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Association Between Mobile Application Usage and Change in Functional Capacity Among Cardiac Rehabilitation Participants: Cohort Study
ABSTRACT
Background:
Cardiac rehabilitation (CR) is underutilized in the US and globally with participation disparities across gender, socioeconomic status, race, and ethnicities. The pandemic led to greater adoption of virtual cardiac rehabilitation and mobile application use.
Objective:
Our primary objective was to estimate the association between CR mobile app use and change in functional capacity from enrollment to completion in patients participating in a CR program. Our secondary objectives were to study the association between mobile app use and changes in blood pressure (BP) or program completion.
Methods:
We conducted a retrospective cohort study of participants enrolled in CR at an urban CR program in the US. Participants were English-speaking, at least 18 years old, participated in the program between May 22, 2020 and May 21, 2022, and downloaded the CR mobile app. Mobile application use was quantified by number of exercise logs, vitals logs, and education material views. The primary outcome was change in functional capacity, measured by change in 6-minute walk distance (6MWD) from enrollment to completion. The secondary outcome was change in BP from enrollment to completion. We estimated associations using multivariable linear or logistic regression models adjusted for age, sex, race, ethnicity, socioeconomic status (SES) by ZIP code, insurance, and primary diagnosis for CR referral.
Results:
A total of 107 participants (mean age 62.9 +/- 13.02, 90/107 (84.1%) male) used the mobile application and completed CR. We found no significant association between total app interactions and change in 6MWD or change in BP. There was no significant association between total exercise logs and change in 6MWD or total BP logs and change in BP. There was no significant association between total app interactions and completion of CR (adjusted OR 1.00; 95% CI 0.99, 1.01; p=0.44).
Conclusions:
CR mobile app use was not associated with greater improvement in functional capacity or blood pressure or with program completion.
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