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October 29, 2014Journal of Medical Internet Research38 citationsOpen Access

Evaluating the Interactive Web-Based Program, Activate Your Heart, for Cardiac Rehabilitation Patients: A Pilot Study

CBChristopher BroughSBSally BoyceLHLinzy Houchen‐Wolloff

Structured PICO

Does a Web-based cardiac rehabilitation program improve exercise capacity, quality of life, and dietary habits in low-risk patients with coronary heart disease?

P
Population
41 low-risk patients with coronary heart disease (CHD) referred to cardiac rehabilitation, mean age 60.5, 37 male / 4 female. Key inclusion: PCI or CABG in the last 3 months, or medically managed; Incremental Shuttle Walking Test (ISWT) ≥420 meters. Key exclusion: unstable angina, significant anxiety/depression (HADS ≥11), moderate-severe left ventricular dysfunction, inability to perform physical activity, not computer literate.
I
Intervention
Activate Your Heart (AYH), an interactive Web-based cardiac rehabilitation program for 8 weeks, including an exercise diary, secondary prevention education, goal setting, and access to CR specialists via private messaging.
O
Outcome
Changes in exercise capacity (Incremental Shuttle Walk Test distance), quality of life (MacNew questionnaire), dietary habits, and psychosocial well-being (HADS) at 8 weeks.patient reported

A Web-based cardiac rehabilitation program significantly improved exercise capacity, quality of life, and dietary habits in low-risk patients with coronary heart disease, offering a viable alternative to traditional supervised programs.

Limitations

  • No control group (observational design)
  • Small sample size
  • Included only low-risk patients with high baseline exercise performance and low baseline anxiety/depression, limiting the scope for improvement

Abstract

BACKGROUND: Conventional cardiac rehabilitation (CR) programs are traditionally based on time-constrained, structured, group-based programs, usually set in hospitals or leisure centers. Uptake for CR remains poor, despite the ongoing evidence demonstrating its benefits. Additional alternative forms of CR are needed. An Internet-based approach may offer an alternative mode of delivering CR that may improve overall uptake. Activate Your Heart (AYH) is a Web-based CR program that has been designed to support individuals with coronary heart disease (CHD). OBJECTIVE: The aim of this pilot study was to observe the outcome for participants following the AYH program. METHODS: We conducted a prospective observational trial, recruiting low-risk patients with CHD. Measures of exercise, exercise capacity, using the Incremental Shuttle Walk Test (ISWT), dietary habits, and psychosocial well-being were conducted by a CR specialist at baseline and at 8 weeks following the Web-based intervention. RESULTS: We recruited 41 participants; 33 completed the program. We documented significant improvements in the ISWT distance (mean change 49.69 meters, SD 68.8, P<.001), and Quality of Life (QOL) (mean change 0.28, SD 0.4, P<.001). Dietary habits improved with an increased proportion of patients consuming at least 5 portions of fruit and vegetables per day, (22 71% to 29 94% P=.01) and an increased proportion of patients consuming at least 2 portions of oily fish per week (14 45% to 21 68%, P=.01). We did not detect changes in anxiety and depression scores or exercise behavior. CONCLUSIONS: We observed important improvements in exercise capacity, QOL, and dietary habits in a group of participants following a Web-based CR program. The program may offer an alternative approach to CR. A mobile version has been developed and we need to conduct further trials to establish its value compared to supervised CR.

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Cite This Study

Brough et al. (2014) studied this question.

synapsesocial.com/papers/6a0f908a2badbc352afe5980https://doi.org/10.2196/jmir.3027
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