: 61.5 ± 8.6 years, 10 women) equally split in the two groups were included in this experiment. A significant increase was observed in both groups on VO₂ peak (telerehabilitation: 8.1 ± 7.8% vs. conventional: 10.1 ± 9.7%, p < 0.001), VO₂ at VT₁ (telerehabilitation: 8.8 ± 4.4% vs. conventional: 7.3 ± 19.0%, p = 0.02) and peak workload (telerehabilitation: 16.6 ± 18.9% vs. conventional: 17.2 ± 7.0%, p < 0.001) after the 3-week telerehabilitation and conventional CR, respectively. No significant difference was noticed between both groups.

Conclusion: A 3-week exercise program improved patients' cardiorespiratory fitness. Telerehabilitation was as effective and represents a safe alternative CR program during the COVID-19 period. In the future, this approach could facilitate the continuity of care for patients unable to participate in center-based CR.

Keywords: COVID-19; cardiac rehabilitation; cardiorespiratory fitness; coronary artery disease; exercise training; physical activity; telerehabilitation.