Mayo Clinic proceedings. Digital health · 2024
Remote, Smart Device-Based Cardiac Rehabilitation After Myocardial Infarction: A Pilot, Randomized Cross-Over SmartRehab Study.
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Wohlfahrt Peter, Jenča Dominik, Melenovský Vojtěch, Mrázková Jolana, Šramko Marek, Kotrč Martin, Želízko Michael, Adámková Věra, Lopez-Jimenez Francisco, Piťha Jan, Kautzner Josef
Аннотация
OBJECTIVE: To evaluate the effect of smart device-based telerehabilitation on Vo2peak in patients after myocardial infarction.
PATIENTS AND METHODS: This was a pilot, single-center, randomized, cross-over study with a 3-month intervention. One month after myocardial infarction, patients had cardiopulmonary exercise testing and a 6-minute walking test (6MWT) and were randomly assigned 1:1. In the intervention group, patients received a smartwatch to track the recommended number of steps, which was individualized and derived from the 6MWT. A study nurse telemonitored adherence to the recommended number of steps a day. In the control group, 150 minutes a week of moderate-intensity physical activity was recommended. After 3 months study arms were crossed over, and study procedures were repeated after 3 months.
RESULTS: Between June 1, 2019, and February 28, 2023, 64 patients were randomized, of which 61 (aged 51±10 years, 10% women) completed the study. Overall, the smart device-based telerehabilitation led to 2.31 mL/kg/min (95% CI, 1.25-3.37; P<.001) Vo2peak increase compared with the control treatment. Furthermore, there was a significant effect on weight (-1.50 kg; 95% CI, -0.39 to -2.70), whereas the effect on the 6MWT distance (4.7 m; 95% CI, -11.8 to 21.1) or Kansas City Quality of Life questionnaire score (0.98; 95% CI, -1.38 to 3.35) was not significant.
CONCLUSION: Smart device-based cardiac rehabilitation may be a promising alternative for patients unable or unwilling to attend in-person cardiac rehabilitation.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT03926312.
PATIENTS AND METHODS: This was a pilot, single-center, randomized, cross-over study with a 3-month intervention. One month after myocardial infarction, patients had cardiopulmonary exercise testing and a 6-minute walking test (6MWT) and were randomly assigned 1:1. In the intervention group, patients received a smartwatch to track the recommended number of steps, which was individualized and derived from the 6MWT. A study nurse telemonitored adherence to the recommended number of steps a day. In the control group, 150 minutes a week of moderate-intensity physical activity was recommended. After 3 months study arms were crossed over, and study procedures were repeated after 3 months.
RESULTS: Between June 1, 2019, and February 28, 2023, 64 patients were randomized, of which 61 (aged 51±10 years, 10% women) completed the study. Overall, the smart device-based telerehabilitation led to 2.31 mL/kg/min (95% CI, 1.25-3.37; P<.001) Vo2peak increase compared with the control treatment. Furthermore, there was a significant effect on weight (-1.50 kg; 95% CI, -0.39 to -2.70), whereas the effect on the 6MWT distance (4.7 m; 95% CI, -11.8 to 21.1) or Kansas City Quality of Life questionnaire score (0.98; 95% CI, -1.38 to 3.35) was not significant.
CONCLUSION: Smart device-based cardiac rehabilitation may be a promising alternative for patients unable or unwilling to attend in-person cardiac rehabilitation.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT03926312.