Mobile Health Intervention Promoting Physical Activity in Adults Post Cardiac Rehabilitation: Pilot Randomized Controlled Trial

A recent article in JMIR Formative Research by Mary Whooley, MD and colleagues, detailed their pilot study of a mobile health intervention using a wearable device and mobile phone app to increase physical activity in patients who had completed cardiac rehabilitation.

Cardiac rehabilitation (CR) is an exercise-based program prescribed after cardiac events associated with improved physical, mental, and social functioning; however, many patients return to a sedentary lifestyle leading to deteriorating functional capacity after discharge from CR. Physical activity (PA) is critical to avoid recurrence of cardiac events and mortality and maintain functional capacity.

The pilot study intervention included a mobile phone app to deliver push-through messages and notifications plus an activity tracker to maintain PA in a vulnerable, older patient population who experienced an adverse cardiac event requiring CR. This mobile health intervention that deployed multiple technologies was deemed feasible with a high retention rate in both study groups (85%) and attested to participants’ motivation to remain active and apply the knowledge they learned during CR. Participants also reported high satisfaction with the technology used in this study, including reminders to walk at least 250 steps every hour in times of inactivity.

Preliminary effects of the intervention were promising, with higher average daily step counts for the intervention group over 2 months of follow-up than those assigned to a control condition (pedometer + paper-and-pencil diary). Participants in the intervention group walked, on average, 2192 more daily steps than the control group.

The mobile health intervention piloted by Whooley and colleagues presented a pragmatic and contemporary approach for adults to promote PA after completing CR. The findings provide evidence for using mobile health to enhance patient self-management and demonstrate strong potential to promote PA maintenance through education, recording goals, tracking PA, and receiving tailored feedback. The pilot also provides support for a full-scale RCT with a longer intervention and monitoring period to assess trends in PA after CR as a result of applying mobile health technology for self-monitoring after CR. Future research will implement more tailored coaching for older adults.

Mary Whooley, MD

Mobile Health Intervention Promoting Physical Activity in Adults Post Cardiac Rehabilitation: Pilot Randomized Controlled Trial
Park LG, Elnaggar A, Lee SJ, Merek S, Hoffmann TJ, Von Oppenfeld J, Ignacio N, Whooley, MA. JMIR For Am Res. 2021 Apr 16;5(4):e20468. doi: 10.2196/20468.