Do wearable electronic devices after a cardiac rehabilitation programme improve adherence to physical exercise?

Abstract Introduction Telemedicine and m-Health have demonstrated beneficial effects on patients with cardiovascular disease. Previous studies have shown the benefit of wearable electronic devices during phase II of cardiac rehabilitation (outpatient phase) with an increase in daily steps and even in peak oxygen consumption. However, there are hardly any studies evaluating the influence of these devices on long-term exercise adherence. Purpose The aim of the study was to analyse total adherence to exercise in patients who had completed a cardiac rehabilitation programme (phase III, maintenance phase). Methods A multicenter randomised clinical trial was conducted in 319 patients who had completed a cardiac rehabilitation programme. Patients were randomised to use a mobile app (n=161) or routine follow-up (n=158). Survival analysis techniques using Kaplan Meier survival analysis and log-rank comparisons between groups were used to estimate exercise adherence outcomes. A univariate analysis was performed on the ‘portable electronic devices’ group. The primary endpoint of the study was the time until the first week in which the patient did not meet ≥ 80% of the physical activity recommended by the World Health Organisation and the European Cardiology Guidelines (at least 150 minutes per week of moderate physical activity). As a secondary objective, the baseline characteristics of patients using portable electronic devices were studied. Results Of the 319 patients who started follow-up, 174 of them used a portable electronic device (54.5%). The group using portable electronic devices had a higher number of diabetics (p=0.016) and a higher frequency of patients reaching ≥ 8 METs at the end of cardiac rehabilitation programme (p=0.050). The remaining baseline characteristics are listed in Table 1. The median follow-up of the study was 1.6 years. Patients using an electronic wearable device were statistically significantly more adherent to long-term physical exercise (Kaplan Meier Figure 1, long-rank test =0.048). Conclusions The use of a portable electronic devices is a safe and economical tool to improve long-term adherence to physical exercise after a cardiac rehabilitation programme.Table 1.Baseline characteristics Figure 1.Time to exercise abandonment