Effectiveness of tele-rehabilitation on the risk factors of persons with metabolic syndrome

█ Original article

DOI: 10.26430/CHUNGARICA.2022.52.4.292

Authors:
Máthéné Köteles Éva¹, Kiszely Ildikó², Szabó Lili Adrienn², Lada Szilvia², Bolgár Tímea², Szálka Brigitta³, Korom Andrea¹, Staberecz Dóra Terézia², Ábrahám Judit³, Szűcs Mónika⁴, Seffer Péter⁵, Biliczki Vilmos⁵, Rafael Beatrix^2,3, Barnai Mária¹, Várkonyi Tamás², Nemes Attila², Lengyel Csaba², Kósa István^2,3
1Szegedi Tudományegyetem, Egészségtudományi és Szociális Képzési Kar, Fizioterápiás Tanszék, Szeged
²Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Belgyógyászati Klinika, Szeged
³Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Preventív Medicina Tanszék, Szeged
⁴Szegedi Tudományegyetem, Szent-Györgyi Albert Orvostudományi Kar, Orvosi Fizikai és Orvosi Informatikai Intézet, Szeged
⁵Szegedi Tudományegyetem, Természettudományi és Informatikai Kar, Informatikai Intézet, Szeged

Summary

Introduction: The proportion of obese people in Hungary has been the highest in Europe for years. This condition is known to increase the likelihood of developing diabetes, but it also has a deteriorating effect on blood pressure and blood fat parameters. A short, 2-3 minutes medical consultation has a minimal effect on changing nutritional and physical activity habits.
Objective: To determine the effect of a three-month telemedicine-supported lifestyle intervention on the development of anthropometric and laboratory parameters in patients with metabolic syndrome.
Method: The study was planned for 65 metabolic syndrome patients. At the time of current, interim evaluation, 41 patients completed the program. At the start of the study, each patient received a mobile phone with mobile internet connection, a Polar M430 heart rate monitoring watch, a weight scale with Bluetooth connection, and a GSM data transmitter capable of transmitting the data without human interaction. The Lavinia nutrition logging application of Pannon University was pre-installed on the mobile phones, as well as the Polar Flow application managing the data of the smart watches. The data of all the devices were synchronized without any human interaction to the Inclouded Telemedicine system of the University of Szeged. Dieticians and physiotherapists overviewed the data on the web based platform of the Inclouded Telemedicine System on a weekly basis and gave feedback to the patients.
Results: The telemedically recorded body weight of the 41 patients with metabolic syndrome was 115.6±36.4 kg on average during the first week of the study, which decreased to 109.2±32.4 kg over the 112.15±30.45 days long follow-up period, resulting in an average weight change of 6.40±6.91 kg. Among the 41 persons, 26 had a change less than 5 kg, 7 had a change of 5-15 kg, and 8 had a change more than 15 kg. Parallel to the weight loss, the fasting blood sugar and HgA1c values of the patients decreased significantly (6.62±1.88 mmol/l vs. 5.95±1.38 mmol/l and 6.52±1.06% vs. 6, 21±0.80%, p<0.001 in both cases). HDL-cholesterol value increased from 1.15±0.31 to 1.27 ± 0.29 (p<0.001). Based on the values recorded in the mobile nutrition diary, these changes were achieved by a moderate caloric restriction (average values of 1433.4±337 kcal/day) and relatively intense estimated daily training sessions (472.6±345.6 kcal/day).
Conclusion: Based on our findings, promising results can be achieved in a significant number of metabolic patients with an intervention using a mobile nutrition logging, heart rate monitored physical training and home weight monitoring, consulted a weekly basis by health care professionals. Undoubtable, almost half of the patients were not able to change their lifestyle habits even with these interventions. On the other hand, approximately one fifth of the patients could realize such a marked change in body weight, which can fundamentally influence the development of T2DM, a critical risk factor of cardiovascular diseases. 

ISSUE: CARDIOLOGIA HUNGARICA | 2022 | VOLUME 52, ISSUE 4