Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial

Hwang, Rita, Bruning, Jared, Morris, Norman R. , Mandrusiak, Allison and Russell, Trevor (2017) Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial. Journal of Physiotherapy, 63 2: 101-107. doi:10.1016/j.jphys.2017.02.017


Author Hwang, Rita
Bruning, Jared
Morris, Norman R.
Mandrusiak, Allison
Russell, Trevor
Title Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial
Journal name Journal of Physiotherapy   Check publisher's open access policy
ISSN 1836-9561
1836-9553
Publication date 2017-03-14
Sub-type Article (original research)
DOI 10.1016/j.jphys.2017.02.017
Open Access Status DOI
Volume 63
Issue 2
Start page 101
End page 107
Total pages 7
Place of publication Chatswood, NSW, Australia
Publisher Elsevier Australia
Collection year 2018
Language eng
Formatted abstract
Question: Is a 12-week, home-based telerehabilitation program conducted in small groups non-inferior to a traditional centre-based program in terms of the change in 6-minute walk distance? Is the telerehabilitation program also non-inferior to a centre-based program in terms of functional capacity, muscle strength, quality of life, urinary incontinence, patient satisfaction, attendance rates, and adverse events?

Design: Randomised, parallel, non-inferiority trial with concealed allocation, intention-to-treat analysis and assessor blinding.

Participants: Patients with stable chronic heart failure (including heart failure with reduced or preserved ejection fraction) were recruited from two tertiary hospitals in Brisbane, Australia.

Intervention: The experimental group received a 12-week, real-time exercise and education intervention delivered into the participant's home twice weekly, using online videoconferencing software. The control group received a traditional hospital outpatient-based program of the same duration and frequency. Both groups received similar exercise prescription.

Outcome measures: Participants were assessed by independent assessors at baseline (Week 0), at the end of the intervention (Week 12) and at follow-up (Week 24). The primary outcome was a between-group comparison of the change in 6-minute walk distance, with a non-inferiority margin of 28. m. Secondary outcomes included other functional measures, quality of life, patient satisfaction, program attendance rates and adverse events.

Results: In 53 participants (mean age 67 years, 75% males), there were no significant between-group differences on 6-minute walk distance gains, with a mean difference of 15. m (95% CI -28 to 59) at Week 12. The confidence intervals were within the predetermined non-inferiority range. The secondary outcomes indicated that the experimental intervention was at least as effective as traditional rehabilitation. Significantly higher attendance rates were observed in the telerehabilitation group.

Conclusion: Telerehabilitation was not inferior to a hospital outpatient-based rehabilitation program in patients with chronic heart failure. Telerehabilitation appears to be an appropriate alternative because it promotes greater attendance at the rehabilitation sessions.

Trial registration: ACTRN12613000390785.
Keyword Cardiac failure
Exercise
Physical therapy
Telemedicine
Telerehabilitation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Health and Rehabilitation Sciences Publications
 
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