Innovative Application of a Home-Based and Remote Sensing Cardiac Rehabilitation Protocol in Chinese Patients After Percutaneous Coronary Intervention

BACKGROUND: Medical care for the Chinese population has been focused on first-line activities, that is, therapy, but with little follow-up on treated patients. However, efficacy of therapy is highly dependent upon post-therapy recovery. For coronary heart disease (CHD), home-based cardiac telerehabilitation (HBCTR) is an alternative to hospital-based or center-based cardiac rehabilitation, and is an innovative approach to enhance recovery, but the approach is seldom used in China. Our preliminary survey in Shantou, China, indicated that most CHD patients showed a positive attitude toward the HBCTR technology. Our follow-up study was focused on assessing the effect of the HBCTR program in low-risk patients after percutaneous coronary intervention (PCI). MATERIALS AND METHODS: A two-arm randomized controlled trial was conducted at the First Affiliated Hospital of the Shantou University Medical College, China. The effectiveness of this program was measured by using blood pressure, Six-Minute Walking Test (6MWT), Fagerstrom Test for Nicotine Dependence (FTND), Cardiac Depression Scale (CDS), and SF-36 Health Survey (SF36). RESULTS: A total of 80 post-PCI patients were recruited and randomly divided into two equal groups. Based upon our effort, the usual care (UC) group received paper-based CHD educational booklets and biweekly outpatient review. The HBCTR group carried out outdoor walking/jogging exercise with real-time physiological monitoring along with CHD education materials. After the 6-week intervention, the 6MWT, SF36 (PCS, MCS), FTND and CDS in both groups were found to have significantly improved compared with baseline. In addition, the improvements in SF36, FTND scores, and 6MWT distance in the HBCTR group were significantly better than those in the UC group (p < 0.05). CONCLUSION: Our observations indicated that the HBCTR program may be applied successfully in Chinese patients who had very little technical skills and its application may be highly cost-effective.