scholarly journals Mobile Technologies to Promote Physical Activity during Cardiac Rehabilitation: A Scoping Review

Sensors ◽  
2020 ◽  
Vol 21 (1) ◽  
pp. 65
Author(s):  
Florian Meinhart ◽  
Thomas Stütz ◽  
Mahdi Sareban ◽  
Stefan Tino Kulnik ◽  
Josef Niebauer
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Mobile Technologies ◽  
Future Directions ◽  
Pubmed Central ◽  
Home Based ◽  
Improve Exercise Capacity ◽  
Fitness Trackers ◽  
The Impact

Promoting regular physical activity (PA) and improving exercise capacity are the primary goals of cardiac rehabilitation (CR). Mobile technologies (mTechs) like smartphones, smartwatches, and fitness trackers might help patients in reaching these goals. This review aimed to scope current scientific literature on mTechs in CR to assess the impact on patients’ exercise capacity and to identify gaps and future directions for research. PubMed, CENTRAL, and CDSR were systematically searched for randomized controlled trials (RCTs). These RCTs had to utilize mTechs to objectively monitor and promote PA of patients during or following CR, aim at improvements in exercise capacity, and be published between December 2014 and December 2019. A total of 964 publications were identified, and 13 studies met all inclusion criteria. Home-based CR with mTechs vs. outpatient CR without mTechs and outpatient CR with mTechs vs. outpatient CR without mTechs did not lead to statistically significant differences in exercise capacity. In contrast, outpatient CR followed by home-based CR with mTechs led to significant improvement in exercise capacity as compared to outpatient CR without further formal CR. Supplying patients with mTechs may improve exercise capacity. To ensure that usage of and compliance with mTechs is optimal, a concentrated effort of CR staff has to be achieved. The COVID-19 pandemic has led to an unprecedented lack of patient support while away from institutional CR. Even though mTechs lend themselves as suitable assistants, evidence is lacking that they can fill this gap.

scholarly journals Home-based exercise with telemonitoring guidance in patients with coronary artery disease: Does it improve long-term physical fitness?

2019 ◽  
Vol 27 (4) ◽  
pp. 367-377 ◽  
Author(s):  
Andrea Avila ◽  
Jomme Claes ◽  
Roselien Buys ◽  
May Azzawi ◽  
Luc Vanhees ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Phase Ii ◽  
Home Based ◽  
Artery Disease ◽  
One Year

Background Home-based interventions might facilitate the lifelong uptake of a physically active lifestyle following completion of a supervised phase II exercise-based cardiac rehabilitation. Yet, data on the long-term effectiveness of home-based exercise training on physical activity and exercise capacity are scarce. Objective The purpose of the TeleRehabilitation in Coronary Heart disease (TRiCH) study was to compare the long-term effects of a short home-based phase III exercise programme with telemonitoring guidance to a prolonged centre-based phase III programme in coronary artery disease patients. The primary outcome was exercise capacity. Secondary outcomes included physical activity behaviour, cardiovascular risk profile and health-related quality of life. Methods Ninety coronary artery disease patients (80 men) were randomly assigned to 3 months of home-based (30), centre-based (30) or a control group (30) on a 1:1:1 basis after completion of their phase II ambulatory cardiac rehabilitation programme. Outcome measures were assessed at discharge of the phase II programme and after one year. Results Eighty patients (72 (91%) men; mean age 62.6 years) completed the one-year follow-up measurements. Exercise capacity and secondary outcomes were preserved in all three groups ( Ptime > 0.05 for all), irrespective of the intervention ( Pinteraction > 0.05 for all). Eighty-five per cent of patients met the international guidelines for physical activity ( Ptime < 0.05). No interaction effect was found for physical activity. Conclusion Overall, exercise capacity remained stable during one year following phase II cardiac rehabilitation. Our home-based exercise intervention was as effective as centre-based and did not result in higher levels of exercise capacity and physical activity compared to the other two interventions. Trial registration ClinicalTrials.gov NCT02047942. https://clinicaltrials.gov/ct2/show/NCT02047942

Effectiveness of mHealth Interventions on Physical Activity and Physical Fitness in Outpatient and Home-Based Cardiac Rehabilitation Programs: A Systematic Review (Preprint)

