Effects of Remote Cardiac Rehabilitation Using Wearable Devices with and without Weekly Online Coaching in CAD Patients: A Randomized trial (Preprint)

BACKGROUND Cardiac rehabilitation (CR) is effective in preventing cardiovascular diseases; however, the impact of remote CR with wearable devices and online coaching remains unclear. This study investigated the effects of interactive communication between healthcare providers and patients on exercise capacity. OBJECTIVE This randomised controlled trial enrolled 50 patients with coronary artery disease (CAD) in a remote CR program (phase III). After baseline cardiopulmonary exercise tests (CPETs), all patients were assigned a CPET-based home exercise program and were provided with a wearable device (Fitbit Sense) with real-time monitoring system (Recoval ©). METHODS The patients were randomly assigned to an intervention group with online coaching (OLC; n=25) or a control group (CON; n=25). The primary outcomes were changes in peak VO2 and anaerobic threshold (AT) VO2 at 12 weeks. The secondary outcomes were changes in CPET parameters, daily activity, anxiety levels, and health-related quality of life. RESULTS Peak VO2 and AT VO2 increased significantly from baseline to 12 weeks in the OLC (+1.6 mL/kg/min, p<0.001; +1.0 mL/kg/min, p=0.001) and CON (+0.6 mL/kg/min, p=0.008; +1.3 mL/kg/min, p=0.002) groups with no significant between-group differences (p=0.65; p=0.9). In the latter half of the intervention, the daily distance and highly active time in the OLC group were significantly increased compared with those in the CON group (all p<0.05). CONCLUSIONS Exercise tolerance improves with appropriate exercise coaching and use of wearable devices in patients with CAD participating in remote CR programs. The benefits of online coaching using real-time monitoring may become more pronounced in the long term. CLINICALTRIAL UMIN 000047789