Meta Analysis Of Rehabilitation Effect Of Remote Exercise Cardiac Rehabilitation With Real-Time Monitoring On Patients With Coronary Heart Disease

Objective: Central exercise cardiac rehabilitation has been proved to be beneficial to the rehabilitation of patients with coronary heart disease,but it has some disadvantages,such as relying on on-site exercise,low participation rate,poor compliance and so on.Remote exercise Cardiac Rehabilitation with Real-time Monitoring has the advantages of independent of on-the-spot exercise,good compliance and high participation rate.However,its curative effect is not very certain.The purpose of this meta-analysis was to compare the differences of Remote exercise Cardiac Rehabilitation with Real-time Monitoring and central exercise cardiac rehabilitation in improving maximum aerobic capacity(Peak VO2),cardiovascular risk factors(BP,BL,BG),body com-position(BMI,WC,HC)and health-related quality of life(HRQo L)in patients with coronary heart disease.Methods: The related randomized controlled trials were searched in Chinese biomedical literature database(CBM),China knowledge Network(CNKI),Wanfang database,Cochrane Library,Embase and Pub Med database.The search time limit is from the establishment of the database to July 13,2019,and the search deadline is August 1,2019.The relevant data are extracted and Meta analysis is carried out with REVMAN 5.1software.Results: A total of 9 randomized controlled trials were included,with a total sample size of 942 cases.8 studies reported the maximum aerobic exercise capacity(Peak VO2),and the data were combined using a fixed effect model.The results showed that the effect of Remote exercise Cardiac Rehabilitation with Real-time Monitoring is similar to that of central exercise cardiac rehabilitation in improving peak oxygen uptake[Z=1.83,P =0.07,MD=0.62,95%CI(-0.04,1.28)].In order to eliminate the influence of the difference in publication years on the results,the study was divided into two subgroups(group A included 2studies in 2002 and group B included 6 studies from 2013 to 2019)for meta analysis.The results of group A showed that the effect of Remote exercise Cardiac Rehabilitation with Real-time Monitoring was similar to that of central exercise cardiac rehabilitation in improving peak oxygen uptake(P>0.05).The results of group B showed that the Remote exercise Cardiac Rehabilitation with Real-time Monitoring was superior to central exercise cardiac rehabilitation in improving peak oxygen uptake(P < 0.05).Compared with central exercise cardiac rehab-ilitation,Remote exercise Cardiac Rehabilitation with Real-time Monit-oring was effective in improving BMI [Z=0.95,P=0.34,MD=0.39,95%CI(-0.42,1.20)],WC [Z= 0.06,P=0.95,MD=0.08,95% CI(-2.47,2.62)],HC [Z =0.20,P=0.84,MD=0.38,95%CI(-3.33,4.08)],RER at peak V-O2[Z=0.76,P=0.45,MD=0.01,95% CI(-0.02,0.04)],HR at peak VO2[Z=0.01,P=0.99,MD =0.04,95%CI(-8.02,8.09)],HR at rest [Z = 1.25,P=0.21,MD=-1.50,95%CI(-3.85,0.85)],BP {SBP[Z=0.39,MD =0.5 4,P=0.69,95%CI(-2.16,3.25)],DBP[Z=0.26,MD =-0.21,P = 0.8,95% CI(-1.86,1.43)]},BL{TC[Z=0.72,P = 0.47,MD = 0.06,95%CI(-0.10,0.21)],TG[Z=0.13,P = 0.90,MD =-0.01,95% CI(-0.16,0.14)],LDL-C [Z=0.09,P=0.92,MD=-0.01,95%CI(-0.26,0.24)],HDL-C [Z=0.21,P = 0.83,MD=0.01,95%CI(-0.05,0.07)]} and BG [Z=0.95,P=0.34,MD=-0.13,95%CI(-0.41,0.14)].The quality of life was evaluated by the total score of HRQo L.The results showed that the Remote exercise Cardiac Rehabilitation with Real-time Monitoring was superior to the central exercise cardiac rehabilitation in improving the quality of life[Z =3.64,P= 0.00 03,MD = 0.11,95%CI(0.05,0.16)].Conclusion: The effect of Remote exercise Cardiac Rehabilitation with Real-time Monitoring was similar to that of central exercise cardiac rehabilitation in improving maximum aerobic exercise capacity,blood pressure,blood lipids,blood glucose,body mass index,waist circum ference,hip circumference,respiratory rate at peak oxygen uptake,heart rate at peak oxygen uptake and heart rate at rest,and better in improving quality of life.Remote exercise Cardiac Rehabilitation with Real-time Monitoring provides additional options for low-and medium-risk coronary heart disease patients who are unable to participate in central exercise cardiac rehabilitation.