IJCS | Volume 31, Nº4, July / August 2018

446 Cristo et al. Telerehabilitation for cardiac patients Int J Cardiovasc Sci. 2018;31(4)443-450 Review Article Figure 1 - Flowchart of the selection of the studies. 29 excluded for not being clinical trials 154 articles identified through search strategy 109 excluded due to duplication 16 included for complete analysis 2 excluded for being prospective 2 excluded due to cohort duplication 5 excluded for not contemplating an outcome 7 studies were included Results This systematic review gathered 154 studies identified through the determined search strategy in electronic databases. Of those 154 studies, 109 were excluded due to duplication in databases, 29 were excluded because of being abstracts, systematic reviews or other studies. Thus, 16 clinical trials were included for complete analysis, of which 2 were excluded because of their prospective character, 2 were excluded due to cohort duplication, and 5 were excluded for not contemplating an outcome. Thus, 7 studies were included for complete analysis in this review (Figure 1). Data regarding the methodology and results of the studies included in this review are shown in Table 3. They assessed the effectiveness of telerehabilitation as compared to conventional CVR, in addition to comparing the effectiveness of conventional CVR to that of hybrid cardiac rehabilitation (HCR), in which the patient practices the exercises at home using sensors that transmit information to the rehabilitation center. Some studies’ outcomes were as follows: influence of rehabilitation on oxygen consumption (VO 2 ), physical capacity, acceptance and efficacy of the technique in different patients. Of the underlying pathologies that led the patients to look for rehabilitation, the following stand out: coronary artery disease (CAD), chronic heart failure (CHF) and diabetes mellitus (DM). Discussion The present systematic review of the literature analyzed seven clinical trials involving telerehabilitation for patients with CVD, adding up to a sample of 1,133 patients. The studies were heterogeneous regarding both their populations and interventions; thus, ameta-analysis could not be performed. Catalina et al. 10 have suggested that CAD is still one of the major causes of premature death in Europe and worldwide, being considered a public health problem. Considering that, some studies have assessed the effects of CVR and telerehabilitation on patients with CAD. According to Vieira et al., 11 the group undergoing telerehabilitation performed better in executive functions, conflict resolution and attention as compared to the group undergoing conventional CVR. According to Brouwers et al., 12 telerehabilitation has provided better physical activity levels in the long run as compared to conventional CVR. Likewise, other authors have evidenced that patients with CAD