Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study

Frontiers in Digital Health

Digital Health

Karl Mayr¹  Fabian Wiesmüller²  Dieter Hayn²  Stefan Höfer³  Norbert Mürzl⁴  Michael Porodko⁴  Josef Niebauer⁵  Mahdi Sareban⁵  Marco Philippi⁶  Lisa-Marie Moser⁷  Christoph Puelacher⁷  Heimo Traninger⁸ 

[1] CARDIOMED Kardiologisches Rehabilitationszentrum GmbH, Linz, Austria;Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, Graz, Austria;Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria;Department of Psychiatry II, Medizinische Universität Innsbruck, Innsbruck, Austria;Institut für Präventiv- und Rehabilitationsmedizin, Cardio Vital Wels, Wels, Austria;Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria;University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Salzburg, Austria;MedReha GmbH, Feldkirch, Austria;Reha Innsbruck, REHAmed-tirol GmbH, Innsbruck, Austria;ZARG Zentrum für ambulante Rehabilitation GmbH, Graz,, Austria;

关键词: mHealth;    telehealth;    cardiac rehabilitation;    wearable;    adherence;   

DOI  :  10.3389/fdgth.2023.1150444

 received in 2023-01-24, accepted in 2023-07-03,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionCardiovascular 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.MethodsIn 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.Results107 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 (Pmax = 186 ± 53 W) as compared to patients without supportive tools (142 ± 41 W, p < 0.001). Both groups improved their Pmax, significantly during phase III rehabilitation, and despite higher baseline Pmax of patients with supportive tools their Pmax improved significantly more (ΔPmax = 19 ± 18 W) than patients without supportive tools (ΔPmax = 9 ± 17 W, p < 0.005). However, after adjusting for baseline differences, the difference in ΔPmax did no longer reach statistical significance.DiscussionTherefore, 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 Pmax 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.

【 授权许可】

Unknown   
© 2023 Hayn, Sareban, Höfer, Wiesmüller, Mayr, Mürzl, Porodko, Puelacher, Moser, Philippi, Traninger and Niebauer.