Cardiac rehabilitation via telerehabilitation in COVID-19 pandemic situation

Sari D.M., Wijaya L.C.G.

Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia


Background: Adherence to medication and lifestyle changes are very important in the secondary prevention of cardiovascular disease. One of the ways is by doing a cardiac rehabilitation program. Main body of the abstract: Cardiac rehabilitation program is divided into three phases. The cardiac rehabilitation program’s implementation, especially the second phase, center-based cardiac rehabilitation (CBCR), has many barriers not to participate optimally. Therefore, the third phase, known as home-based cardiac rehabilitation (HBCR), can become a substitute or addition to CBCR. On the other hand, this phase is also an essential part of the patients’ functional capacity. During the coronavirus disease-2019 pandemic, HBCR has become the leading solution in the cardiac rehabilitation program’s sustainability. Innovation is needed in its implementation, such as telerehabilitation. So, the cardiac rehabilitation program can be implemented by patients and monitored by health care providers continuously. Short conclusion: Physicians play an essential role in motivating patients and encouraging their family members to commit to a sustainable CR program with telerehabilitation to facilitate its implementation. © 2021, The Author(s).

Cardiac rehabilitation; Coronavirus disease-2019 pandemic; Home-based exercise; Telerehabilitation


Egyptian Heart Journal

Publisher: Springer Science and Business Media Deutschland GmbH

Volume 73, Issue 1, Art No 31, Page – , Page Count

Journal Link:

