Purpose: Cardiac rehabilitation participation rates are low despite strong recommendations, and many chronic heart failure patients remain physically inactive. Rural living, long travel distance, costs, age, and frailty might be factors explaining this. To increase cardiac rehabilitation uptake, we designed an exercise-based randomized controlled telerehabilitation trial enabling chronic heart failure patients unable or unwilling to participate in outpatient cardiac rehabilitation to exercise at home. Aim was to evaluate the long-term effects of telerehabilitation on physical activity levels.Methods and results: CHF patients (n = 61) with reduced (≤40%), mildly reduced (41-49%), or preserved ejection fraction (≥50%) were randomized (1:1) to telerehabilitation (n = 31) with an initial 3-month group-based high-intensity exercise telerehabilitation program or control (n = 30), with regular follow-up visits over a 2-year period. All participants attended a "Living with heart failure" course. Outcomes were measures of physical activity, peak oxygen uptake, 6-minute walk test distance, quality of life, morbidity, and mortality. We found no significant differences between groups for long-term changes in moderate to vigorous activity (MVPA) or peak oxygen uptake from baseline to the 2-year follow-up. Nor quality of life differed between groups, but both groups had significant within-group improvements in score on the Minnesota living with heart failure questionnaire (p = 0.000) and improvement in EQ-5D VAS score was significant (p = 0.05) in the telerehabilitation group.Conclusions: Telerehabilitation performed as home-based real-time high-intensity exercise sessions provided by videoconferencing for participants unable or unwilling to participate in standard outpatient cardiac rehabilitation did not affect long-term physical activity levels or physical capacity as expected. Still, a positive effect on health-related quality of life was seen in both groups.

中文翻译：

---

心力衰竭患者基于运动的远程康复 - 一项随机对照试验。


目的：尽管有强烈建议，但心脏康复参与率很低，许多慢性心力衰竭患者仍然缺乏身体活动。农村生活、长途旅行、成本、年龄和虚弱可能是解释这一点的因素。为了提高心脏康复的摄取率，我们设计了一项基于运动的随机对照远程康复试验，使不能或不愿参加门诊心脏康复的慢性心力衰竭患者能够在家中锻炼。目的是评估远程康复对身体活动水平的长期影响。方法和结果：射血分数降低 （≤40%） 、轻度降低 （41-49%） 或射血分数保留 （≥50%） 的 CHF 患者 （n = 61） 被随机分配 （1：1） 接受远程康复 （n = 31） 联合初始 3 个月的基于小组的高强度运动远程康复计划或对照 （n = 30），并在 2 年期间定期随访。所有参与者都参加了“与心力衰竭共存”课程。结局是身体活动、峰值摄氧量、6 分钟步行测试距离、生活质量、发病率和死亡率的测量。我们发现从基线到 2 年随访，中度至剧烈活动 （MVPA） 或峰值摄氧量的长期变化在组间没有显著差异。两组之间的生活质量也没有差异，但两组在明尼苏达心力衰竭患者问卷的评分 （p = 0.000） 的组内评分都有显着改善，远程康复组的 EQ-5D VAS 评分有显著改善 （p = 0.05）。结论： 远程康复作为视频会议为不能或不愿参加标准门诊心脏康复的参与者提供的家庭实时高强度锻炼课程进行，并没有像预期的那样影响长期身体活动水平或身体能力。尽管如此，在两组中都观察到了对健康相关生活质量的积极影响。