Xiangya Hospital Completes Technology Transfer of X-CircuiT Cardiac Rehabilitation Program to ShuKang Digital Therapeutics
In late May, the five-day “Xiangya·The 14th National Workshop on Advances in Cardiac Rehabilitation and Prevention and International Joint Forum on Cardiac Rehabilitation” was successfully held in Changsha, Hunan Province. At the event, VCBeat observed that the Cardiac Rehabilitation Center of Xiangya Hospital—a key development center at this top-tier, Grade A tertiary general hospital integrating medical care, teaching, and research—places significant emphasis on digital therapeutics and has integrated them into patient management.
Xiangya Hospital has signed a technology transfer agreement with Shukang, a pioneer in digital therapeutics, to incorporate the second set of resistance band-based cardiac rehabilitation exercises, X-CircuiT, into Shukang’s digital intervention system. Additionally, the Xiangya Cardiac Rehabilitation Outpatient Clinic has designated a specialized “Digital Cardiac Rehabilitation Training Zone” to further strengthen the exploration and implementation of digital cardiac rehabilitation programs.
Taking this opportunity, VCBeat interviewedProfessor Liu Suixin, Director of the Department of Rehabilitation Medicine and Director of the Cardiac Rehabilitation Center at Xiangya Hospitalto gain insight into Xiangya’s digital cardiac rehabilitation model and her unique perspectives on digital therapeutics, particularly those for cardiac rehabilitation, as well as her outlook on the future.
Liu Suixin, Professor of Cardiovascular Medicine, Chief Physician (Grade I), Selected Expert at Xiangya Hospital, and Doctoral and Postdoctoral Supervisor in Rehabilitation Medicine. She currently serves as Director of the Department of Rehabilitation Medicine and Director of the Cardiac Rehabilitation Center at Xiangya Hospital of Central South University, Advisor to the “German-Chinese Rehabilitation Association,” Vice President of the Rehabilitation Branch of the Chinese Geriatrics Society, and Vice Chairperson of the Cardiovascular Disease Professional Committee of the Chinese Association of Rehabilitation Medicine.
With 41 years of experience in cardiovascular medicine and cardiac rehabilitation (including 17 years in cardiovascular medicine and 23 years in cardiac rehabilitation), I have accumulated extensive clinical expertise. I specialize in comprehensive rehabilitation for coronary heart disease (including angina pectoris, myocardial infarction, post-percutaneous coronary intervention, and post-coronary artery bypass grafting), various types of heart failure, hypertension, diabetes, and obesity. I possess profound expertise in the prevention and treatment of heart disease through an integrated approach combining pharmacotherapy, exercise therapy, and nutritional guidance, ranking among the leading authorities in China. From 2006 to 2008, I engaged in two years of study and academic exchange at Yale University in the United States. Over the past 14 years, as one of the pioneers in the field of cardiac rehabilitation in China, I have repeatedly represented China in academic exchanges in the United States, Japan, Germany, France, Canada, and other countries, making significant contributions to advancing Chinese cardiac rehabilitation onto the global stage.
Why Is Cardiac Rehabilitation Necessary?
The market is sufficiently large. The “Healthy China Action (2019–2030)” explicitly calls for prevention and control initiatives targeting cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, diabetes, and other conditions. Currently, thisThe burden of four major chronic diseases accounts for more than 70% of the total disease burden, indicating a vast unmet market demand.. As a comprehensive treatment regimen, the cardiac rehabilitation program aims to provide holistic rehabilitation and care support for patients with heart disease and has incorporated these four categories of conditions into its scope.
Strong willingness. Cardiac rehabilitation programs are typically delivered by multidisciplinary medical teams, including cardiologists, rehabilitation therapists, psychologists, and dietitians. As a nationally recognized cardiac rehabilitation training center, Xiangya Hospital’s more than two decades of experience demonstrate that tertiary hospitals, prefecture-level city hospitals, and community hospitals alike have shown great enthusiasm for implementing cardiac rehabilitation services after witnessing their tangible benefits for patients.
Given this, why has cardiac rehabilitation not yet become widespread?
On the demand side of healthcare, improving patient adherence to cardiac rehabilitation is a global challenge, with rates in developed regions of Europe and America standing at only about 50%. Therefore, it is necessary toEnhancing Patient Awareness, and to itProvideEasy-to-Adhere-To Regimens to Improve Patient Compliance. In addition to exercise rehabilitation itself, cardiac rehabilitation also addresses patients' nutrition, medication, sleep, and unhealthy lifestyle habits.Comprehensive Improvement, ultimately helping patients developBenign Self-Management.
On the supply side of healthcare, a 2019 survey conducted by Xiangya Hospital among 238 medical trainees from its center, representing 28 provinces, municipalities, and autonomous regions across China, revealed that only one-third of the trained medical institutions were able to smoothly implement cardiac rehabilitation services. Cardiac rehabilitation carries certain risks; even with the willingness to offer such services, many departments hesitate due to concerns about their ability to manage these risks. Furthermore, given its focus on comprehensive functional improvement, cardiac rehabilitation typically requires a dedicated multidisciplinary team, including physicians, nurses, and dietitians, to jointly drive its implementation.
Therefore, relying solely on training centers for support is far from sufficient. There is a need for more scientific and efficient tools to make cardiac rehabilitation techniques safer, more effective, and easier to master and promote, thereby enabling various types of departments to implement standardized cardiac rehabilitation practices to the greatest extent possible.
In this context, the emergence of digital therapeutics technology offers greater potential for the promotion of cardiac rehabilitation.
