Added value of home virtual exercise in cardiac rehabilitation during covid-19

ABSTRACT

Objectives: Cardiac rehabilitation is the key component in optimizing physical function, reducing the cardiovascular risk and mortality for cardiac patients. However, as the coronavirus disease 2019 (COVID- 19) pandemic has begun since the end of 2019, usual service is affected. Patients' compliance and attendance to exercise training is worth concern and the general recommendation of 150-minute per week of moderate intensity exercise is almost unachievable. The limitation of routine health care delivery is explored. In order to increase patients' physical activity and prevent secondary complication, the Cardiac Society of Australia and New Zealand (CSANZ) recommended health care profession continued to deliver evidencedbased strategies with the use of electronic health platforms as it was more accessible during the pandemic. This study sought to examine the value of home virtual exercise in cardiac rehabilitation during COVID-19. Methods: Twenty-eight patients were recruited from the Cardiac Rehabilitation program (CRP) in Tseung Kwan O Hospital between December 2019 and August 2020. Patients who attended the CRP were under usual care receiving 1.5-hour center-based training 1-2 times per week. The home virtual exercise which was circuit training was given via QR code. All patients completed 12-sessions of CRP. Patients' safety, body weight and body mass index (BMI), 6 Minutes Walk Test (6MWT) distance, Five Times Sit To Stand (FTSTS) and Cardiac Exercise Self-Efficacy Instrument (CESEI) were measured at baseline and at end of 12th session. Results: No adverse events were reported in relation to home virtual exercise. Although there were no statistically changes in body weight and BMI (p>0.109), there were significant improvement in 6MWT distance (p=0.000), FTSTS (p=0.000) and CESEI (p=0.007). Conclusion: Home virtual exercise appears to be safe and effective for patients to exercise at home during COVID-19. Improvement in functional capacity and self-efficacy were observed, therefore, suggesting that home virtual exercise could be used in addition to center-based training to improve cardiovascular risk. Cardiac rehabilitation specialists should consider using electronic platforms during the pandemic to deliver exercise regimes. Future study is needed to explore the long-term effects of virtual exercise after program completion.