The feasibility and effectiveness of smartwatch device on the adherence to the home-based cardiac rehabilitation in patients with coronary heart disease: A randomized controlled trial. (Preprint)

BACKGROUND Digital technologies have the potential to address many of the challenges associated with the traditional center-based CR (CBCR), but the remote home-based cardiac rehabilitation(HBCR) model remains a challenge. OBJECTIVE This study is designed to investigate the feasibility, and efficacy of a smartwatch-facilitated HBCR model in patients with coronary heart disease (CHD). METHODS It was a single-center, randomized, non-blind, and parallel-controlled study. We recruited patients aged 18 years or older with coronary heart disease from a tertiary hospital in Jilin Province, China. The intervention group received a 3-month smartwatch-based HBCR program involving remotely delivered real-time feedback, supervision, and education. The control group received conventional HBCR. Adherence is the primary outcome of the trial, assessed by the Home-Based Cardiac Rehabilitation Exercise Adherence Scale. The secondary outcomes include cardiopulmonary function, measured by cardiopulmonary exercise testing, anxiety (General Anxiety Disorder-7), depression(Patient Health Questionnaire-9), and quality of life (36-Item Short Form Health Survey) at 3 months. RESULTS Between January 1, 2023, and December 30, 2023, 62 patients (mean age 59.93±10.06 years), of whom 33.3% were female and 66.% were male, were recruited and subsequently randomly assigned to the smartwatch group (n=32) or control group (n=30). No difference was detected in the baseline characteristics between the two groups. After the intervention, the subjects in the smartwatch group performed significantly better in peak VO2, home-based cardiac rehabilitation adherence, GAD-7, PHQ-9, and some other parameters than those in the control group. CONCLUSIONS This feasibility study showed that the smartwatch device was well-accepted and effective in supporting a home-based cardiac rehabilitation model for patients with coronary heart disease (CHD). CLINICALTRIAL Clinical Trials Registry: ChiCTR2400088039; https://www.chictr.org.cn/bin/project/edit?pid=215602