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Review
. 2022 Jun 29;11(13):3772.
doi: 10.3390/jcm11133772.

Effectiveness of Home-Based Cardiac Rehabilitation, Using Wearable Sensors, as a Multicomponent, Cutting-Edge Intervention: A Systematic Review and Meta-Analysis

Varsamo Antoniou  1 , Constantinos H Davos  2 , Eleni Kapreli  1 , Ladislav Batalik  3   4 , Demosthenes B Panagiotakos  5   6 , Garyfallia Pepera  1
Affiliations
Review

Effectiveness of Home-Based Cardiac Rehabilitation, Using Wearable Sensors, as a Multicomponent, Cutting-Edge Intervention: A Systematic Review and Meta-Analysis

Varsamo Antoniou et al. J Clin Med. .

Abstract

Exercise-based cardiac rehabilitation is a highly recommended intervention towards the advancement of the cardiovascular disease (CVD) patients' health profile; though with low participation rates. Although home-based cardiac rehabilitation (HBCR) with the use of wearable sensors is proposed as a feasible alternative rehabilitation model, further investigation is needed. This systematic review and meta-analysis aimed to evaluate the effectiveness of wearable sensors-assisted HBCR in improving the CVD patients' cardiorespiratory fitness (CRF) and health profile. PubMed, Scopus, Cinahl, Cochrane Library, and PsycINFO were searched from 2010 to January 2022, using relevant keywords. A total of 14 randomized controlled trials, written in English, comparing wearable sensors-assisted HBCR to center-based cardiac rehabilitation (CBCR) or usual care (UC), were included. Wearable sensors-assisted HBCR significantly improved CRF when compared to CBCR (Hedges' g = 0.22, 95% CI 0.06, 0.39; I2 = 0%; p = 0.01), whilst comparison of HBCR to UC revealed a nonsignificant effect (Hedges' g = 0.87, 95% CI -0.87, 1.85; I2 = 96.41%; p = 0.08). Effects on physical activity, quality of life, depression levels, modification of cardiovascular risk factors/laboratory parameters, and adherence were synthesized narratively. No significant differences were noted. Technology tools are growing fast in the cardiac rehabilitation era and promote exercise-based interventions into a more home-based setting. Wearable-assisted HBCR presents the potential to act as an adjunct or an alternative to CBCR.

Keywords: accelerometer; cardiorespiratory fitness; cardiovascular disease; home-based cardiac rehabilitation; physical activity; wearable sensors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Risk of bias summary. Avila, 2018 [42]; Avila, 2020 [41]; Batalik, 2020 [40]; Bravo-Escobar, 2017 [38]; Cai, 2021 [30]; Dehghani, 2019 [43]; Frederix, 2015 [34]; Hwang, 2017 [32]; Kraal, 2017 [33]; Maddison, 2019 [31]; Piotrowicz, 2015 [35]; Skobel, 2017 [37]; Snoek, 2021 [36]; Song, 2020 [39].
Figure 3
Figure 3
Risk of bias graph.
Figure 4
Figure 4
Results from the restricted maximum likelihood (REML) random effects meta-analysis (Hedges’ g criteria), concerning the difference in cardiorespiratory fitness (CRF) change post-intervention, between the home-based cardiac rehabilitation group (HBCR) and the center-based rehabilitation group (CBCR) [31,33,34,40,42,43].
Figure 5
Figure 5
Results from the restricted maximum likelihood (REML) random effects meta-analysis (Hedges’ criteria), concerning the difference in cardiorespiratory fitness (CRF) change post-intervention, between the home-based cardiac rehabilitation group (HBCR) and the usual care group (UC) [30,35,36,39,42].
See this image and copyright information in PMC

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