doi: 10.1186/s43044-021-00156-7

Issn: 11102608

Type: All Open Access, Gold


Doimo, S., Fabris, E., Piepoli, M., Barbati, G., Antonini-Canterin, F., Bernardi, G., Maras, P., Sinagra, G., Impact of ambulatory cardiac rehabilitation on cardiovascular outcomes: a long-term follow-up study (2019) Eur Heart J, 40 (8), pp. 678-685; Hald, K., Larsen, F.B., Nielsen, K.M., Meillier, L.K., Johansen, M.B., Larsen, M.L., Christensen, B., Nielsen, C.V., Medication adherence, biological and lifestyle risk factors in patients with myocardial infarction: a ten-year follow-up on socially differentiated cardiac rehabilitation (2019) Scand J Prim Health Care, 37 (2), pp. 182-190; Kim, Y.H., So, W.Y., Gender differences in home-based cardiac rehabilitation of post-percutaneous coronary intervention patients (2019) Aging Clin Exp Res, 31 (2), pp. 249-255; Hald, K., Nielsen, K.M., Nielsen, C.V., Meillier, L.K., Larsen, F.B., Christensen, B., Larsen, M.L., Expanded cardiac rehabilitation in socially vulnerable patients with myocardial infarction: a 10-year follow-up study focusing on mortality and non-fatal events (2018) BMJ Open, 8 (1); Noites, A., Freitas, C.P., Pinto, J., Melo, C., Vieira, Á., Albuquerque, A., Teixeira, M., Bastos, J.M., Effects of a phase IV home-based cardiac rehabilitation program on cardiorespiratory fitness and physical activity (2017) Heart Lung Circ, 26 (5), pp. 455-462; Marzolini, S., Ghisi, G., Hébert, A.A., Ahden, S., Oh, P., Cardiac rehabilitation in Canada during COVID-19 (2021) CJC Open, 3 (2), pp. 152-158; Riebe, D., Ehrman, J.K., Liguori, G., Magal, M., (2018) ASCM’s guidelines for exercise testing and prescription, pp. 184-188. , 10, Wolters Kluwer Health, Philadelphia; Bartels, M., Cardiac rehabilitation (2010) DeLisa’s Physical Medicine & Rehabilitation Principles and Practice, 1, pp. 1075-1097. , Frontera WR, DeLisa JA, Gans BM, Walsh NE, Robinson LR, (eds), 5, Lippincott Williams & Wilkins, Philadelphia; (2013) Guidelines for cardiac rehabilitation and secondary prevention programs, , 5, Human Kinetics, Champaign; Dunn, S.L., Dunn, L.M., Buursma, M.P., Clark, J.A., Berg, L.V., DeVon, H.A., Home- and hospital-based cardiac rehabilitation exercise: the important role of physician recommendation (2017) West J Nurs Res, 39 (2), pp. 214-233; Tedjasukmana, D., Return to work in patients with acute coronary syndrome (2017) Indonesian J Phys Med Rehabil, 6 (2), p. 23; Leon, A.S., Franklin, B.A., Costa, F., Balady, G.J., Berra, K.A., Stewart, K.J., Thompson, P.D., Lauer, M.S., Cardiac rehabilitation and secondary prevention of coronary heart disease (2005) Circulation., 111 (3), pp. 369-376; Ibanez, B., James, S., Agewall, S., Antunes, M.J., Bucciarelli-Ducci, C., Bueno, H., Caforio, A.L.P., Gale, C.P., 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation (2018) Eur Heart J, 39 (2), pp. 119-177; Thomas, R.J., Beatty, A.L., Beckie, T.M., Brewer, L.C., Brown, T.M., Forman, D.E., Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology (2019) J Am Coll Cardiol, 74 (1), pp. 133-153; Afilalo, J., Evaluating and treating frailty in cardiac rehabilitation (2019) Clin Geriatr Med, 35 (4), pp. 445-457; Sunamura, M., Ter Hoeve, N., van den Berg-Emons, R.J.G., Boersma, E., Geleijnse, M.L., van Domburg, R.T., Patients who do not complete cardiac rehabilitation have an increased risk of cardiovascular events during long-term follow-up (2020) Neth Hear J, 28 (9), pp. 460-466; Vieira, Á., Melo, C., Machado, J., Gabriel, J., Virtual reality exercise on a home-based phase III cardiac rehabilitation program, effect on executive function, quality of life and depression, anxiety and stress: a randomized controlled trial (2018) Disab Rehabil Assist Technol, 13 (2), pp. 112-123; Beckie, T.M., Utility of home-based cardiac rehabilitation for older adults (2019) Clin Geriatr Med, 35 (4), pp. 499-516; Bravo-Escobar, R., González-Represas, A., Gómez-González, A.M., Montiel-Trujillo, A., Aguilar-Jimenez, R., Carrasco-Ruíz, R., Salinas-Sánchez, P., Effectiveness and safety of a home-based cardiac rehabilitation programme of mixed surveillance in patients with ischemic heart disease at moderate cardiovascular risk: a randomised, controlled clinical trial (2017) BMC Cardiovasc Disord, 17 (1), p. 66; Zwisler, A.D., Norton, R.J., Dean, S.G., Dalal, H., Tang, L.H., Wingham, J., Taylor, R.S., Home-based cardiac rehabilitation for people with heart failure: a systematic review and meta-analysis (2016) Int J Cardiol, 221, pp. 963-969; Bernocchi, P., Vitacca, M., La Rovere, M.T., Volterrani, M., Galli, T., Baratti, D., Home-based telerehabilitation in older patients with chronic obstructive pulmonary disease and heart failure: a randomised controlled trial (2018) Age Ageing, 47 (1), pp. 82-88; Moulson, N., Bewick, D., Selway, T., Harris, J., Suskin, N., Oh, P., Coutinho, T., Krahn, A.D., Cardiac rehabilitation during the COVID-19 era: guidance on implementing virtual care (2020) Can J Cardiol, 36 (8), pp. 1317-1321; Scherrenberg, M., Wilhelm, M., Hansen, D., Völler, H., Cornelissen, V., Frederix, I., Kemps, H., Dendale, P., The future is now: a call for action for cardiac telerehabilitation in the COVID-19 pandemic from the secondary prevention and rehabilitation section of the European Association of Preventive Cardiology (2020) Eur J Prev Cardiol, , (,),.,.,; Hwang, R., Bruning, J., Morris, N.R., Mandrusiak, A., Russell, T., Home-based telerehabilitation is not inferior to a centre-based program in patients with chronic heart failure: a randomised trial (2017) J Physiother, 63 (2), pp. 101-107; Khera, A., Baum, S.J., Gluckman, T.J., Gulati, M., Martin, S.S., Michos, E.D., Navar, A.M., Shapiro, M.D., Continuity of care and outpatient management for patients with and at high risk for cardiovascular disease during the COVID-19 pandemic: a scientific statement from the American Society for Preventive Cardiology (2020) Am J Prev Cardiol, 1, p. 100009; Kemps, H.M.C., Brouwers, R.W.M., Cramer, M.J., Jorstad, H.T., De Kluiver, E.P., Kraaijenhagen, R.A., Recommendations on how to provide cardiac rehabilitation services during the COVID-19 pandemic (2020) Neth Hear J, 28 (7-8), pp. 387-390; Rosen, K., Patel, M., Lawrence, C., Mooney, B., Delivering telerehabilitation to COVID-19 inpatients: a retrospective chart review suggests it is a viable option (2020) HSS J, , (,),.,.,; Yu, J.C., Mcintyre, M., Dow, H., Robinson, L., Winston, P., Changes to rehabilitation service delivery and the associated physician perspectives during the COVID-19 pandemic (2020) Am J Phys Med Rehabil, 99 (9), pp. 775-782; Scherrenberg, M., Frederix, I., De Sutter, J., Dendale, P., Use of cardiac telerehabilitation during COVID-19 pandemic in Belgium (2020) Acta Cardiol, 30, pp. 1-4; Tersalvi, G., Winterton, D., Cioffi, G.M., Ghidini, S., Roberto, M., Biasco, L., Pedrazzini, G., Vicenzi, M., Telemedicine in heart failure during COVID-19: a step into the future (2020) Front Cardiovasc Med, 7. , (,),.,.,; Ribeiro, F., Santos, M., Exercise-based cardiac rehabilitation in COVID-19 times: one small step for health care systems, one giant leap for patients (2020) Revista espanola de cardiologia (English ed), 73 (11), pp. 969-970; Besnier, F., Gayda, M., Nigam, A., Juneau, M., Bherer, L., Cardiac rehabilitation during quarantine in COVID-19 pandemic: challenges for center-based programs (2020) Arch Phys Med Rehabil, 101 (10), pp. 1835-1838; Babu, A.S., Arena, R., Ozemek, C., Lavie, C.J., COVID-19: a time for alternate models in cardiac rehabilitation to take centre stage (2020) Can J Cardiol, 36 (6), pp. 792-794

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