Effectiveness of a digital technology-assisted personalized exercise prescription in the telerehabilitation of postoperative coronary heart disease patients: A randomized controlled trial.

OBJECTIVE

This study aimed to evaluate whether cardiac rehabilitation with a technology-assisted personalized exercise prescription is superior to traditional remote home-based rehabilitation in improving cardiorespiratory endurance and quality of life in postoperative patients.

METHODS

From October 2022 to April 2024, 62 patients who underwent percutaneous coronary intervention for coronary heart disease were recruited from a tertiary hospital in Beijing and randomly assigned to either an intervention group or a control group. After baseline assessments of cardiorespiratory endurance and exercise function, the intervention group received a digitalized personalized exercise prescription combined with remote monitoring rehabilitation. This included an exercise prescription delivered via a mobile application, weekly remote monitoring sessions with an exercise therapist to supervise prescription adherence, provide feedback based on real-time electrocardiographic data, and make personalized adjustments to the exercise prescription based on this information. The control group received an application-delivered exercise movement library and a wearable electrocardiogram device for self-monitoring of exercise intensity. Both groups underwent the 12-week intervention. Changes in maximal oxygen uptake and quality of life were evaluated at enrollment, as well as at 4 weeks, 12 weeks, and 24 weeks after the intervention commenced.

RESULTS

A total of 58 participants completed the study (the intervention group [n=30], the control group [n=28]). Twelve weeks after the interventions, the intervention group showed statistically improvements in VO2AT (Z = 2.247, P = 0.025), general health (Z = 2.126, P = 0.033) and social functioning (Z = 3.349, P = 0.001) compared to the control group. At 24 weeks of follow-up, the intervention group continued to exhibit statistically significant improvements in VO2AT (Z = 2.017, P = 0.044) and social functioning (Z = 3.126, P = 0.002). The exercise duration of patients in the intervention group during the exercise test was significantly prolonged at both 4 weeks (Z = -2.420, P = 0.021), 12 weeks (Z = -2.240, P = 0.029) and 24weeks (Z = -2.300, P = 0.025) showing statistically significant differences compared to the control group.

CONCLUSIONS

This study provides new evidence-based support for the practical effectiveness of nurses acting as supervisors of rehabilitation implementation and coordinators of multidisciplinary teams within a remote digital cardiac rehabilitation model, underscoring their significant value in the secondary prevention management system for cardiovascular diseases in the information era.