Safety, Efficacy And Acceptability Of Pediatric Cardiac Tele-rehabilitation In Adolescents With Acquired Or Congenital Heart Disease

PURPOSE: Healthcare advocates need more data from randomized control trials to support the development and reimbursement of Pediatric Cardiac Tele-Rehabilitation (PCTR). We aimed to demonstrate the safety and efficacy of PCTR in a clinically diverse population of adolescents with heart disease using a prospective randomized control-trial design. METHODS: Cardiopulmonary exercise testing, questionnaires and heart rate (HR) / activity level data (Fitbit) were collected pre and post intervention, which consisted of a 12-week semi-supervised PCTR program administered over zoom. The PCTR group received a Fitbit, electrocardiogram monitor, stationary bicycle, hand-weights, resistance-bands, and personalized exercise prescriptions. The control group received Fitbits and weekly check-ins. RESULTS: Forty-three out of 49 patients completed the study (25 PCTR, 18 control), mean age 15 years (95%CI 13-17); 37% were female (p = .035); 44% had Pulmonary Hypertension, 35% had Congenital Heart Disease, and 21% Orthotropic Heart Transplant. Four adverse events occurred; nosebleeds with exercise due to anti-coagulation medication, ventricular ectopy that improved with modification of the exercise, mild chest discomfort that resolved and skin irritation from the Fitbit-wristband. Eighty-seven percent of patients completed all 12 one-on-one sessions. PCTR improved anxiety scores (p = .007), quality of life scores (p = .009), peak exercise time (p < .001), and peak O2 pulse (p = .003). Anaerobic threshold time (AT) (p = .012) and AT HR (p = .043) were improved more in the PCTR group than in the control group when adjusted for age, gender and diagnosis. CONCLUSION: PCTR was safe and effective across a clinically diverse group of adolescents with heart disease. These results provide evidence supporting the effectiveness of pediatric cardiac tele-rehabilitation, beyond that provided by weekly contact and Fitbits. Supported by: Innovation Nucleation Fund