JMIR Publications

ABSTRACT

Background:

Cardiovascular diseases (CVDs) cause the most deaths globally. The risk factors for CVDs are physical inactivity and increased BMI, and cardiac rehabilitees typically have a risk of reduced quality of life. With physical activity, it is possible to prevent CVDs, improve quality of life, and help maintain a healthy body mass. The current literature shows the possibilities of digitalization and advanced technology in supporting independent self-rehabilitation. However, the interpretation of the results is complicated by the high heterogeneity of the studies. In addition, the added value of technology has not been well studied, especially in cardiac rehabilitation.

Objective:

The aim of this study was to examine the effectiveness of added remote technology in cardiac rehabilitation on physical function, anthropometrics, and quality of life in CVD participants compared with conventional rehabilitation

Methods:

Participants were cluster randomized (CRT) into three remote technology intervention groups (n=29) and three reference groups (n=30). The reference groups received conventional cardiac rehabilitation, and the intervention groups received self-rehabilitation intervention with added remote technology, namely, Movendos m-coach-application and a Wrist-worn Fitbit Charge-accelerometer. The twelve months of rehabilitation consisted of three five-day in-rehabilitation periods in the rehabilitation center. Between these periods were two 6-month self-rehabilitation periods. Outcome measurements were the 6-minute walk test, body mass, body mass index, waist circumference, and the Quality of Life-BREF questionnaire at baseline, 6 months and 12 months. Between-group change differences were assessed using independent samples t tests and Mann‒Whitney U test. Within-group change differences were analyzed using a paired samples t test or Wilcoxon signed-rank test.

Results:

Fifty-nine participants (60 ± 6.0 years; 81% men) were included in the study. Waist circumference decreased more [6 months (1.6 cm; P=.04); 12 months (3.0 cm; P<.01)] and self-assessed quality of life increased more (environmental factors; 0.5; P<.05) in the remote technology intervention group than in the reference group. The remote technology intervention group also achieved a statistically significant change in the 6MWT (35.8 m; P=.04) during first 6-month period, but there were no statistically significant changes between groups.

Conclusions:

Remote cardiac rehabilitation brought added value to conventional cardiac rehabilitation in terms of waist circumference and quality of life. The results were clinically small, but the findings may suggest that adding remote technology to cardiac rehabilitation may increase beneficial health outcomes. The results are indicative of the small intervention and control groups. According to this study, remote rehabilitation may be recommended for cardiac patients. Clinical Trial: Registration number ISRCTN61225589