Evaluating digital prehabilitation in cardiac rehabilitation: impact on patient recall of exercise guidelines and programme familiarisation

Background/Aims: The efficacy of UK cardiac rehabilitation to improve patient outcomes has been questioned owing to many programmes not prescribing a full dose of exercise as recommended by the Association of Chartered Physiotherapists in Cardiac Rehabilitation. The aims of this study were to 1) evaluate whether providing digital prehabilitation to patients prescribed a lower exercise dose than Association of Chartered Physiotherapists in Cardiac Rehabilitation guidelines recommend enabled them to recall the exercise targets, and 2) to determine whether digital prehabilitation helped patients feel more familiar and prepared for participation in the cardiac rehabilitation programme. Methods: Fifty-five patients were initially recruited to the study. Fifty-one patients were provided with digital prehabilitation via an online weblink 7 days before starting their phase III cardiac rehabilitation programme. Thirty-three patients engaged with the video and were given an online survey to complete relating to the digital prehabilitation, and twenty-three patients responded. Results: Eleven (47.8%) patients felt ‘very’ confident that they were meeting the prescribed exercise targets for intensity and duration. Meanwhile, four (17.4%) patients felt ‘extremely’ confident, and four (17.4%), two (8.7%) and two (8.7%) felt ‘somewhat’, ‘not so’ and ‘not at all confident’ that they were meeting prescribed exercise targets. Three (13.0%) recalled the rating of perceived exertion exercise intensity target range (11–14) correctly. For the gym-based cardiac rehabilitation exercise programme, of the 16 patients who responded, none (100%) recalled the full rating of perceived exertion range (14–16) correctly. Eight (34.8%) patients recalled the minimum exercise duration (20 minutes) target correctly. Conclusions: Despite most patients feeling confident about their understanding of exercise targets, the actual recall of rating of perceived exertion and exercise duration targets was limited, indicating a gap between perceived knowledge and recall. This familiarisation approach has potential but requires enhancement to improve the patients' recall of exercise dose.