Potential Benefits of Remote Monitoring in Physical Rehabilitation for Myocardial Infarction Patients
Study Objective: To evaluate the potential benefits of using mobile technologies for remote monitoring of patients undergoing home-based physical rehabilitation programs after ST-segment elevation myocardial infarction (STEMI). Study Design: This was a prospective study. Materials and Methods: Twenty-four patients with STEMI (mean age 55.3 ± 8.3) took part in the study. They joined the remote monitoring program on day 31 ± 5 after STEMI. Physical rehabilitation was done at home in the form of controlled walking. Remote monitoring included automatic transmission of electrocardiogram (ECG) recordings, monitoring of the patient's physical activity and clinical parameters, and store-and-forward (asynchronous) counselling. The effectiveness of physical rehabilitation was assessed by the distance covered in a six-minute walk test (6MWT), patient activity as recorded by remote monitoring, and changes in the patient's subjective responses. Study Results: Twenty-one (87.5%) patients completed the study. After three months of physical rehabilitation, there was a positive change in 6MWT results (443 ± 32 m vs. 362 ± 37 at baseline; р < 0.05); mean time of walking during the day was 44 ± 8 min, mean number of steps taken per day was 3,223.6 ± 27.7, and total distance covered per week was 10.4 ± 0.2 km. The patients' subjective responses were stable. During automatic ECG transmission, asymptomatic episodes of ischemia were documented in two (9.5%) patients, and heart rhythm disturbances were seen in eight (38.1%) patients. The percentage of patients with no or minimal signs of maladaptation increased to 33.3% from 12.5% at the outset (р < 0.001). Conclusion: This remote monitoring system can be recommended for outpatient physical rehabilitation of STEMI patients. Digital devices for self-monitoring provide information that can be analyzed and used in adjusting physical rehabilitation plans. Improved patient motivation, achieved through a combination of acquired self-monitoring skills and better doctor-patient communication, may serve as an integrated factor in the effectiveness of physical rehabilitation.