Physical activity monitoring after inpatient cardiopulmonary rehabilitation: device preferences and step trajectories

Background Inpatient cardiopulmonary rehabilitation aims to restore patients’ functioning and increase their physical activity. However, little is known about patients’ activity levels once they return home, and the most suitable step-counting devices for routine post-discharge monitoring remains unclear. Purpose This ongoing study investigates the patient preferences for step-counting devices and examines daily step trajectories during the transition from inpatient rehabilitation to home. Methods Through shared decision-making, patients selected a suitable step count device (i.e. simple pedometers, fitness trackers, smartphone applications, or a personal devices) to record their activity during their final days of rehabilitation and for up to one month post-discharge. Self-monitored step counts and user feedback were reported by patients through a telephone interview one month post-discharge. Daily step trajectories were analysed using a negative binomial generalized additive model with phase-specific smooths. Results Among 51 patients (55% cardiovascular, 45% pulmonary, 33% female, mean age 68.3 ± 12.4 years), 51% selected a simple pedometer, 37% a fitness tracker and 12% their own smartwatch. After one month, all patients reported to be comfortable with using their selected device and 39% were willing to continue to self-monitor their steps. A non-significant 11% reduction in overall step counts was observed from rehabilitation to post-discharge (mean ratio = 0.89, p = 0.606). Post-discharge step counts increased significantly over time (p < 0.001), whereas no time trend was observed during rehabilitation (Figure 1). Conclusion Offering simple pedometers alongside wearable fitness trackers through shared decision-making appears to promote participation in daily step-count monitoring after inpatient rehabilitation. Although average step counts did not differ significantly between rehabilitation and home, there was an immediate decline after discharge, followed by a gradual increase toward rehabilitation levels within the first month. This pattern may reflect patients’ initial adjustment challenges when transitioning to daily life outside the structured rehabilitation environment. Continuous monitoring may help identify patients whose activity remains low after discharge and who may benefit from targeted follow-up support.