Abstract
BACKGROUND: Physical exercise is known to enhance vascular function by regulating PPARs, ERs, and RXR signaling pathways. It improves cardiopulmonary capacity through optimized lipid metabolism, immune regulation, and blood pressure reduction. Additionally, exercise reduces postoperative complications by maintaining energy expenditure and skeletal muscle function, which may ultimately improve patients' quality of life (QoL). However, the safety and efficacy of exercise therapy post-endovascular aortic aneurysm repair (EVAR) remain uncertain. Due to the potential impact of exercise training on abdominal pressure, supervised exercise by medical professionals is crucial for ensuring patient safety. Although exercise offers notable benefits, patient adherence tends to be low. Therefore, leveraging smartphones as pervasive monitoring tools may provide timely feedback on patients' exercise status and influence their behavior. This trial aims to assess whether a smartphone-monitored physical exercise management program, including physical exercise interventions under medical supervision for 3 months, affects the short-term QoL of individuals post-EVAR. METHODS: A total of 176 participants with abdominal aortic aneurysms will be recruited from the Department of Vascular Surgery at West China Hospital of Sichuan University. All participants will receive standard medical care according to current guidelines. The experimental group will be monitored via smartphones using WeChat for exercise tracking by medical staff, while the control group will not have real-time monitoring or feedback from mobile health tools. The trial will last 3 months, with assessments at baseline and 3 months. Primary outcomes include QoL assessments at 1 and 3 months post-surgery. Secondary outcomes include exercise capacity, frailty status, muscle strength, resting heart rate, and lung function at 1 and 3 months post-surgery. Additionally, adverse events in the first month post-surgery will be measured, including all-cause mortality, unplanned reoperations, readmissions, endoleaks, major adverse cardiovascular and cerebrovascular events, renal impairment, and pulmonary infections. Exercise-related adverse events, such as falls, injuries, and fractures, will also be assessed. DISCUSSION: The study utilizes smartphones to monitor physical exercise during and after activities. It provides personalized feedback and implements strategies to enhance motivation through engaging activities. The results of this study will provide crucial insights and evidence on the impact of early exercise in patients post-EVAR, guiding the scientific prescription of exercise programs for these patients. Providing exercise instructors and dynamically tailoring exercises to individual cases is crucial for reinforcing patient adherence to smartphone-based tracking and exercise programs. TRIAL REGISTRATION: chictr.org.cn ChiCTR2400083901. Registered on May 7, 2024.