Professor Liu Suixin stated, “The digitization of cardiac rehabilitation is an inevitable trend that meets the health needs of both the nation and its people. What clinicians value most is its alignment with evidence-based medicine, providing intervention plans supported by robust evidence. In terms of efficacy, when used appropriately, digital therapeutic cardiac rehabilitation yields outcomes comparable to those of center-based rehabilitation. Furthermore, with the support of digital therapeutics, the work efficiency of healthcare professionals in rehabilitation centers can be improved. Patients at low-to-moderate risk can leverage these tools to achieve home-based rehabilitation, and the enhanced convenience can further boost patient engagement and adherence.”
“In terms of comprehensive patient management, digital therapeutics can facilitate holistic health improvements through exercise prescriptions and educational guidance, achieving the goal of ‘one patient recovers, the whole family benefits.’ Overall, digital therapeutics can expand the reach of existing cardiac rehabilitation technologies to serve a larger population, thereby reducing the societal disease burden on a broader scale,” added Professor Liu Suixin.
Currently, the cardiac rehabilitation team at Xiangya Hospital has made certain explorations in the field of digital therapeutics.
After multiple rounds of negotiations, Xiangya Hospital has signed a technology transfer agreement with Shukang, a “pioneer in digital therapeutics,” to incorporate the second set of resistance band-based cardiac rehabilitation exercises (internationally named “Xiangya Hospital Circuit Training, X-CircuiT”) as part of Shukang’s digital intervention protocols. The digital application of this technological achievement will significantly improve the accessibility of cardiac rehabilitation services, benefiting more patients with chronic cardiovascular diseases.
X-CircuiT was developed by Professor Liu Suixin’s team, drawing on over 20 years of clinical experience and tailored to the characteristics of older adults and patients with chronic diseases. The exercise regimen has been validated through a decade of clinical application at the Xiangya Cardiac Rehabilitation Center and more than 100 hospitals across 28 provinces and municipalities in China, along with a series of clinical studies demonstrating its safety and efficacy. In 2023, two high-impact papers were published, with impact factors of 12.688 and 6.088, respectively.
“Most people are unaware of how to exercise scientifically; they only engage in aerobic activities such as running, walking, swimming, and ball games, without realizing the importance of resistance, flexibility, and balance training. This exercise routine integrates aerobic, resistance, flexibility, and balance training, offering a more comprehensive approach than traditional single-mode aerobic exercises. It is suitable for individuals of all age groups, particularly middle-aged and older adults,” introduced Professor Liu Suixin.
In the long term, X-CircuiT can improve cardiorespiratory fitness in older adults, prevent sarcopenia, treat musculoskeletal pain, and prevent falls among the elderly. It can also significantly reverse pre-frailty, reducing the absolute risk of pre-frailty in community-dwelling older adults by 82%, demonstrating promising clinical application prospects. Its therapeutic effects are highly aligned with the goals of Shukang.
It is reported that the X-CircuiT-Shukang digital intervention primarily comprises two modules: assessment and exercise prescription. The assessment module enables patients to quickly understand their risk levels (low, moderate, or high), thereby facilitating the formulation of appropriate treatment plans. As the core operational component, the exercise prescription module provides personalized and diverse exercise regimens, ultimately aiming to enhance patients’ rehabilitative outcomes.
In recent years, China has made significant progress in cardiac care, particularly in improving the success rates of treatment for angina and acute myocardial infarction, as well as in the widespread adoption of interventional techniques. However, compared with treatment, the overall aspects of prevention and rehabilitation remain relatively weak.
In fact, cardiac rehabilitation is not only applicable to post-operative recovery following heart surgery but also holds significant importance for addressing declines in cardiorespiratory endurance associated with chronic conditions such as cardiovascular disease, hypertension, and diabetes. Engaging in cardiac rehabilitation can effectively enhance cardiorespiratory endurance and reduce the risk of disease occurrence.
Professor Liu Suixin stated, “The incidence of cardiovascular disease continues to rise, with no sign of a turning point yet, and patients are increasingly presenting at younger ages. The primary reasons are insufficient prevention efforts and imperfect rehabilitation services. In fact, the interventions involved in cardiac rehabilitation and prevention are highly similar; therefore, we are also committed to strengthening the prevention of conditions such as hypertension, diabetes, and obesity. We aim to develop safe and effective exercise programs, cultivate habits of scientific physical activity among the public, improve overall population health, and reduce disease incidence.”
Today, with the integration of X-CircuiT evidence-based medicine and Shukang digital therapeutics technology, how to achieve clinical promotion has become an immediate and practical issue.
Professor Liu Suixin believes that the absence of a need for complex configurations is a highlight in the promotion of digital therapeutics. In the initial phase, pilot programs can be implemented among low-risk populations; in later stages, greater government support should be secured based on the outcomes of these pilots. As an expert team, Xiangya Heart Health bears the responsibility to develop new technologies that benefit public health and will continue to focus on and advance the optimization and refinement of digital therapeutics for cardiac rehabilitation, contributing to the realization of the Healthy China initiative.
“China Digital Cardiac Rehabilitation Promotion Plan”
"China Digital Cardiac Rehabilitation Promotion Plan," jointly initiated by the Changsha Suixin Cujian Public Welfare and Charitable Foundation and Chengdu RECOVERY PLUS Information Technology Co., Ltd., aims to help medical institutions interested in launching cardiac rehabilitation services rapidly achieve end-to-end project implementation. Key areas of support include:
1. Assist medical institutions in establishing and applying for cardiac rehabilitation billing items based on their specific circumstances.
2. Assist in the development of digital cardiac rehabilitation services, lower the barriers to entry regarding facilities and equipment for implementing cardiac rehabilitation, and improve the work efficiency of healthcare professionals.
3. Provide reference solutions for cardiac rehabilitation services spanning Phases I through III.
“Digital Cardiac Rehabilitation” Medical Institutions: Please scan the QR code below to register:
