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Meta-Analysis
. 2023 May 5:29:e939132.
doi: 10.12659/MSM.939132.

Benefits of Using Smartphones and Other Digital Methods in Achieving Better Cardiac Rehabilitation Goals: A Systematic Review and Meta-Analysis

Miruna Popovici  1 , Sorin Ursoniu  2   3 , Horea Feier  1   4 , Mihaela Mocan  5 , Otilia Mihaela G Tomulescu  1 , Nilima Rajpal Kundnani  1   4 , Mihaela Valcovici  1   4 , Simona Ruxanda Dragan  1   4
Affiliations
Meta-Analysis

Benefits of Using Smartphones and Other Digital Methods in Achieving Better Cardiac Rehabilitation Goals: A Systematic Review and Meta-Analysis

Miruna Popovici et al. Med Sci Monit. .

Abstract

BACKGROUND The importance of introducing digital technology as an alternative to classical cardiac rehabilitation has been discussed in several reviews. The purpose of this systematic review and meta-analysis was to analyze the effectiveness of digital technology use in cardiac rehabilitation to determine whether digital methods like use of smartphones, compared to traditional rehabilitation methods, can improve the overall quality of life and exercise capacity of cardiac patients. MATERIAL AND METHODS PubMed, EMBASE, and ScienceDirect were systematically searched in a randomized manner, resulting in 11 randomized controlled trials (RCTs) that met all the inclusion criteria. The inclusion criteria were patients with coronary heart disease, valvular surgery, or post- myocardial revascularization that were in a technology-assisted cardiac rehabilitation program vs traditional standard physical follow-up protocol. RESULTS Seven eligible trials including a total of 802 participants examined the effect of interventions on VO2 peak. One of the studies comprised 2-stage analysis for this parameter. We found that VO₂ peak was significantly higher in the intervention group. Three studies analyzed the 6-minute walk test (6MWT) results; significant differences were reported, with better results in the interventional group. CONCLUSIONS The results of our meta-analysis support conducting further randomized trials, considering that the development of technology is on the rise. In the past decade there has been an immense increase in the use of smartphones, which can widely be used in healthcare, with promising benefits in having efficient home-based monitoring of the patients and in reducing financial burden.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1
Figure 1
Prisma flow diagram of study selection.
Figure 2
Figure 2
Forest plot for VO2 peak.
Figure 3
Figure 3
Forest plot for a 6-minute walk test (6MWT).
Figure 4
Figure 4
Forest plot for VO2 peak (supervised vs not supervised control group).
Figure 5
Figure 5
Forest plot for 6MWT (supervised vs not supervised control group).
Figure 6
Figure 6
Leave one out sensitivity analysis for VO2 peak.
Figure 7
Figure 7
Funnel plot for VO2 peak.
Figure 9
Figure 9
Plot of the summary mean difference of intervention versus control and the respective 95% confidence interval (random-effects meta-analysis) for various values of SD of IMDOM under the IMDOM=1 assumption.
Figure 8
Figure 8
Forrest plot showing results of primary and secondary analysis.
See this image and copyright information in PMC

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