Rehabilitación cardíaca domiciliaria como alternativa en tiempos de pandemia: una revisión sistemática / Home cardiac rehabilitation as an alternative in times of pandemic: a systematic review

RESUMEN

Resumen La pandemia mundial producto del coronavirus que causa la enfermedad (COVID-19) ha ocasionado un gran impacto a nivel mundial y en los programas de rehabilitación cardíaca tradicional (RCT). En la actualidad, se debe promover que los pacientes con enfermedades cardiovasculares (ECV) se mantengan haciendo ejercicio físico a pesar de la pandemia. Objetivo: Analizar la evidencia científica sobre rehabilitación cardíaca domiciliar (RCD) y RCT en la seguridad del paciente y su eficacia en la mejora del volumen de oxígeno máximo (VO2máx) y capacidad funcional en pacientes con ECV. Metodología: Se desarrolló mediante los lineamientos PRISMA. Se realizó la búsqueda de artículos en las bases de datos "PubMed", "ScienceDirect", "Academic Search Ultimate" y "SportDiscus". Se utilizó el término de búsqueda ("heart disease" OR "cardiac disease" OR "coronary artery disease" OR "heart failure") AND ("cardiac rehabilitation" OR "center based" OR "exercise" OR "training") AND ("home based" OR "home training" OR "home exercise") NOT ("animal"). Resultados: Se analizaron un total de 1516 estudios de los cuales se incluyeron 21 artículos. La muestra fue de 1316 pacientes con ECV. Existe una prevalencia de eventos adversos de 3.8% en la RCD y de 4.3% en RCT. El VO2máx aumentó entre 4.1% a 39.6% utilizando la RCD y entre 4% y 54.1% con RCT. La capacidad funcional incrementó entre 3.0% y 11.7% con RCD y entre 4.9% y 11.8% con RCT. Conclusiones: Los programas de RCD son tan seguros y eficaces como los programas de RCT manifestando incrementos similares en el VO2máx y la capacidad funcional.

ABSTRACT

Abstract Home cardiac rehabilitation as an alternative in times of pandemic a systematic review The worldwide pandemic caused by the coronavirus disease (COVID-19) has produced global health, economic and social impact, as well in traditional cardiac rehabilitation (CR) programs. Patients with cardiovascular disease (CVD) should be encouraged to keep doing exercise, despite the pandemic. Objective: To analyze the scientific evidence on home-based CR (HBCR) and traditional CR (TRC) in patient safety and its efficacy in improving the maximum oxygen volume (VO2max) and functional capacity in patients with CVD. Methods: This systematic review was developed through PRISMA agreements. The scientific articles were searched using the electronic databases "PubMed", "ScienceDirect", "Academic Search Ultimate" and "SportDiscus". Two search terms or Boolean phrase were used ("heart disease" OR "cardiac diseases" OR "coronary artery disease" OR "heart failure") AND ("cardiac rehabilitation" OR "center-based" OR "exercise" OR "training") AND ("home-based" OR "home training" OR "home exercise") NOT ("animal"). Results: A total of 1516 studies were reviewed where 21 articles were included and 1316 patients with CVD that met inclusion criteria. The prevalence of adverse events was 3.8% in HCR and 4.3% in TCR. VO2max increased from 4.1% to 39.6% with HCR and between 4.0% to 54.1% with TCR. Functional capacity increased between 3.0% to 11.7% with HCR and between 4.9% and 11.8% withTCR. Conclusions: This scientific evidence shows that HBCR programs are as safe and effective as TCR programs providing similar improving effects on increasing VO2max and functional capacity and offering a great exercise alternative during the COVID-19 pandemic.