Exercise Telemonitoring and Telerehabilitation Compared to Traditional Cardiac and Pulmonary Rehabilitation : A Systematic Review and Meta-analysis Chan, Christen; Yamabayash, Cristiane; Syed, Nafeez; Kirkham, Ashley; Camp, Pat
Background: Despite exercise capacity and quality of life benefits, pulmonary rehabilitation (PR) and cardiac rehabilitation (CR) programmes are not easily accessed due to a number of barriers. A solution may be telerehabilitation (TR) in which patients exercise in their communities while monitored via tele-technologies. However, the benefits of TR for PR and CR purposes have not been systematically reviewed. Objective: To determine if the benefits of the exercise component of PR and CR using TR are comparable to usual care (UC) programmes. Methods: A comprehensive literature search was performed on the Medline, Embase, and CINAHL databases up to July 13, 2015. Meta-analyses were performed for peak oxygen consumption, peak workload, exercise test duration, and 6-minute walk test (6MWT) distance using I2 statistic and forest plots displaying standardized mean difference (SMD). Results: From 1431 citations found, nine CR studies met inclusion criteria. There were no differences in exercise outcomes between UC and TR groups for CR studies, except in exercise test duration, which slightly favoured UC (SMD 0.268, 95% confidence interval 0.002 to 0.534; p < 0.05). Only one PR study was included and it showed similar improvements in 6MWT between UC and TR groups. Conclusion: TR for patients with cardiac conditions provided similar benefits to usual care with no adverse effects reported. Similar studies on TR for patients with pulmonary conditions need to be conducted.
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