Remote Cardiovascular Rehabilitation at COVID-19 Times: Experience in a University Hospital

*Dávolos Ignacio
Division Of Cardiology, Hospital De Clínicas "José De San Martín", Ergometry And Cardiovascular Rehabilitation Service, Argentina

*Corresponding Author:
Dávolos Ignacio
Division Of Cardiology, Hospital De Clínicas "José De San Martín", Ergometry And Cardiovascular Rehabilitation Service, Argentina
Email:ignacio.davolos@gmail.com

Published on: 2022-07-06

Abstract

Multiple studies have shown that cardiovascular rehabilitation (CVR) programs are safe and effective in improving functional capacity and quality of life, as well as reducing readmission and all-cause mortality. Unfortunately, CVR programs are significantly underutilized, with 20-30% of eligible patients participating, with even fewer women, older adults, and individuals from underserved populations. Our study was designed to determine the feasibility of remote CVR in our patient population and to point to improvements in functional and quality-of-life endpoints after a 12-week hybrid period of multicomponent team intervention. COVID-19 is added to the already known barriers of CVR. As seen in our recent experience, remote rehabilitation is undoubtedly an alternative that we should explore. We consider highly relevant the configuration of a multi-component team, and the incorporation of psychosocial support (mental health) into the rehabilitation team to optimize the social role of the participants. Remote CVR is a viable alternative, as it has not only improved the quality of life for patients during the pandemic but also overcomes barriers such as travel and social problems, which often impede patient care. Without a doubt, there is no better time than now to explore and implement methodologies that improve or complement existing CVR programs.

Keywords

Remote Cardiovascular Rehabilitation; Cardiovascular Rehabilitation; COVID-19

Introduction

Multiple studies have shown that cardiovascular rehabilitation (RCV) programs are safe and effective in improving functional capacity and quality of life and reducing re-Internation and mortality by all causes. The first step of secondary prevention is multidisciplinary RCV, which aims to reverse the physiological and psychological effects of cardiovascular disease, obtain clinical stabilization (which leads to significant reductions in hospitalizations, cardiovascular events and premature death), Optimize cardiovascular risk and improve the psychosocial and vocational state of participants [1-3]. In this sense, guides recommend that RCV contemplate patient education, and emphasize healthy behaviors and training with exercises (IA recommendation) [4,5].
Unfortunately, RCV programs are considerably underutilized, and between 20-30% of eligible patients participate, being even lower in women, older adults and individuals of unattended populations. (6-8) barriers or factors that hinder the RCV include the lack of derivation and resources, logistics and psychological problems. The development of new technologies provides the opportunity to include telemedicine in the organization of outpatient care [5,9, and 10].
From the preventive and mandatory social isolation by COVID-19, the question of how to continue cardiovascular rehabilitation programs was raised [11]. Although most centers lack experience in operating at a distance, this alternative also known as TV -Rehabilitation has taken relevance in the last year in our country. Distance rehabilitation could be adopted for selected patient groups, in which it demonstrated adherence and safety, and would also solve the aforementioned barriers allowing more patients to benefit. On the other hand, the availability (quotas) of the rehabilitation center would increase to incorporate a greater number of patients.
Our study was designed to determine the feasibility of remote RCV in our patient population, and point out the improvements in functional and quality of life after a hybrid period of 12 weeks of intervention of a multi-component team.

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