2019 ◽  
Author(s):  
Sheeba Nadarajah ◽  
Susan Buchholz ◽  
Kristen Dickins
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Fitness ◽  
Cardiac Rehabilitation ◽  
Text Messaging ◽  
English Language ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Mixed Effect ◽  
Home Based

BACKGROUND Globally, cardiovascular disease is the leading cause of death. Cardiovascular mortality can be decreased by participation in cardiac rehabilitation. Researchers are exploring the use of mHealth technology in cardiac rehabilitation. OBJECTIVE The aim of this systematic review is to examine the effectiveness of randomized controlled trials that use a mHealth intervention as a part of an outpatient and/or home-based cardiac rehabilitation program on improving physical activity and physical fitness outcomes. METHODS For this systematic review, mHealth interventions were limited to text messaging, mobile apps, and use of a mobile phone network for data transmission, used to deliver cardiac rehabilitation program. Using six databases, the search strategy included published English language studies through 2016. Data was extracted independently by two reviewers, and then synthesized. RESULTS The initial search yielded 149 articles, of which 15 articles that represented nine studies met inclusion criteria. Articles were published from 2010 to 2016 and came from two continents. The majority (84%) of participants were male. Generally, the participant mean age was late 50s to early 60s. Text messaging was the most frequently used intervention. The results of the physical activity and physical fitness findings were mixed. Effect sizes for intervention as measured by the 6-minute walk test ranged from 0.46 to 0.58 and peak VO2 ranged from 0.03 to 1.35. CONCLUSIONS Globally, use of mHealth in outpatient and/or home-based cardiac rehabilitation is being studied with greater attention. However, these studies are limited by geography, gender, and age. Therefore, further research in the area of cardiac rehabilitation and mHealth is recommended, especially in developing countries, among women, and older adults.

Modello di riabilitazione cardiologica teleguidata durante pandemia da COVID-19

2020 ◽  
pp. 271-275
Author(s):  
Giovanni Pasanisi ◽  
Biagio Sassone ◽  
Jonathan Myers ◽  
Giorgio Chiaranda ◽  
Andrea Raisi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Physical Activity Intervention ◽  
Rehabilitation Program ◽  
Physical And Mental Health ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Video Tutorials ◽  
Rapid Spread ◽  
Collateral Effects

Background. The COVID-19 pandemic has induced many governments to promote national lockdowns. Despite a period of quarantine is the best option and recommendation to stop the rapid spread of infections, this may have collateral effects on other dimensions of the isolated patients’ physical and mental health. Physical activity is the major component of cardiac rehabilitation programs that have been abruptly discontinued. Aims. To counteract physical inactivity during the COVID-19 outbreak we propose an home cardiac rehabilitation program under telemonitoring guidance, the home-bAsed physiCal acTivity Intervention during cOvid-19 quaraNtine (ACTION) study, testing its feasibility. Methods and results. ACTION is an observational study in cardiac outpatients referred to an exercise-based cardiac rehabilita-tion program. A program consisting of aerobic recommendations combined with a selection of strength and balance exercises is recommended. Video tutorials providing details of the workouts will be sent to patients. Selected patients can be followed during the home-sessions via video connection using current smartphone applications. Conclusions. The ACTION study could provide applicable results for safe and effective exercise therapy in outpatients with car-diovascular disease, while preventing the COVID-19 outbreak from generating adverse health consequences due to acute cessa-tion of physical activity. Findings from the ACTION study can also be useful after the end of COVID-19 outbreak for patients who cannot participate in traditional center- or home-based cardiac rehabilitation programs.

The impact of statins on physical activity and exercise capacity: an overview of the evidence, mechanisms, and recommendations

2020 ◽  
Vol 120 (6) ◽  
pp. 1205-1225
Author(s):  
Allyson M. Schweitzer ◽  
Molly A. Gingrich ◽  
Thomas J. Hawke ◽  
Irena A. Rebalka
Keyword(s):  
Physical Activity ◽  
Exercise Capacity ◽  
Physical Activity And Exercise ◽  
The Impact

scholarly journals Dietary education provision within a cardiac rehabilitation programme in the UK: a pilot study

