心肌梗塞后基于远程智能设备的心脏康复：智能康复试点随机交叉研究

Mayo Clinic Proceedings. Digital health Pub Date : 2024-06-20 DOI:10.1016/j.mcpdig.2024.06.001

Peter Wohlfahrt MD, PhD , Dominik Jenča MD , Vojtěch Melenovský MD, PhD , Jolana Mrázková Mgr , Marek Šramko MD, PhD , Martin Kotrč MD , Michael Želízko MD , Věra Adámková MD, PhD , Francisco Lopez-Jimenez MD, MSc, MBA , Jan Piťha MD, PhD , Josef Kautzner MD, PhD

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引用次数: 0

摘要

目的评估基于智能设备的远程康复对心肌梗塞后患者 Vo2peak 的影响。患者和方法这是一项为期 3 个月的试点、单中心、随机、交叉研究。心肌梗死一个月后，患者接受心肺运动测试和 6 分钟步行测试 (6MWT)，并按 1:1 随机分配。在干预组中，患者会收到一块智能手表，用于追踪建议的步数，该步数是根据 6MWT 得出的个性化步数。一名研究护士负责远程监控患者是否遵守每天的建议步数。对照组建议每周进行 150 分钟中等强度的体育锻炼。3 个月后研究臂交叉，3 个月后重复研究程序。结果在 2019 年 6 月 1 日至 2023 年 2 月 28 日期间，64 名患者被随机分配，其中 61 人（年龄为 51±10 岁，10% 为女性）完成了研究。总体而言，与对照组治疗相比，基于智能设备的远程康复治疗使 Vo2peak 增加了 2.31 mL/kg/min（95% CI，1.25-3.37；P<.001）。此外，对体重（-1.50 千克；95% CI，-0.39 至 -2.70）有显著影响，而对 6MWT 距离（4.7 米；95% CI，-11.8 至 21.1）或堪萨斯城生活质量问卷评分（0.98；95% CI，-1.38 至 3.35）的影响不显著：NCT03926312

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Remote, Smart Device-Based Cardiac Rehabilitation After Myocardial Infarction: A Pilot, Randomized Cross-Over SmartRehab Study

Objective

To evaluate the effect of smart device-based telerehabilitation on Vo_2peak in patients after myocardial infarction.

Patients and Methods

This was a pilot, single-center, randomized, cross-over study with a 3-month intervention. One month after myocardial infarction, patients had cardiopulmonary exercise testing and a 6-minute walking test (6MWT) and were randomly assigned 1:1. In the intervention group, patients received a smartwatch to track the recommended number of steps, which was individualized and derived from the 6MWT. A study nurse telemonitored adherence to the recommended number of steps a day. In the control group, 150 minutes a week of moderate-intensity physical activity was recommended. After 3 months study arms were crossed over, and study procedures were repeated after 3 months.

Results

Between June 1, 2019, and February 28, 2023, 64 patients were randomized, of which 61 (aged 51±10 years, 10% women) completed the study. Overall, the smart device-based telerehabilitation led to 2.31 mL/kg/min (95% CI, 1.25-3.37; P<.001) Vo_2peak increase compared with the control treatment. Furthermore, there was a significant effect on weight (−1.50 kg; 95% CI, −0.39 to −2.70), whereas the effect on the 6MWT distance (4.7 m; 95% CI, −11.8 to 21.1) or Kansas City Quality of Life questionnaire score (0.98; 95% CI, −1.38 to 3.35) was not significant.