| Abstrakt: |
Introduction:Cardiac rehabilitation (CR) is an exercise-based program prescribed after cardiac events that is associated with improved physical, mental, and social functioning; however, as few as 15-50% of patients report any exercise 6 months after CR. Physical activity (PA) is critical to avoid recurrence of cardiac events and mortality as well as maintaining functional capacity after completing Phase II CR. Leveraging digital heath strategies to increase adherence to PA is a promising approach. Our aim was to determine whether engagement with the MOVN mobile application (app) and a Fitbit wearable activity tracker would improve step counts over 2 months after CR. The primary objective of this pilot randomized controlled trial was to establish an effect size for average daily step counts between study arms.Methods:We randomized patients 1:1 to the intervention or control group. The intervention group used the MOVN app (for PA self-management and to receive messages on motivation and education on secondary prevention of cardiovascular disease) and wore a Fitbit Charge 2 to track daily steps. Participants in the usual care group wore a pedometer and recorded their daily steps in a diary. Data from the self-reported questionnaires were collected at baseline and 2 months. We conducted a t-test and Cohen?s d calculation to determine any differences between groups on the primary outcome of average daily step counts and effect size over 2 months, respectively.Results:We recruited 60 patients from 2 CR sites of a community hospital in Northern California. The mean age was 66.8 ? 8.6 and 22% were female; retention rate was 85%. Over 2 months, the intervention group had approximately 2,100 more steps per day than the control group (8,832 ? 3,408 vs. 6,747 ? 3,990; P=0.051; Cohen?s d=0.54), but this study was not powered to detect significant differences.Conclusions:Our digital health intervention presents a promising, pragmatic approach to promote PA maintenance after CR. Future research is needed to test the efficacy of this intervention as a full-scale clinical trial. This intervention addresses a major public health initiative to promote PA in patients with CVD with the potential to improve critical PA, clinical, and psychosocial outcomes. |