2020 ◽  
Vol 15 (8) ◽  
pp. 1-12
Author(s):  
Chelsea E Moore ◽  
Costas Tsakirides ◽  
Zoe Rutherford ◽  
Michelle G Swainson ◽  
Karen M Birch ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Rehabilitation Programme ◽  
Habitual Physical Activity ◽  
Activity Levels ◽  
Nutrient Intakes ◽  
Cardiac Rehabilitation Programme ◽  
Physical Activity Levels ◽  
Dietary Education ◽  
The Impact

Background/aims The primary aim of this study was to evaluate the effectiveness of two 30-minute dietary education sessions, within cardiac rehabilitation, as a means to optimise nutrient and energy intakes. A secondary aim was to evaluate patients' habitual physical activity levels. Methods Thirty patients (males: n=24, 61.8±11.2 years; females: n=6, 66.7±8.5 years) attended a 6-week early outpatient cardiac rehabilitation programme in the UK and received two 30-minute dietary education sessions emphasising Mediterranean diet principles. Energy intakes and nutrient intakes were measured through completion of 3-day food diaries in weeks one and six (before and after the dietary education sessions) to assess the impact of these sessions on nutrient intakes. At the same time-points, a sub-group (n=13) of patients had their physical activity levels assessed via accelerometery to assess the impact of the cardiac rehabilitation programme on physical activity. Results Estimated energy requirements at week one (1988±366 kcal d−1) were not matched by actual energy intakes (1785±561 kcal d−1) (P=0.047, d=−0.36). Energy intakes reduced to 1655±470 kcal d−1 at week six (P=0.66, d=−0.33) whereas estimated energy requirements increased as a function of increased activity (cardiac rehabilitation sessions). Nutrient intakes remained suboptimal, while no significant increases were observed in healthy fats and fibre, which are core elements of a Mediterranean diet. Statistically significant increases were not observed in physical activity; however, patients decreased sedentary time by 11±12% in week six compared with week one (P=0.009; d=−0.54). Conclusions The present study findings suggest that two 30-minute dietary education sessions did not positively influence energy intakes and nutrient intakes, while habitual physical activity levels were not significantly increased as a result of the cardiac rehabilitation programme. Future research should explore means of optimising nutrition and habitual physical activity within UK cardiac rehabilitation.

scholarly journals Exploring patient-reported outcomes of home-based cardiac rehabilitation in relation to Scottish, UK and European guidelines: an audit using qualitative methods

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024499 ◽  
Author(s):  
Hannah Ranaldi ◽  
Carolyn Deighan ◽  
Louise Taylor
Keyword(s):  
Cardiac Rehabilitation ◽  
Patient Reported Outcomes ◽  
Psychosocial Support ◽  
Daily Lives ◽  
Medical Risk ◽  
European Guidelines ◽  
Home Based ◽  
Patient Reported ◽  
The Uk ◽  
The Impact

ObjectivesThe Heart Manual (HM) is the UK’s leading facilitated home-based cardiac rehabilitation (CR) programme for individuals recovering from myocardial infarction and revascularisation. This audit explored patient-reported outcomes of home-based CR in relation to current Scottish, UK and European guidelines.SettingPatients across the UK returned their questionnaire after completing the HM programme to the HM Department (NHS Lothian).ParticipantsQualitative data from 457 questionnaires returned between 2011 and 2018 were included for thematic analysis. Seven themes were identified from the guidelines. This guided initial deductive coding and provided the basis for inductive subthemes to emerge.ResultsThemes included: (1) health behaviour change and modifiable risk reduction, (2) psychosocial support, (3) education, (4) social support, (5) medical risk management, (6) vocational rehabilitation and (7) long-term strategies and maintenance. Both (1) and (2) were reported as having the greatest impact on patients' daily lives. Subthemes for (1) included: guidance, engagement, awareness, consequences, attitude, no change and motivation. Psychosocial support comprised: stress management, pacing, relaxation, increased self-efficacy, validation, mental health and self-perception. This was followed by (3) and (4). Patients less frequently referred to (5), (6) and (7). Additional themes highlighted the impact of the HM programme and that patients attributed the greatest impact to a combination of all the above themes.ConclusionsThis audit highlighted the HM as comprehensive and inclusive of key elements proposed by Scottish, UK and EU guidelines. Patients reported this had a profound impact on their daily lives and proved advantageous for CR.

scholarly journals An m-Health system for education and motivation in cardiac rehabilitation: the experience of HeartCycle guided exercise

