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Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study

INTRODUCTION: Cardiovascular diseases are the leading cause of death worldwide and are partly caused by modifiable risk factors. Cardiac rehabilitation addresses several of these modifiable risk factors, such as physical inactivity and reduced exercise capacity. However, despite its proven short-ter...

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Autores principales: Hayn, Dieter, Sareban, Mahdi, Höfer, Stefan, Wiesmüller, Fabian, Mayr, Karl, Mürzl, Norbert, Porodko, Michael, Puelacher, Christoph, Moser, Lisa-Marie, Philippi, Marco, Traninger, Heimo, Niebauer, Josef
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382682/
https://www.ncbi.nlm.nih.gov/pubmed/37519897
http://dx.doi.org/10.3389/fdgth.2023.1150444
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author Hayn, Dieter
Sareban, Mahdi
Höfer, Stefan
Wiesmüller, Fabian
Mayr, Karl
Mürzl, Norbert
Porodko, Michael
Puelacher, Christoph
Moser, Lisa-Marie
Philippi, Marco
Traninger, Heimo
Niebauer, Josef
author_facet Hayn, Dieter
Sareban, Mahdi
Höfer, Stefan
Wiesmüller, Fabian
Mayr, Karl
Mürzl, Norbert
Porodko, Michael
Puelacher, Christoph
Moser, Lisa-Marie
Philippi, Marco
Traninger, Heimo
Niebauer, Josef
author_sort Hayn, Dieter
collection PubMed
description INTRODUCTION: Cardiovascular diseases are the leading cause of death worldwide and are partly caused by modifiable risk factors. Cardiac rehabilitation addresses several of these modifiable risk factors, such as physical inactivity and reduced exercise capacity. However, despite its proven short-term merits, long-term adherence to healthy lifestyle changes is disappointing. With regards to exercise training, it has been shown that rehabilitation supplemented by a) home-based exercise training and b) supportive digital tools can improve adherence. METHODS: In our multi-center study (ClincalTrials.gov Identifier: NCT04458727), we analyzed the effect of supportive digital tools like digital diaries and/or wearables such as smart watches, activity trackers, etc. on exercise capacity during cardiac rehabilitation. Patients after completion of phase III out-patient cardiac rehabilitation, which included a 3 to 6-months lasting home-training phase, were recruited in five cardiac rehabilitation centers in Austria. Retrospective rehabilitation data were analyzed, and additional data were generated via patient questionnaires. RESULTS: 107 patients who did not use supportive tools and 50 patients using supportive tools were recruited. Already prior to phase III rehabilitation, patients with supportive tools showed higher exercise capacity (P(max) = 186 ± 53 W) as compared to patients without supportive tools (142 ± 41 W, p < 0.001). Both groups improved their P(max), significantly during phase III rehabilitation, and despite higher baseline P(max) of patients with supportive tools their P(max) improved significantly more (ΔP(max) = 19 ± 18 W) than patients without supportive tools (ΔP(max) = 9 ± 17 W, p < 0.005). However, after adjusting for baseline differences, the difference in ΔP(max) did no longer reach statistical significance. DISCUSSION: Therefore, our data did not support the hypothesis that the additional use of digital tools like digital diaries and/or wearables during home training leads to further improvement in P(max) during and after phase III cardiac rehabilitation. Further studies with larger sample size, follow-up examinations and a randomized, controlled design are required to assess merits of digital interventions during cardiac rehabilitation.
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spelling pubmed-103826822023-07-30 Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study Hayn, Dieter Sareban, Mahdi Höfer, Stefan Wiesmüller, Fabian Mayr, Karl Mürzl, Norbert Porodko, Michael Puelacher, Christoph Moser, Lisa-Marie Philippi, Marco Traninger, Heimo Niebauer, Josef Front Digit Health Digital Health INTRODUCTION: Cardiovascular diseases are the leading cause of death worldwide and are partly caused by modifiable risk factors. Cardiac rehabilitation addresses several of these modifiable risk factors, such as physical inactivity and reduced exercise capacity. However, despite its proven short-term merits, long-term adherence to healthy lifestyle changes is disappointing. With regards to exercise training, it has been shown that rehabilitation supplemented by a) home-based exercise training and b) supportive digital tools can improve adherence. METHODS: In our multi-center study (ClincalTrials.gov Identifier: NCT04458727), we analyzed the effect of supportive digital tools like digital diaries and/or wearables such as smart watches, activity trackers, etc. on exercise capacity during cardiac rehabilitation. Patients after completion of phase III out-patient cardiac rehabilitation, which included a 3 to 6-months lasting home-training phase, were recruited in five cardiac rehabilitation centers in Austria. Retrospective rehabilitation data were analyzed, and additional data were generated via patient questionnaires. RESULTS: 107 patients who did not use supportive tools and 50 patients using supportive tools were recruited. Already prior to phase III rehabilitation, patients with supportive tools showed higher exercise capacity (P(max) = 186 ± 53 W) as compared to patients without supportive tools (142 ± 41 W, p < 0.001). Both groups improved their P(max), significantly during phase III rehabilitation, and despite higher baseline P(max) of patients with supportive tools their P(max) improved significantly more (ΔP(max) = 19 ± 18 W) than patients without supportive tools (ΔP(max) = 9 ± 17 W, p < 0.005). However, after adjusting for baseline differences, the difference in ΔP(max) did no longer reach statistical significance. DISCUSSION: Therefore, our data did not support the hypothesis that the additional use of digital tools like digital diaries and/or wearables during home training leads to further improvement in P(max) during and after phase III cardiac rehabilitation. Further studies with larger sample size, follow-up examinations and a randomized, controlled design are required to assess merits of digital interventions during cardiac rehabilitation. Frontiers Media S.A. 2023-07-14 /pmc/articles/PMC10382682/ /pubmed/37519897 http://dx.doi.org/10.3389/fdgth.2023.1150444 Text en © 2023 Hayn, Sareban, Höfer, Wiesmüller, Mayr, Mürzl, Porodko, Puelacher, Moser, Philippi, Traninger and Niebauer. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Digital Health
Hayn, Dieter
Sareban, Mahdi
Höfer, Stefan
Wiesmüller, Fabian
Mayr, Karl
Mürzl, Norbert
Porodko, Michael
Puelacher, Christoph
Moser, Lisa-Marie
Philippi, Marco
Traninger, Heimo
Niebauer, Josef
Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study
title Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study
title_full Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study
title_fullStr Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study
title_full_unstemmed Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study
title_short Effect of digital tools in outpatient cardiac rehabilitation including home training—results of the EPICURE study
title_sort effect of digital tools in outpatient cardiac rehabilitation including home training—results of the epicure study
topic Digital Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10382682/
https://www.ncbi.nlm.nih.gov/pubmed/37519897
http://dx.doi.org/10.3389/fdgth.2023.1150444
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