A controlled trial of cardiac rehabilitation in the home setting using electrocardiographic and voice transtelephonic monitoring

Objective The goal of this study was to compare the effectiveness of home-b ased, transtelephonically monitored cardiac rehabilitation with standard, o n-site, supervised cardiac rehabilitation. Background Participation in cardiac rehabilitation has been demonstrated to increase exercise capacity, decrease cardiovascular symptoms, improve psyc hosocial status, and decrease total and cardiovascular mortality races in p atients with coronary heart disease. Because of multiple factors, national overall participation is only at 15% of eligible patients. Methods Effects of a 3-month home-based, transtelephonically monitored reha bilitation program (n = 83 patients) with simultaneous voice and electrocar diographic transmission to a centrally located nurse coordinator were compa red with effects of a standard on-site rehabilitation program (n = 50 patie nts). The study design was a multicenter, controlled trial. Primary outcome variables were peak aerobic capacity and quality of life, as measured by t he Health Status Questionnaire. Results Patients in the home-based monitoring program increased peak aerobi c capacity to a similar degree as patients who exercised on site (18% vs 23 %). Quality of life domains of physical functioning, social functioning, ph ysical role limitations, emotional role limitations, bodily pain, and energ y/fatigue improved similarly in both groups. There were no circulatory arre sts or other major exercise-related medical events in either group. A total of 3100 hours of home exercise were transtelephonically monitored. Conclusions Patients with coronary heart disease can effectively participat e in home-based, monitored cardiac rehabilitation, with exercise and qualit y of life improvements comparable to those demonstrated at on-site programs .