Feasibility, safety and patient perceptions of exercise-based cardiac telerehabilitation in a multicentre real-world setting after myocardial infarction—the remote exercise SWEDEHEART study
(2025) In European Heart Journal - Digital Health 6(3). p.508-518- Abstract
Aims Cardiac telerehabilitation addresses common barriers for attendance at exercise-based cardiac rehabilitation (EBCR). Pragmatic real-world studies are however lacking, limiting generalizability of available evidence. We aimed to evaluate feasibility, safety, and patient perceptions of remotely delivered EBCR in a multicentre clinical practice setting after myocardial infarction (MI). Methods and results This study included 232 post-MI patients (63.7 years, 77.5% men) from 23 cardiac rehabilitation centres in Sweden (2020–22). Exercise was delivered twice per week for 3 months through a real-time group-based video meeting connecting a physiotherapist to patients exercising at home. Outcomes were assessed before and after remote EBCR... (More)
Aims Cardiac telerehabilitation addresses common barriers for attendance at exercise-based cardiac rehabilitation (EBCR). Pragmatic real-world studies are however lacking, limiting generalizability of available evidence. We aimed to evaluate feasibility, safety, and patient perceptions of remotely delivered EBCR in a multicentre clinical practice setting after myocardial infarction (MI). Methods and results This study included 232 post-MI patients (63.7 years, 77.5% men) from 23 cardiac rehabilitation centres in Sweden (2020–22). Exercise was delivered twice per week for 3 months through a real-time group-based video meeting connecting a physiotherapist to patients exercising at home. Outcomes were assessed before and after remote EBCR completion and comprised assessment of physical fitness, self-reported physical activity and exercise, physical capacity, kinesiophobia, health-related quality of life (HRQoL), self-efficacy for exercise, exercise adherence, patient acceptance. Safety monitoring in terms of adverse events (AE) and serious adverse events (SAE) was recorded. A total of 67.2% of the patients attended ≥ 75% of prescribed exercise sessions. Significant improvements in physical fitness, self-reported exercise, physical capacity, kinesiophobia, and HRQoL were observed. Patients agreed that remote EBCR improved health care access (83%), was easy to use (94%) and found exercise performance and interaction acceptable (95%). Sixteen exercise-related AEs (most commonly dizziness and musculoskeletal symptoms) were registered, all of which were resolved. Two SAEs requiring hospitalization were reported, both unrelated to exercise. Conclusion This multicentre study supports remote EBCR post-MI as feasible and safe with a high patient acceptance in a real-world setting. The clinical effectiveness needs to be confirmed in a randomized controlled trial.
(Less)
- author
- organization
- publishing date
- 2025-05-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac rehabilitation, Coronary artery disease, eHealth, Exercise, Secondary prevention, Telerehabilitation
- in
- European Heart Journal - Digital Health
- volume
- 6
- issue
- 3
- pages
- 11 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:105005765070
- ISSN
- 2634-3916
- DOI
- 10.1093/ehjdh/ztaf014
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology.
- id
- 18d0514b-19e8-43c9-8c55-7c2085208261
- date added to LUP
- 2025-08-11 15:20:04
- date last changed
- 2025-08-11 15:20:34
@article{18d0514b-19e8-43c9-8c55-7c2085208261, abstract = {{<p>Aims Cardiac telerehabilitation addresses common barriers for attendance at exercise-based cardiac rehabilitation (EBCR). Pragmatic real-world studies are however lacking, limiting generalizability of available evidence. We aimed to evaluate feasibility, safety, and patient perceptions of remotely delivered EBCR in a multicentre clinical practice setting after myocardial infarction (MI). Methods and results This study included 232 post-MI patients (63.7 years, 77.5% men) from 23 cardiac rehabilitation centres in Sweden (2020–22). Exercise was delivered twice per week for 3 months through a real-time group-based video meeting connecting a physiotherapist to patients exercising at home. Outcomes were assessed before and after remote EBCR completion and comprised assessment of physical fitness, self-reported physical activity and exercise, physical capacity, kinesiophobia, health-related quality of life (HRQoL), self-efficacy for exercise, exercise adherence, patient acceptance. Safety monitoring in terms of adverse events (AE) and serious adverse events (SAE) was recorded. A total of 67.2% of the patients attended ≥ 75% of prescribed exercise sessions. Significant improvements in physical fitness, self-reported exercise, physical capacity, kinesiophobia, and HRQoL were observed. Patients agreed that remote EBCR improved health care access (83%), was easy to use (94%) and found exercise performance and interaction acceptable (95%). Sixteen exercise-related AEs (most commonly dizziness and musculoskeletal symptoms) were registered, all of which were resolved. Two SAEs requiring hospitalization were reported, both unrelated to exercise. Conclusion This multicentre study supports remote EBCR post-MI as feasible and safe with a high patient acceptance in a real-world setting. The clinical effectiveness needs to be confirmed in a randomized controlled trial.</p>}}, author = {{Bäck, Maria and Leosdottir, Margret and Ekström, Mattias and Hambraeus, Kristina and Ravn-Fischer, Annica and Borg, Sabina and Brosved, Madeleine and Flink, Marcus and Hedin, Kajsa and Lans, Charlotta and Olovsson, Jessica and Urell, Charlotte and Öberg, Birgitta and James, Stefan}}, issn = {{2634-3916}}, keywords = {{Cardiac rehabilitation; Coronary artery disease; eHealth; Exercise; Secondary prevention; Telerehabilitation}}, language = {{eng}}, month = {{05}}, number = {{3}}, pages = {{508--518}}, publisher = {{Oxford University Press}}, series = {{European Heart Journal - Digital Health}}, title = {{Feasibility, safety and patient perceptions of exercise-based cardiac telerehabilitation in a multicentre real-world setting after myocardial infarction—the remote exercise SWEDEHEART study}}, url = {{http://dx.doi.org/10.1093/ehjdh/ztaf014}}, doi = {{10.1093/ehjdh/ztaf014}}, volume = {{6}}, year = {{2025}}, }