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[Effects of hybrid comprehensive cardiac telerehabilitation conducted under the pension prevention program of the Social Insurance Institution].

BACKGROUND
The Polish Social Insurance Institution (SII), under its pension prevention initiative, has taken measures to support the patients return to work and thus developed a new model of hybrid, comprehensive, cardiac telerehabilitation (HCCT). The aim of the study was to analyze the effects of HCCT in terms of its acceptance, adherence to and influence on patients' physical capacity and ability to return to work.


MATERIAL AND METHODS
The study included 99 patients, aged 54.6±6.3 years, who suffered from cardiovascular diseases. They participated in a 24-day HCCT consisting of preliminary and final examinations, 10 days of out-patients rehabilitation based on cycloergometer training (5 sessions) and Nordic walking training (10 sessions), and 12 days of home telerehabilitation based on Nordic walking training. The effectiveness of HCCT was assessed by comparing changes in functional capacity expressed by metabolic equivalent of task (MET) and a 6-min walking test (6-MWT) distance from the beginning and the end of HCCT. Acceptance of HCCT was evaluated using a questionnaire. Adherence to HCCT was assessed by the patients' participation in the training sessions. Effectiveness of HCCT in terms of return to work was assessed according to SII definition.


RESULTS
Hybrid, comprehensive, cardiac telerehabilitation resulted in significant improvement of functional capacity 7.6±2.0 vs. 8.1±2.4 MET (p < 0.0001) and distance in 6-MWT 448.5±79.2 m vs. 480.5±84.1 m (p < 0.0001). There were 82.8% of adherent, 16.2% of partially adherent and 1% of non-adherent patients. After HCCT 48 patients were able to return to work.


CONCLUSIONS
Hybrid, comprehensive, cardiac telerehabilitation was well accepted and led to the improvement of the patients' physical capacity. Adherence to HCCT was high and allowed 48.48% of patients return to work. Med Pr 2017;68(1):61-74.