A Systematic Review of the Effects of Telerehabilitation in Patients With Cardiopulmonary Diseases

PURPOSE: To examine the effects of telerehabilitation compared with other delivery models for improving physical or functional outcomes in patients with cardiopulmonary diseases. METHODS: A search was completed for English language publications from 1990 to August 2013 across 4 electronic databases and gray literature. Inclusion criteria were: (1) home-based telerehabilitation as a core component; (2) at least 2 exercise sessions; (3) randomized controlled trials; and (4) reporting of physical or functional outcome measures in adult patients with coronary heart disease, chronic heart failure, and chronic respiratory disease. Studies were independently screened by 2 reviewers and graded by a reviewer according to the Downs and Black checklist. A narrative synthesis of the included studies was undertaken. RESULTS: Eleven studies were analyzed. It appears that telerehabilitation is no different to other delivery models for patients with cardiopulmonary diseases, in terms of exercise capacity expressed as distance on the 6-minute walk test and peak oxygen consumption and quality of life. Telerehabilitation appears to have higher adherence rates compared with center-based exercise. There has been similar or no adverse events reported in telerehabilitation compared with center-based exercise. CONCLUSIONS: Although telerehabilitation shows promise in patients with cardiopulmonary diseases, compelling evidence is still limited. There is a need for more detailed, high-quality studies and for studies on the use of video-based telerehabilitation.