Quality of life in heart failure patients undergoing home-based telerehabilitation versus outpatient rehabilitation--a randomized controlled study

Abstract

Background: The most common manifestation of heart failure is physical capacity impairment resulting in dyspnoea and fatigue. The disease deteriorates the quality of life (QoL). Its consequences restrict not only functioning in the physical aspect of QoL but also patients' emotional condition.

Objective: The study is aimed to assess QoL changes in HF patients after home-based telemonitored cardiac rehabilitation (HTCR Group) versus outpatient-based standard cardiac rehabilitation (SCR Group).

Methods: The study comprised 131 heart failure patients (aged 56.4±10.9 years; II/III NYHA) rehabilitated for eight weeks in two random groups: HTCR Group (n=75), participating in home-based rehabilitation supervised telemedically based on walking training; SCR Group (n=56), participating in traditional outpatient-based rehabilitation (cycloergometer training). QoL parameters were assessed with a Polish version of the Medical Outcomes Study Short Form 36 Health Survey Questionnaire (SF-36).

Results: After rehabilitation, both groups achieved a significant QoL improvement, both physically and mentally. HTCR Group patients improved in QoL physical categories in one subscale (physical function), and in two subscales in the mental categories (mental health, vitality). In SCR Group, three physical subscales improved (physical function, role limitation caused by physical problems, bodily pain). In the mental categories, also three subscales improved (social function, mental health, vitality).

Conclusions: The study demonstrated that in heart failure patients HTCR provided a similar improvement in total QoL index as SCR. Yet it differed in QoL subscales. Patients who underwent home-based telerehabilitation observed an improvement mainly in the mental categories. Patients in SCR Group improved their general physical well-being.

Keywords: Quality of life; heart failure; telerehabilitation.