Exploring the Needs and Preferences of Athletes in Cardiac (Tele)Rehabilitation to Enhance Rehabilitation Outcome: A Qualitative Study

Lonneke Fruytier,1,2 Irina Bianca Serban,3 Danny AJP Van de Sande,1 Sara Colombo,4 Steven Houben,3 Aarnout Brombacher,3 Hareld Kemps1,3 1Department of Cardiology, Máxima Medical Center, Veldhoven, the Netherlands; 2Department of Sports Medicine, Máxima Medical Center, Veldhoven, the Netherlands; 3Department of Industrial Design, Eindhoven University of Technology, Eindhoven, the Netherlands; 4Department of Industrial Design Engineering, Delft University of Technology, Delft, the NetherlandsCorrespondence: Lonneke Fruytier, Department of Cardiology, Máxima Medical Center, De Run 4600, Veldhoven, 5504 DB, the Netherlands, Email [email protected]: To define the user needs and preferences of the athletic population in cardiac (tele)rehabilitation (CTR).Patients and Methods: In this qualitative study, we included athletes with established coronary artery disease (CAD) who participated in a cardiac rehabilitation (CR) program and health care professionals involved in CR. All athletes engaged in sports for at least four hours per week. Fourteen male and one female athlete (mean age 63 ± 10.6 years) participated in CR after an acute coronary syndrome, percutaneous coronary intervention and/or coronary bypass surgery. The twelve healthcare professionals invited included cardiac nurse practitioners, cardiologists, sports physicians, physiotherapists, and a clinical psychologist. This study consists of four phases: a stakeholder identification session, twenty-five semi-structured individual interviews, six card-sorting focus groups and a data analysis phase with thematic analysis.Results: User needs for athletes in CR encompass personalized exercise plans featuring clear and quantifiable exercise recommendations and limitations. Additionally, there is a need for monitoring health and exercise data; measuring progression and performance longitudinally; easy-to-use, and reliable healthcare information systems with accurate sensors and data; as well as clinical supervision and validation of information and data. Social support from both peers and family is also identified as a crucial need. The preferred technological features for a CTR system tailored for athletes include periodic digital consultations with clinicians, home-based training specific to one’s sport, utilization of technology to monitor workouts, data sharing and remote feedback, personalized exercise recommendations and online educational materials.Conclusion: This research explored the user needs and preferences of athlete patients in CR. The findings indicated that enhancing CR for athletes necessitates a personalized and sport-specific methodology. The integration of various technological features within a CTR program can play a pivotal role in assisting athletes with CAD to maintain an active lifestyle and regain their previous athletic performance levels.Keywords: interview, focus group, telerehabilitation features, highly active individuals, coronary artery disease