Abstract
PURPOSE: Contemporary cardiac rehabilitation (CR) has a moderate effect on physical activity (PA), whereas novel technologies offer promise for enhancing PA levels. Therefore, we assessed the effect of a home-based smartphone training program in addition to center-based CR on PA levels in patients with coronary artery disease (CAD). METHODS: CAD patients participating in CR were included in this randomized controlled trial (1:1, stratified for index diagnosis). The control group received usual care CR, whereas the intervention group additionally received a 6-week remote smartphone program. The primary outcome was the change in accelerometer-derived moderate-to-vigorous PA (MVPA) from baseline to post-CR. Secondary outcomes included changes in light intensity PA, step count, sedentary time, functional parameters, quality of life, and cardiac anxiety. A baseline-adjusted linear mixed model was used. RESULTS: Participants (16% female, intervention n = 44, control n = 49) were 63 [56-69] years old and had a baseline MVPA of 1.0 (95% Confidence interval (CI): 0.9; 1.1) h/day. Changes in MVPA did not differ between the intervention (0.1 (95% CI: -0.0; 0.2) h/day) and control group post-CR (0.1 (95% CI: -0.0; 0.2) h/day, p(-interaction) = 0.75). Also, no differences between the groups were observed for light intensity PA (0.5 (95% CI: 0.2; 0.8) versus 0.4 (95% CI: 0.1; 0.8) h/day, p(-interaction) = 0.79). Similarly, changes in other secondary outcomes did not differ among groups. CONCLUSIONS: A smartphone training program on top of the usual CR did not yield additional benefits. A more elaborate mHealth intervention seems needed to change PA during CR in active patients with CAD.