JMIR Publications

ABSTRACT

Background:

Cardiac rehabilitation (CR) is an evidence-based approach for preventing secondary cardiac events. Smartphone applications are starting to be used in cardiac rehabilitation to give patients real time feedback on their health, connect them remotely with their medical team, and allow them to perform their rehabilitation at home. The usage of smartphone apps is becoming omnipresent and has real potential in impacting patients in need of CR.

Objective:

This paper provides critical examinations and summaries of existing research studies with an in-depth analysis of not only the individual studies, but also the larger patterns that have emerged with smartphone applications in CR as well as their significance for practice change.

Methods:

A systematic review was conducted by broad database searches that focused on evaluating randomized controlled trials (RCT), in compliance with the PRISMA expectations. There were a total of 43 articles that were evaluated and 6 were chosen for this review. The dates ranged from 2014-2020 and focused on the population of cardiac outpatients who needed CR after suffering a cardiac event, with an intervention of smartphone devices that incorporated the CR standards of the American Heart Association. Outcomes measured were directed at focusing on improved exercise function capacity, valued at a significance level of P <.05, for improved 6 minute walk test (6MWT) and peak oxygen uptake (PVO2).

Results:

Of the evaluated articles, results were inconsistent for CR smartphone apps having significant positive effect on cardiac patients’ physical function capacity, in terms of 6MWT and PVO2 when using a smartphone application to aid in cardiac rehabilitation.

Conclusions:

Since evidence in the literature suggests nonhomogeneous results for successful usage of smartphone applications in cardiac rehabilitation, it is crucial to investigate the potential reasons for this. An important observation from this systematic review is that smartphone apps being used in cardiac rehabilitation have better clinical outcomes related to physical function capacity if the app auto-records information or provides real-time feedback to participant about their progress, compared to apps that only educate and encourage usage while making the participant manually log CR activities. In addition, other factors to keep in mind during these studies include the starting health of the patients, the sample sizes, and the specific components of cardiac rehabilitation that smartphone apps are utilizing. Overall, more clinical trials are needed that implement smartphone apps with these factors in mind, while placing stronger emphasis on using bio-sensing capabilities that can automatically log and send results to providers on a real-time dashboard.