J Telemed Telecare 2009;15:297-301 doi:10.1258/jtt.2009.090208 © 2009 Royal Society of Medicine Press http://jtt.rsmjournals.com/
Home-based exercise rehabilitation with telemedicine following cardiac surgery: Simonetta Scalvini * , Emanuela Zanelli *, Laura Comini *, Margherita Dalla Tomba , Giovanni Troise and Amerigo Giordano * * Fondazione Salvatore Maugeri IRCCS, Lumezzane, Brescia; Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
We evaluated the feasibility of a home-based rehabilitation programme, which was designed to resemble an in-hospital rehabilitation programme. Patients who underwent cardiac surgery (EuroSCORE 0–10) followed a one-month home rehabilitation programme supervised by a nurse-tutor and a physiotherapist. Physiotherapy was performed at home with calisthenic exercises and bicycle-ergometer tests. Patients transmitted the recorded ECGs by telephone to a service centre. They also performed a 6-minute walking test and filled in a satisfaction questionnaire at the end of the programme. A total of 47 patients were enrolled in the study. There were 3050 telephone calls, of which 3012 (99%) were scheduled and 38 were unscheduled. No further action was required in 95% of calls. There were 809 sessions for calisthenic exercises and 1039 for exercise training. There was a significant increase in the 6-minute walking test distance at the end of the programme compared to the baseline (404 m vs. 307 m, P < 0.001). Patient satisfaction, as measured in a questionnaire, was about 95% overall. This type of home rehabilitation using telemedicine appears to be worth implementing in selected categories of patients.
Rehabilitation Systems Comments
With the fast emerging telemedicine / telecare programmming that is becoming part of the healthcare industry, home management of chronic disease is the fastest growing component of telemedicine care in the United States. We forsee the combination of technology and medicine as one effective method for increasing access to care for Cancer, Cardiac, Pulmonary, and Diabetes Rehabilitation at the same time that health care costs are being decreased in the United States. Telemedicine training for home-based programs can be found here: http://www.rehabsys.com/register