2017 ◽  
Vol 24 (4) ◽  
pp. 303-316 ◽  
Author(s):  
Dario Salvi ◽  
Manuel Ottaviano ◽  
Salla Muuraiskangas ◽  
Alvaro Martínez-Romero ◽  
Cecilia Vera-Muñoz ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Health System ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Intervention Group ◽  
Systems Design ◽  
Perceived Usefulness ◽  
Mobile Technologies ◽  
Exercise Habits ◽  
Home Based

Introduction Home-based programmes for cardiac rehabilitation play a key role in the recovery of patients with coronary artery disease. However, their necessary educational and motivational components have been rarely implemented with the help of modern mobile technologies. We developed a mobile health system designed for motivating patients to adhere to their rehabilitation programme by providing exercise monitoring, guidance, motivational feedback, and educational content. Methods Our multi-disciplinary approach is based on mapping “desired behaviours” into specific system’s specifications, borrowing concepts from Fogg’s Persuasive Systems Design principles. A randomised controlled trial was conducted to compare mobile-based rehabilitation (55 patients) versus standard care (63 patients). Results Some technical issues related to connectivity, usability and exercise sessions interrupted by safety algorithms affected the trial. For those who completed the rehabilitation (19 of 55), results show high levels of both user acceptance and perceived usefulness. Adherence in terms of started exercise sessions was high, but not in terms of total time of performed exercise or drop-outs. Educational level about heart-related health improved more in the intervention group than the control. Exercise habits at 6 months follow-up also improved, although without statistical significance. Discussion Results indicate that the adopted design methodology is promising for creating applications that help improve education and foster better exercise habits, but further studies would be needed to confirm these indications.

scholarly journals A home-based care model for outpatient cardiac rehabilitation based on mobile technologies

2009 ◽  
Author(s):  
Antti Sarela ◽  
Jukka Salminen ◽  
Esa Koskinen ◽  
Ole Kirkeby ◽  
Ilkka Korhonen ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Mobile Technologies ◽  
Care Model ◽  
Home Based ◽  
Home Based Care

scholarly journals Electronic Health Physical Activity Behavior Change Intervention to Self-Manage Cardiovascular Disease: Qualitative Exploration of Patient and Health Professional Requirements (Preprint)

2017 ◽  
Author(s):  
Deirdre MJ Walsh ◽  
Kieran Moran ◽  
Véronique Cornelissen ◽  
Roselien Buys ◽  
Nils Cornelis ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Cardiac Rehabilitation ◽  
Intervention Development ◽  
Premature Death ◽  
Physical Activity Behavior ◽  
Physical Factors ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Key Stakeholders

BACKGROUND Cardiovascular diseases are a leading cause of premature death worldwide. International guidelines recommend routine delivery of all phases of cardiac rehabilitation. Uptake of traditional cardiac rehabilitation remains suboptimal, as attendance at formal hospital-based cardiac rehabilitation programs is low, with community-based cardiac rehabilitation rates and individual long-term exercise maintenance even lower. Home-based cardiac rehabilitation programs have been shown to be equally effective in clinical and health-related quality of life outcomes and yet are not readily available. OBJECTIVE Given the potential that home-based cardiac rehabilitation programs have, it is important to explore how to appropriately design any such intervention in conjunction with key stakeholders. The aim of this study was to engage with individuals with cardiovascular disease and other professionals within the health ecosystem to (1) understand the personal, social, and physical factors that inhibit or promote their capacity to engage with physical activity and (2) explore their technology competencies, needs, and wants in relation to an eHealth intervention. METHODS Fifty-four semistructured interviews were conducted across two countries. Interviews were audiotaped, transcribed verbatim, and analyzed using thematic analysis. Barriers to the implementation of PATHway were also explored specifically in relation to physical capability and safety as well as technology readiness and further mapped onto the COM-B model for future intervention design. RESULTS Key recommendations included collection of patient data and use of measurements, harnessing hospital based social connections, and advice to utilize a patient-centered approach with personalization and tailoring to facilitate optimal engagement. CONCLUSIONS In summary, a multifaceted, personalizable intervention with an inclusively designed interface was deemed desirable for use among cardiovascular disease patients both by end users and key stakeholders. In-depth understanding of core needs of the population can aid intervention development and acceptability.

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