JMIR Publications

ABSTRACT

Background:

The European Society of Cardiology recommends cardiac rehabilitation (CR) for all patients with acute coronary syndrome, which may be facilitated through mobile applications using physical activity monitoring and goal setting.

Objective:

This systematic review aims to identify and summarize which techniques are employed by mobile app-based CR programs.

Methods:

We searched Embase, Medline, Cochrane Library and CINAHL from their inception to 2/4/2025 for articles describing the use of mobile apps within a CR programme. Review papers, commentaries, correspondence, and study protocols were excluded. Articles detailing the development of a CR program or mobile app without patient testing were excluded. Studies describing hybrid programs where patients participated in both hospital-based and home rehabilitation programs were also excluded. Risk of bias was assessed using the Cochrane Collaboration ROB tool, Risk of Bias in Non-Randomized Studies of Interventions tool (ROBINS I) and Newcastle-Ottawa scale. We present a narrative synthesis of the techniques employed by mobile apps to deliver CR.

Results:

The review included 46 articles, detailing the use of physical activity monitoring (PAM) devices, goal setting, motivational messaging, phone and video calls, or web portals. Several of these articles were small-scale feasibility studies. The majority of these programmes incorporated goal setting strategies (n=37), while physical activity monitoring (PAM) devices were utilized in 25 studies. These devices were worn in different body locations and helped monitor physical activity, as well as sedentary behaviour. Goal setting was often an important component of a home-based CR programme. Monitoring physical activity levels and having targets helped participants with their motivation whilst increasing self-awareness. Home-based CR programmes offered greater patient choice and improved participation.

Conclusions:

Home-based CR programmes delivered via mobile apps offer a convenient alternative for patients unable to attend hospital-based CR programmes. These apps personalize rehabilitation plans through features like activity tracking and custom goal setting, potentially improving engagement and adherence. Studies included in this review had several limitations including small sample sizes. Larger clinical trials with longer follow-up periods are needed to assess their full effectiveness.