Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.16/2876 |
Resumo: | Background: Tele-rehabilitation (TR) may be an effective alternative or complement to centre-based cardiac rehabilitation (CBCR) with heart failure (HF) patients, helping overcome accessibility problems to CBCR. The aim of this study is to systematically review the literature in order to assess the clinical effectiveness of TR programs in the management of chronic HF patients, compared to standard of care and standard rehabilitation (CBCR). Methods and results: We conducted a systematic review and meta-analysis of randomized controlled trials on the effect and safety of TR programs in HF patients, regarding cardiovascular death, heart failure-related hospitalizations, functional capacity and quality of life. We searched 4 electronic databases up until May 2020, reviewed references of relevant articles and contacted experts. A quantitative synthesis of evidence was performed by means of random-effects meta-analyses. We included 17 primary studies, comprising 2206 patients. Four studies reported the number of hospitalizations (TR: 301; Control: 347). TR showed to be effective in the improvement of HF patients' functional capacity in the 6 Minute Walk-Test (Mean Difference (MD) 15.86; CI 95% [7.23; 24.49]; I2 = 74%) and in peak oxygen uptake (pVO2) results (MD 1.85; CI 95% [0.16; 3.53]; I2 = 93%). It also improved patients' quality of life (Minnesota Living with Heart Failure Questionnaire: MD -6.62; CI 95% [-11.40; -1.84]; I2 = 99%). No major adverse events were reported during TR exercise. Conclusion: TR showed to be superior than UC without CR on functional capacity improvement in HF patients. There is still scarce evidence of TR impact on hospitalization and cv death reduction. Further research and more standardized protocols are needed to improve evidence on TR effectiveness, safety and cost-effectiveness. |
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Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysisTele-rehabilitationfunctional capacityheart failurehospitalizationsquality of lifeBackground: Tele-rehabilitation (TR) may be an effective alternative or complement to centre-based cardiac rehabilitation (CBCR) with heart failure (HF) patients, helping overcome accessibility problems to CBCR. The aim of this study is to systematically review the literature in order to assess the clinical effectiveness of TR programs in the management of chronic HF patients, compared to standard of care and standard rehabilitation (CBCR). Methods and results: We conducted a systematic review and meta-analysis of randomized controlled trials on the effect and safety of TR programs in HF patients, regarding cardiovascular death, heart failure-related hospitalizations, functional capacity and quality of life. We searched 4 electronic databases up until May 2020, reviewed references of relevant articles and contacted experts. A quantitative synthesis of evidence was performed by means of random-effects meta-analyses. We included 17 primary studies, comprising 2206 patients. Four studies reported the number of hospitalizations (TR: 301; Control: 347). TR showed to be effective in the improvement of HF patients' functional capacity in the 6 Minute Walk-Test (Mean Difference (MD) 15.86; CI 95% [7.23; 24.49]; I2 = 74%) and in peak oxygen uptake (pVO2) results (MD 1.85; CI 95% [0.16; 3.53]; I2 = 93%). It also improved patients' quality of life (Minnesota Living with Heart Failure Questionnaire: MD -6.62; CI 95% [-11.40; -1.84]; I2 = 99%). No major adverse events were reported during TR exercise. Conclusion: TR showed to be superior than UC without CR on functional capacity improvement in HF patients. There is still scarce evidence of TR impact on hospitalization and cv death reduction. Further research and more standardized protocols are needed to improve evidence on TR effectiveness, safety and cost-effectiveness.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This article was supported by NORTE-01-0145-FEDER-032069 – “AdHeart – Engage with your heart”, financed by NORTE2020 under PORTUGAL2020; Project - NORTE-01-0145-FEDER-000026 – “Symbiotic technology for societal efficiency gains: Deus ex Machina”, financed by NORTE2020 under PORTUGAL2020; National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020).SAGE PublicationsRepositório Científico do Centro Hospitalar Universitário de Santo AntónioCavalheiro, AnaSilva Cardoso, JoséRocha, AfonsoMoreira, EmíliaAzevedo, Luís Filipe2023-10-31T13:29:25Z2021-062021-06-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2876engCavalheiro AH, Silva Cardoso J, Rocha A, Moreira E, Azevedo LF. Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis. Health Serv Insights. 2021;14:11786329211021668. doi:10.1177/117863292110216681178-632910.1177/11786329211021668info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-02T05:59:45Zoai:repositorio.chporto.pt:10400.16/2876Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:26:28.812275Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis |
title |
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis |
spellingShingle |
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis Cavalheiro, Ana Tele-rehabilitation functional capacity heart failure hospitalizations quality of life |
title_short |
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis |
title_full |
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis |
title_fullStr |
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis |
title_full_unstemmed |
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis |
title_sort |
Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis |
author |
Cavalheiro, Ana |
author_facet |
Cavalheiro, Ana Silva Cardoso, José Rocha, Afonso Moreira, Emília Azevedo, Luís Filipe |
author_role |
author |
author2 |
Silva Cardoso, José Rocha, Afonso Moreira, Emília Azevedo, Luís Filipe |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Repositório Científico do Centro Hospitalar Universitário de Santo António |
dc.contributor.author.fl_str_mv |
Cavalheiro, Ana Silva Cardoso, José Rocha, Afonso Moreira, Emília Azevedo, Luís Filipe |
dc.subject.por.fl_str_mv |
Tele-rehabilitation functional capacity heart failure hospitalizations quality of life |
topic |
Tele-rehabilitation functional capacity heart failure hospitalizations quality of life |
description |
Background: Tele-rehabilitation (TR) may be an effective alternative or complement to centre-based cardiac rehabilitation (CBCR) with heart failure (HF) patients, helping overcome accessibility problems to CBCR. The aim of this study is to systematically review the literature in order to assess the clinical effectiveness of TR programs in the management of chronic HF patients, compared to standard of care and standard rehabilitation (CBCR). Methods and results: We conducted a systematic review and meta-analysis of randomized controlled trials on the effect and safety of TR programs in HF patients, regarding cardiovascular death, heart failure-related hospitalizations, functional capacity and quality of life. We searched 4 electronic databases up until May 2020, reviewed references of relevant articles and contacted experts. A quantitative synthesis of evidence was performed by means of random-effects meta-analyses. We included 17 primary studies, comprising 2206 patients. Four studies reported the number of hospitalizations (TR: 301; Control: 347). TR showed to be effective in the improvement of HF patients' functional capacity in the 6 Minute Walk-Test (Mean Difference (MD) 15.86; CI 95% [7.23; 24.49]; I2 = 74%) and in peak oxygen uptake (pVO2) results (MD 1.85; CI 95% [0.16; 3.53]; I2 = 93%). It also improved patients' quality of life (Minnesota Living with Heart Failure Questionnaire: MD -6.62; CI 95% [-11.40; -1.84]; I2 = 99%). No major adverse events were reported during TR exercise. Conclusion: TR showed to be superior than UC without CR on functional capacity improvement in HF patients. There is still scarce evidence of TR impact on hospitalization and cv death reduction. Further research and more standardized protocols are needed to improve evidence on TR effectiveness, safety and cost-effectiveness. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06 2021-06-01T00:00:00Z 2023-10-31T13:29:25Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.16/2876 |
url |
http://hdl.handle.net/10400.16/2876 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Cavalheiro AH, Silva Cardoso J, Rocha A, Moreira E, Azevedo LF. Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis. Health Serv Insights. 2021;14:11786329211021668. doi:10.1177/11786329211021668 1178-6329 10.1177/11786329211021668 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
SAGE Publications |
publisher.none.fl_str_mv |
SAGE Publications |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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