TY - JOUR
T1 - Effect of digital tools in outpatient cardiac rehabilitation including home training-results of the EPICURE study
AU - Hayn, Dieter
AU - Sareban, Mahdi
AU - Höfer, Stefan
AU - Wiesmüller, Fabian
AU - Mayr, Karl
AU - Mürzl, Norbert
AU - Porodko, Michael
AU - Puelacher, Christoph
AU - Moser, Lisa-Marie
AU - Philippi, Marco
AU - Traninger, Heimo
AU - Niebauer, Josef
N1 - © 2023 Hayn, Sareban, Höfer, Wiesmüller, Mayr, Mürzl, Porodko, Puelacher, Moser, Philippi, Traninger and Niebauer.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
PY - 2023/7/14
Y1 - 2023/7/14
N2 - INTRODUCTION: Cardiovascular diseases are the leading cause of death worldwide and are partly caused by modifiable risk factors. Cardiac rehabilitation addresses several of these modifiable risk factors, such as physical inactivity and reduced exercise capacity. However, despite its proven short-term merits, long-term adherence to healthy lifestyle changes is disappointing. With regards to exercise training, it has been shown that rehabilitation supplemented by a) home-based exercise training and b) supportive digital tools can improve adherence.METHODS: In our multi-center study (ClincalTrials.gov Identifier: NCT04458727), we analyzed the effect of supportive digital tools like digital diaries and/or wearables such as smart watches, activity trackers, etc. on exercise capacity during cardiac rehabilitation. Patients after completion of phase III out-patient cardiac rehabilitation, which included a 3 to 6-months lasting home-training phase, were recruited in five cardiac rehabilitation centers in Austria. Retrospective rehabilitation data were analyzed, and additional data were generated via patient questionnaires.RESULTS: 107 patients who did not use supportive tools and 50 patients using supportive tools were recruited. Already prior to phase III rehabilitation, patients with supportive tools showed higher exercise capacity ( P max = 186 ± 53 W) as compared to patients without supportive tools (142 ± 41 W, p < 0.001). Both groups improved their P max, significantly during phase III rehabilitation, and despite higher baseline P max of patients with supportive tools their P max improved significantly more ( ΔP max = 19 ± 18 W) than patients without supportive tools ( ΔP max = 9 ± 17 W, p < 0.005). However, after adjusting for baseline differences, the difference in ΔP max did no longer reach statistical significance. DISCUSSION: Therefore, our data did not support the hypothesis that the additional use of digital tools like digital diaries and/or wearables during home training leads to further improvement in P max during and after phase III cardiac rehabilitation. Further studies with larger sample size, follow-up examinations and a randomized, controlled design are required to assess merits of digital interventions during cardiac rehabilitation.
AB - INTRODUCTION: Cardiovascular diseases are the leading cause of death worldwide and are partly caused by modifiable risk factors. Cardiac rehabilitation addresses several of these modifiable risk factors, such as physical inactivity and reduced exercise capacity. However, despite its proven short-term merits, long-term adherence to healthy lifestyle changes is disappointing. With regards to exercise training, it has been shown that rehabilitation supplemented by a) home-based exercise training and b) supportive digital tools can improve adherence.METHODS: In our multi-center study (ClincalTrials.gov Identifier: NCT04458727), we analyzed the effect of supportive digital tools like digital diaries and/or wearables such as smart watches, activity trackers, etc. on exercise capacity during cardiac rehabilitation. Patients after completion of phase III out-patient cardiac rehabilitation, which included a 3 to 6-months lasting home-training phase, were recruited in five cardiac rehabilitation centers in Austria. Retrospective rehabilitation data were analyzed, and additional data were generated via patient questionnaires.RESULTS: 107 patients who did not use supportive tools and 50 patients using supportive tools were recruited. Already prior to phase III rehabilitation, patients with supportive tools showed higher exercise capacity ( P max = 186 ± 53 W) as compared to patients without supportive tools (142 ± 41 W, p < 0.001). Both groups improved their P max, significantly during phase III rehabilitation, and despite higher baseline P max of patients with supportive tools their P max improved significantly more ( ΔP max = 19 ± 18 W) than patients without supportive tools ( ΔP max = 9 ± 17 W, p < 0.005). However, after adjusting for baseline differences, the difference in ΔP max did no longer reach statistical significance. DISCUSSION: Therefore, our data did not support the hypothesis that the additional use of digital tools like digital diaries and/or wearables during home training leads to further improvement in P max during and after phase III cardiac rehabilitation. Further studies with larger sample size, follow-up examinations and a randomized, controlled design are required to assess merits of digital interventions during cardiac rehabilitation.
KW - mHealth
KW - telehealth
KW - cardiac rehabilitation
KW - wearable
KW - adherence
U2 - 10.3389/fdgth.2023.1150444
DO - 10.3389/fdgth.2023.1150444
M3 - Article
C2 - 37519897
SN - 2673-253X
VL - 5
JO - Frontiers in Digital Health
JF - Frontiers in Digital Health
M1 - 1150444
ER -
