Abstract
BACKGROUND: Cardiac rehabilitation using mobile health is increasingly being described as effective in improving exercise habits and physical function. However, the effectiveness of combined mobile health and hospital-based cardiac rehabilitation in older patients with cardiovascular disease is unknown. OBJECTIVE: To investigate the effect of a wearable watch device combined with hospital-based cardiac rehabilitation in older patients with cardiovascular disease compared with those with usual care. METHODS: A randomized, controlled trial was conducted in patients with cardiovascular disease aged ⩾60 years who underwent hospital-based cardiac rehabilitation. The patients were randomized 1:1 in those with a wearable watch (Fitbit Versa 3) or usual care. During out-of-hospital cardiac rehabilitation, patients with a wearable watch were advised to check their heart rate with a wearable watch and to target their physical activity at the heart rate determined by cardiopulmonary exercise testing. The primary endpoint was a change in physical activity obtained from the International Physical Activity Questionnaire (metabolic equivalents [METs]-minute/week) between the 2 groups during 12 weeks. RESULTS: Among 39 patients (median age = 73 years, 82% men), the change in physical activity was significantly greater in patients with a wearable watch than in those with usual care (median: 2073 [1155-4400] vs 148 [-1261-899] METs-minute/week; analysis of covariance; P < .001). In patients with a wearable watch, 6-minute walk distance, the peak oxygen uptake, peak METs, and anaerobic threshold were significantly improved, whereas no significant increase was observed in patients with usual care from baseline to 12 weeks. CONCLUSIONS: In older patients with cardiovascular disease, a wearable watch device combined with hospital-based cardiac rehabilitation increases physical activity and improves exercise capacity outside of hospital.