Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2024; 12(12): 2009-2015
Published online Apr 26, 2024. doi: 10.12998/wjcc.v12.i12.2009
Comprehensive and personalized approach is a critical area for developing remote cardiac rehabilitation programs
Garyfallia Pepera, Varsamo Antoniou, Jing Jing Su, Rose Lin, Ladislav Batalik
Garyfallia Pepera, Varsamo Antoniou, Clinical Exercise Physiology and Rehabilitation Research Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, Lamia GR35100, Greece
Jing Jing Su, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
Rose Lin, University of Rochester School of Nursing, New York, NY 14602, United States
Ladislav Batalik, Department of Rehabilitation, University Hospital Brno, Brno 62500, Czech Republic
Ladislav Batalik, Department of Public Health, Faculty of Medicine, Masaryk University, Brno 62500, Czech Republic
Author contributions: Batalik L conceptualized the topic; Pepera G, Antoniou V, Su JJ, Lin R and Batalik L wrote the manuscript; Batalik L and Lin R contributed to the figures and tables; and all authors reviewed and approved the final manuscript.
Supported by The Ministry of Health, Czech Republic; Conceptual Development of Research Organization, FNBr, No. 65269705.
Conflict-of-interest statement: Authors declare no potential conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ladislav Batalik, PhD, Physiotherapist, Research Assistant Professor, Department of Rehabilitation, University Hospital Brno, Jihlavska 20, Brno 62500, Czech Republic. batalik.ladislav@fnbrno.cz
Received: November 30, 2023
Peer-review started: November 30, 2023
First decision: February 2, 2024
Revised: February 9, 2024
Accepted: March 26, 2024
Article in press: March 26, 2024
Published online: April 26, 2024

In the evolving landscape of cardiac rehabilitation (CR), adopting digital technologies, including synchronous/real-time digital interventions and smart applications, has emerged as a transformative approach. These technologies offer real-time health data access, continuous vital sign monitoring, and personalized educational enhanced patient self-management and engagement. Despite their potential benefits, challenges and limitations exist, necessitating careful consideration. Synchronous/real-time digital CR involves remote, two-way audiovisual communication, addressing issues of accessibility and promoting home-based interventions. Smart applications extend beyond traditional healthcare, providing real-time health data and fostering patient empowerment. Wearable devices and mobile apps enable continuous monitoring, tracking of rehabilitation outcomes, and facilitate lifestyle modifications crucial for cardiac health maintenance. As digital CR progresses, ensuring patient access, equitable implementation, and addressing the digital divide becomes paramount. Artificial intelligence holds promise in the early detection of cardiac events and tailoring patient-specific CR programs. However, challenges such as digital literacy, data privacy, and security must be addressed to ensure inclusive implementation. Moreover, the shift toward digital CR raises concerns about cost, safety, and potential depersonalization of therapeutic relationships. A transformative shift towards technologically enabled CR necessitates further research, focusing not only on technological advancements but also on customization to meet diverse patient needs. Overcoming challenges related to cost, safety, data security, and potential depersonalization is crucial for the widespread adoption of digital CR. Future studies should explore integrating moral values into digital therapeutic relationships and ensure that digital CR is accessible, equitable, and seamlessly integrated into routine cardiac care. Theoretical frameworks that accommodate the dynamic quality of real-time monitoring and feedback feature of digital CR interventions should be considered to guide intervention development.

Keywords: Cardiac rehabilitation, Digital approaches, Remote care, Equity in technology access, Synchronous/real-time interventions, Digital innovation in healthcare

Core Tip: Digital technologies have revolutionized cardiac rehabilitation (CR), offering flexible and novel approaches to care. The integration of digital health technologies and artificial intelligence in remote CR is transforming traditional paradigms, providing real-time access to health data, and enhancing patient self-management. Mobile and digital CR models, including synchronous/real-time digital interventions, are addressing accessibility barriers, and promoting equity in healthcare delivery. Despite the potential benefits, challenges such as the digital divide, cost, safety, and data security must be addressed. Future research should prioritize accessibility, equity, and the seamless integration of digital CR into routine cardiac care.