JMIR cardio · 2026
Real-Time Physical Activity Self-Monitoring in Patients Hospitalized for Cardiology Care: Interrupted Time Series Analysis.
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de Miguel Llorente Carlos, Sieswerda Gertjan T J, Karramass Kaoutar, Rommens Charlotte, Hoogeboom Thomas J, Valkenet Karin
Аннотация
BACKGROUND: Hospital admission is associated with increased sedentary behavior and low levels of physical activity. Hospitals have developed several strategies and interventions to address this unwanted inactivity and increase patient movement during admission. Self-monitoring of physical activity is a promising approach to support activity during hospital stays.
OBJECTIVE: This study investigated whether providing patients with real-time physical activity feedback, compared to a context where only health care practitioners had access to activity data, supported patients in maintaining activity levels in the cardiology ward.
METHODS: A Hybrid Type 2 interrupted time series design was applied. In phase 1 (24 wk), patients wore accelerometers (Physical Activity Monitor [PAM] AM400) with data visible only to health care professionals. In phase 2 (24 wk), self-monitoring was introduced using a ward-based screen that provided patients with real-time feedback on daily physical activity. Implementation outcomes were evaluated within the RE-AIM (Reach, Effectiveness, Adoption, and Implementation) framework, with "Maintenance," defined as daily physical activity trends over time, serving as the primary outcome. The other RE-AIM dimensions were assessed as secondary outcomes.
RESULTS: A total of 159 patients were included (n=75 in phase 1 and n=84 in phase 2). Daily physical activity levels were expressed as active minutes per day. No significant immediate change in daily activity occurred at the start of phase 2 vs the end of phase 1 (β=-0.127, P=.81). In phase 1, physical activity declined statistically significantly over time (β=-0.002, P<.001; ~6% decrease per month). In phase 2, following the introduction of the self-monitoring intervention, this decline was no longer observed, and activity levels were maintained. A significant phase interaction (β=0.002, P=.03) confirmed stabilization of physical activity levels in phase 2. Secondary RE-AIM outcomes did not differ between phases.
CONCLUSIONS: The decline observed when only health care professionals accessed the data was no longer present once patients could monitor their own physical activity. Although seasonal influences cannot be excluded, these findings suggest that patient self-monitoring may support the maintenance of physical activity during hospital stays. Sustainability is complex, and determining the effect of patient self-monitoring alone remains challenging. Larger studies are needed to confirm these results.
OBJECTIVE: This study investigated whether providing patients with real-time physical activity feedback, compared to a context where only health care practitioners had access to activity data, supported patients in maintaining activity levels in the cardiology ward.
METHODS: A Hybrid Type 2 interrupted time series design was applied. In phase 1 (24 wk), patients wore accelerometers (Physical Activity Monitor [PAM] AM400) with data visible only to health care professionals. In phase 2 (24 wk), self-monitoring was introduced using a ward-based screen that provided patients with real-time feedback on daily physical activity. Implementation outcomes were evaluated within the RE-AIM (Reach, Effectiveness, Adoption, and Implementation) framework, with "Maintenance," defined as daily physical activity trends over time, serving as the primary outcome. The other RE-AIM dimensions were assessed as secondary outcomes.
RESULTS: A total of 159 patients were included (n=75 in phase 1 and n=84 in phase 2). Daily physical activity levels were expressed as active minutes per day. No significant immediate change in daily activity occurred at the start of phase 2 vs the end of phase 1 (β=-0.127, P=.81). In phase 1, physical activity declined statistically significantly over time (β=-0.002, P<.001; ~6% decrease per month). In phase 2, following the introduction of the self-monitoring intervention, this decline was no longer observed, and activity levels were maintained. A significant phase interaction (β=0.002, P=.03) confirmed stabilization of physical activity levels in phase 2. Secondary RE-AIM outcomes did not differ between phases.
CONCLUSIONS: The decline observed when only health care professionals accessed the data was no longer present once patients could monitor their own physical activity. Although seasonal influences cannot be excluded, these findings suggest that patient self-monitoring may support the maintenance of physical activity during hospital stays. Sustainability is complex, and determining the effect of patient self-monitoring alone remains challenging. Larger studies are needed to confirm these results.