Effect of Telerehabilitation on Exercise Capacity, Cardiac Function and Physical Activity in a Patient with Systemic Arterial Hypertension: A Case Report

Year 2025, Volume: 3 Issue: 1, 48 - 53, 31.01.2025

Beyza Nur Durukan , Farzin Jam , Yasemin Çırak , Zeynep Ozan , Yusuf Ziya Şener , Naciye Vardar Yaglı

Abstract

Aim: The aim of this study was to investigate the effects of calisthenic-based aerobic exercise training applied via real-time telerehabilitation on cardiac functions, exercise capacity, physical activity and body composition in an adult patient with systemic hypertension.
Methods: A 48-year-old female case is presented in this study. The hypertensive individual who applied to the Sorgun State Hospital Department of Cardiology was consulted for cardiac rehabilitation (CR). Since the patient did not have access to outpatient CR, the physical therapist decided to perform synchronous telerehabilitation. Before and at the end of the exercise training, exercise capacity was assessed with 6-minute stepper test and maximal stress test, physical activity level with the International Physical Activity Scale and smart watch, body composition with bioelectrical impedance analysis, and systolic and diastolic functions with echocardiography. The patient underwent submaximal exercise training via video conference for 24 sessions and real-time heart rate monitoring was performed with a smart watch during the exercise.
Results: The patient (height: 155 cm, body mass index: 31.61 kg/m²) completed all 24 sessions (100%). No adverse events were observed during the exercise sessions. At the end of the exercise training, there were improvements in the patient’s systolic and diastolic functions as well as in 24-hour blood pressure monitoring. Moreover, there was a significant increase in predicted oxygen consumption and exercise capacity levels. In addition, positive changes were observed in the patient’s physical activity level and body composition.
Discussion: Hypertension, a major cause of morbidity and mortality, can benefit from aerobic exercise training delivered via telerehabilitation, which has demonstrated significant improvements in cardiometabolic health. Given the high adherence rate, cost-effectiveness, and feasibility, cardiac telerehabilitation appears to be a promising intervention for managing hypertension in clinical practice.

Keywords

hypertension, exercise, telerehabilitation

Ethical Statement

None

Supporting Institution

None

Project Number

None

References

• 1. Beevers G, Lip GY, O'Brien E. The pathophysiology of hypertension. BMJ. 2001;322(7291):912-6.
• 2. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO). Eur Heart J. 2024;45(38):3912-4018.
• 3. Mancia Chairperson G, Brunström M, Burnier M, Grassi G, Januszewicz A, Muiesan ML, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH). J Hypertens. 2023.
• 4. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO). Eur Heart J. 2024:ehae178.
• 5. Diaz KM, Shimbo D. Physical activity and the prevention of hypertension. Curr Hypertens Rep. 2013;15:659-68.
• 6. Lee MK, Lee CJ, Goo SY, Lee TH, Moon JY, Jung J, et al. Development and application of a home-based exercise program for patients with cardiovascular disease: a feasibility study. BMC Sports Science, Medicine and Rehabilitation. 2024;16(1):51.
• 7. Pollock ML, Foster C, Schmidt D, Hellman C, Linnerud A, Ward A. Comparative analysis of physiologic responses to three different maximal graded exercise test protocols in healthy women. Am Heart J. 1982;103(3):363-73.
• 8. Liguori G, Medicine ACoS. ACSM's guidelines for exercise testing and prescription: Lippincott Williams & Wilkins; 2020.
• 9. McArdle WD, Katch FI, Katch VL. Exercise physiology: nutrition, energy, and human performance: Lippincott Williams & Wilkins; 2010.
• 10. Rijal A, Adhikari TB, Dhakal S, Maagaard M, Piri R, Nielsen EE, et al. Effect of exercise on functional capacity and body weight for people with hypertension, type 2 diabetes, or cardiovascular disease: a systematic review with meta-analysis and trial sequential analysis. BMC Sports Science, Medicine and Rehabilitation. 2024;16(1):38.
• 11. Han TS, Al‐Gindan YY, Govan L, Hankey CR, Lean ME. Associations of body fat and skeletal muscle with hypertension. The Journal of Clinical Hypertension. 2019;21(2):230-8.
• 12. Linderman GC, Lu J, Lu Y, Sun X, Xu W, Nasir K, et al. Association of body mass index with blood pressure among 1.7 million Chinese adults. JAMA network open. 2018;1(4):e181271-e.
• 13. de Assis Ramos R, Guimarães FS, Dionyssiotis Y, Tsekoura D, Papathanasiou J, de Sá Ferreira A. Development of a multivariate model of the six-minute walked distance to predict functional exercise capacity in hypertension. J Bodyw Mov Ther. 2019;23(1):32-8.
• 14. Pescatello LS, Buchner DM, Jakicic JM, Powell KE, Kraus WE, Bloodgood B, et al. Physical activity to prevent and treat hypertension: a systematic review. Med Sci Sports Exerc. 2019;51(6):1314-23.
• 15. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-62.
• 16. Banach M, Lewek J, Surma S, Penson PE, Sahebkar A, Martin SS, et al. The association between daily step count and all-cause and cardiovascular mortality: a meta-analysis. European journal of preventive cardiology. 2023;30(18):1975-85.