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Cardiovascular telerehabilitation improves functional capacity, cardiorespiratory fitness and quality of life in older adults: A systematic review and meta-analysis

Diego Nacarato, Amanda Veiga Sardeli, Lilian Oliveira Mariano, Mara Patrícia Traina Chacon‐Mikahil

2022Journal of Telemedicine and Telecare12 citationsDOIOpen Access PDF

Abstract

Introduction The aim was to identify whether cardiovascular telerehabilitation programs (CV-T-REHAB) can improve functional capacity, cardiorespiratory fitness and quality of life (QoL) to the same extent of presential rehabilitation (CV-P-REHAB) in older adults, by meta-analysis of previous studies. Methods Literature search was conducted in October 2020 in four databases to select controlled trials of CV-T-REHAB effects on functional capacity (six-minute walk test [6MWT]), cardiorespiratory fitness (maximal oxygen consumption [[Formula: see text]O 2max ]), and QoL in older adults (> 50 years) and included new articles in April 2022. Results CV-T-REHAB improved 6MWT (11.14 m [CI95% = 8.03; 14.26], p < 0.001), [Formula: see text]O 2max (1.18 ml/kg/min [CI95% = 0.70; 1.66], p < 0.001), and QoL (standardized mean difference [SMD] = 0.36 [CI95% = 0.05; 0.67], p = 0.02). CV-T-REHAB increased [Formula: see text]O 2max to a greater extent than CV-P-REHAB (1.08 ml/kg/min [0.39; 1.76], p = 0.002). Although the 6MWT and [Formula: see text]O 2max analyses proved consistent and homogeneous, the QoL analysis showed considerable inconsistency ( I 2 = 92.90%), suggesting the need for studies exploring the effect of CV-T-REHAB on QoL in this population. Part of the heterogeneity was explained by age differences, as CV-T-REHAB improved QoL in adults >65 years, but not in adults <64 years. Conclusion CV-T-REHAB improved cardiorespiratory fitness to a level equal to or higher than CV-P-REHAB and improved functional capacity and QoL; being mainly effective for QoL in older adults >65 years. Thus, CV-T-REHAB can be a good alternative, when not the best option and might be considered especially for individuals with limited access to participate in face-to-face programs.

Topics & Concepts

TelerehabilitationCardiorespiratory fitnessMeta-analysisPhysical medicine and rehabilitationMedicineQuality of life (healthcare)Physical therapyGerontologyPhysical activityTelemedicineHealth careInternal medicineEconomicsEconomic growthNursingCardiac Health and Mental HealthStroke Rehabilitation and RecoveryTelemedicine and Telehealth Implementation