Increasing the medium-term clinical benefits of hospital-based cardiac rehabilitation by physical activity telemonitoring in coronary artery disease patients

Abstract

Background: The purpose of this study was to evaluate the effect of a physical activity telemonitoring program on daily physical activity level, oxygen uptake capacity (VO(2peak)), and cardiovascular risk profile in coronary artery disease (CAD) patients who completed phase II cardiac rehabilitation (CR).

Methods: Eighty CAD patients who completed phase II CR were randomly assigned to an additional telemonitoring intervention or standard CR. The patients in the intervention group (n = 40) wore a motion sensor continuously for 18 weeks. Each week these patients received a step count goal, with the aim to gradually increase the patients' physical activity level. In the control group (n = 40), the patients wore an unreadable motion sensor for seven days for measurement purposes only (at start of follow-up, and after six and 18 weeks). At start of follow-up and after 18 weeks blood lipid profile, glycemic control, waist circumference and body mass index was assessed. VO(2peak) was assessed at start of follow-up, and after six and 18 weeks. Re-hospitalisation rate was followed during this timeframe.

Results: In the intervention group, VO(2peak) increased significantly during follow-up (P = 0.001), in the control group it did not (P = 0.273). A significant correlation was found between daily aerobic step count and improvement in VO(2peak) (P = 0.030, r = 0.47). Kaplan-Meier curve analysis showed a trend towards fewer re-hospitalisations for patients in the telemonitoring group (P = 0.09).

Conclusions: The study showed that, to maintain exercise tolerance and lower re-hospitalisation rate after hospital-based CR in CAD patients, a physical activity telemonitoring program might be an effective intervention.

Keywords: 3D accelerometer; Physical activity; coronary artery disease; peak oxygen uptake; telemonitoring.