We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Feasibility, Acceptability, and Clinical Effectiveness of a Technology-Enabled Cardiac Rehabilitation Platform (Physical Activity Toward Health-I): Randomized Controlled Trial.
- Authors
Claes, Jomme; Cornelissen, Véronique; McDermott, Clare; Moyna, Niall; Pattyn, Nele; Cornelis, Nils; Gallagher, Anne; McCormack, Ciara; Newton, Helen; Gillain, Alexandra; Budts, Werner; Goetschalckx, Kaatje; Woods, Catherine; Moran, Kieran; Buys, Roselien
- Abstract
<bold>Background: </bold>Cardiac rehabilitation (CR) is highly effective as secondary prevention for cardiovascular diseases (CVDs). Uptake of CR remains suboptimal (30% of eligible patients), and long-term adherence to a physically active lifestyle is even lower. Innovative strategies are needed to counteract this phenomenon.<bold>Objective: </bold>The Physical Activity Toward Health (PATHway) system was developed to provide a comprehensive, remotely monitored, home-based CR program for CVD patients. The PATHway-I study aimed to investigate its feasibility and clinical efficacy during phase III CR.<bold>Methods: </bold>Participants were randomized on a 1:1 basis to the PATHway (PW) intervention group or usual care (UC) control group in a single-blind, multicenter, randomized controlled pilot trial. Outcomes were assessed at completion of phase II CR and 6-month follow-up. The primary outcome was physical activity (PA; Actigraph GT9X link). Secondary outcomes included measures of physical fitness, modifiable cardiovascular risk factors, endothelial function, intima-media thickness of the common carotid artery, and quality of life. System usability and patients' experiences were evaluated only in PW. A mixed-model analysis of variance with Bonferroni adjustment was used to analyze between-group effects over time. Missing values were handled by means of an intention-to-treat analysis. Statistical significance was set at a 2-sided alpha level of .05. Data are reported as mean (SD).<bold>Results: </bold>A convenience sample of 120 CVD patients (mean 61.4 years, SD 13.5 years; 22 women) was included. The PATHway system was deployed in the homes of 60 participants. System use decreased over time and system usability was average with a score of 65.7 (SD 19.7; range 5-100). Moderate-to-vigorous intensity PA increased in PW (PW: 127 [SD 58] min to 141 [SD 69] min, UC: 146 [SD 66] min to 143 [SD 71] min; Pinteraction=.04; effect size of 0.42), while diastolic blood pressure (PW: 79 [SD 11] mmHg to 79 [SD 10] mmHg, UC: 78 [SD 9] mmHg to 83 [SD 10] mmHg; Pinteraction=.004; effect size of -0.49) and cardiovascular risk score (PW: 15.9% [SD 10.4%] to 15.5% [SD 10.5%], UC: 14.5 [SD 9.7%] to 15.7% [SD 10.9%]; Pinteraction=.004; effect size of -0.36) remained constant, but deteriorated in UC.<bold>Conclusions: </bold>This pilot study demonstrated the feasibility and acceptability of a technology-enabled, remotely monitored, home-based CR program. Although clinical effectiveness was demonstrated, several challenges were identified that could influence the adoption of PATHway.<bold>Trial Registration: </bold>ClinicalTrials.gov NCT02717806; https://clinicaltrials.gov/ct2/show/NCT02717806.<bold>International Registered Report Identifier (irrid): </bold>RR2-10.1136/bmjopen-2017-016781.
- Subjects
CARDIAC rehabilitation; RANDOMIZED controlled trials; CLINICAL trial registries; CARDIOVASCULAR diseases risk factors; PHYSICAL activity; CAROTID intima-media thickness; MENTAL health; QUALITY of life; PILOT projects; RESEARCH; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; EXERCISE
- Publication
Journal of Medical Internet Research, 2020, Vol 22, Issue 2, pN.PAG
- ISSN
1439-4456
- Publication type
journal article
- DOI
10.2196/14221