Evaluation of a personalized home-based exercise program for patients with combined chronic cardiac and pulmonary disease.

Chronic cardiac and pulmonary diseases often co-exist and both diseases are associated with high morbidity and mortality. Exercise is a proven effective strategy in these patients to reduce the risk of rehospitalization and improve functional capacity. However, due to breathlessness, muscle atrophy and anxiety, patients with combined cardiac and pulmonary disease generally have low activity levels and have low motivation to participate in center based rehabilitation programs. To improve exercise behavior in the home environment we aim to conduct a pilot-study to evaluate the feasibility of a telemonitored home-based exercise program. The results of this study will be used to design a larger randomized trial.

A novel, home-based, goal-orientated exercise program for patients with combined chronic cardiac and pulmonary disease is feasible and safe.

At baseline / intake the following questionnaires and functional tests will be obtained:
- EQ-5D-5L (quality of life) questionnaire
- mMRC dyspnea scale
- One-minute sit-to-stand test
- Handgrip test
- Patient Specific Complaints (PSC) questionnaire

At final evaluation the following questionnaires and functional tests will be obtained:
- EQ-5D-5L (quality of life) questionnaire
- mMRC dyspnea scale
- One-minute sit-to-stand test
- Handgrip test
- Patient Specific Complaints (PSC) questionnaire
- CSQ-8 (patient satisfaction) questionnaire
- Purpose-designed patients satisfaction questionnaire

Eligible patients participate in an 8 week home-based, goal-orientated exercise program. The program begins with in an intake at the outpatient physical therapy clinic of Máxima MC. This intake is performed with both a physical therapist and an occupational therapist. Based on this intake, the patient receives a personalized, goal-orientated exercise program using a digital platform to report training sessions and a smartwatch. Weekly video consultations take place to discuss progress and to adjust the training scheme if needed. Also, the digital platform is equipped with an activity diary to be filled in by the patient for evaluation with the occupational therapist. After 8 weeks a final evaluation takes place at the outpatient physical therapy clinic.