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Feasibility, safety and patient perceptions of exercise-based cardiac telerehabilitation in a multicentre real-world setting after myocardial infarction—the remote exercise SWEDEHEART study

Bäck, Maria ; Leosdottir, Margret LU ; Ekström, Mattias ; Hambraeus, Kristina ; Ravn-Fischer, Annica ; Borg, Sabina ; Brosved, Madeleine ; Flink, Marcus ; Hedin, Kajsa and Lans, Charlotta , et al. (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.

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organization
publishing date
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}},
}