Home-based versus in-hospital cardiac rehabilitation after cardiac surgery: a nonrandomized controlled study

Source: Scalvini et al. 2013 - Pubmed ID: 23599353

Setting: Italy, Hospital

Study design:

CT

 

Follow-up: 4 weeks

Patient group:

Sample size:

Total: 200

IG: 100

CG: 100

 

Inclusion criteria:

  • Cardiac surgery
  • Low to medium risk for early mortality (EuroSCORE 0–5)
Type of technology:

(DVD, video conference and phone call

 

Video consultation (DVD)

  • Exercises
  • Physical activity
  • Clinical data

Phone call

  • Physical activity
  • Clinical data
  • Personal health record
  • Diet
  • Guidance:
    – Behavioral modification strategies
    – Risk-factor management
    – Psychological and psychosocial management
Intervention:

Intervention: Home based exercise rehabilitation with personalized training program. Daily callisthenic (60 min). Bicycle training twice a day (40 min). DVD illustrating the correct way to perform exercises. Telemonitored daily by a nurse and physical therapist. Home visits by nurse every 2 weeks and physical therapist every week. Supervised by a cardilogist

 

Duration:  4 weeks
Add on: NA

 

Control group: Usual care

Clinical effect/ Patient safety:

Clinical effect:

  • Six-Minute Walk Test  6MWT→
  • LVEF→
  • Hb↑

 

Patient safety:

  • Clinical events→
  • Patients with antiplatelet/anticoagulant at discharge→
  • Patients with statins at discharge↑
Patient experiences/ Staff experiences:

Patient experience: NA

 

Staff experience: NA

Costs and organization:

Investment:
Equipment

  • Mobile phone
  • DVD
  • ECG
  • Computer

 

Running:
Technical

  • Mobile phone
  • DVD
  • ECG
  • Computer

Staff

  • Monitoring
  • Coaching
  • Treatment adjustments

 

Organization: NA

 

Health care utilization:

  • Rehabilitation period→
  • Days from the surgical intervention to rehabilitation↓
  • Total duration of the rehabilitative sessions→
  • ECG/patient↓
  • Chest radiographs /patient→
  • Blood withdrawings /patient↓
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Information

“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)