A Home-based Virtual Exercise Program For Rural Older Adults With Cardiovascular Disease

Exercise-based cardiac rehabilitation is integral for the treatment of cardiovascular disease (CVD); yet enrollment and completion rates are low, especially among older adults and those in rural areas. While home-based programs have the potential to expand reach and utilization, few studies have investigated the impact of such programs in underserved communities. PURPOSE: To determine the feasibility, acceptability, and efficacy of a home-based exercise program for rural older adults with CVD. METHODS: Vivo Heart is an ongoing study targeting 40 adults aged 60-80 yrs who live in a rural area and have CVD. All participants complete a 12-week program consisting of online, live, small group exercise classes led by a certified trainer (Vivo, 2x/week) and nutrition classes led by a registered dietitian (1x/week). The program uses individually tailored dual-task exercises to improve strength, endurance, and balance and incorporates social engagement through interactive sessions. Lower extremity function, mobility, grip strength, and peak aerobic capacity are assessed in clinic before and after the intervention. RESULTS: To date, 22 participants have been enrolled and 12 have completed the study (mean age: 67.6 ± 4.5 yrs, 42% female, 8% Hispanic). Participants had good physical function at baseline, with an average Short Physical Performance Battery (SPPB) score of 11.2 ± 1.3, gait speed of 1.01 ± 0.15 m/s, and grip strength of 36.4 ± 12.5 kg, although peak aerobic capacity was low (18.5 ± 3.2 ml/kg/min). Attendance rates were nearly 80% for both the exercise and nutrition classes. After 12 weeks, lower extremity function improved (expanded SPPB: 0.14 ± 0.19, p = 0.03), and there was a small, but meaningful change in gait speed (0.05 ± 0.13 m/s) that was not statistically significant (p = 0.24). No other functional outcomes were significantly improved. At the end of the study, 100% of participants reported being satisfied with the program and 75% agreed they would continue to exercise. CONCLUSION: Rural older adults with CVD are receptive to virtual exercise programs that are supervised and tailored to their individual abilities. Our findings, marked by high attendance and satisfaction, suggest that home-based programs like Vivo Heart may be an effective strategy to increase exercise and improve function in this population. Supported by: P30-AG21332