Hatch Victoria, Davies William R
Royal Papworth Hospital Foundation Trust, Cambridge Biomedical Campus, Cambridgeshire CB2 0AY, UK.
Eur Heart J Suppl. 2022 Nov 11;24(Suppl H):H25-H31. doi: 10.1093/eurheartjsupp/suac054. eCollection 2022 Nov.
Wearable activity monitors, together with smartphone-based health and fitness applications (apps), are becoming more accessible and their widespread use provides an additional opportunity for the recording of cardiovascular metrics in patients with cardiovascular disease. The use of selected metrics by cardiac rehabilitation (CR) programmes allows the facilitation of individualized and tailored positive lifestyle changes to patients and places the patient at the centre of their recovery programme. To investigate the role of such devices on outcomes with patients on a CR programme, a cohort/case-control study was conducted. Patients post-myocardial infarction who were treated with either percutaneous coronary intervention or surgical coronary revascularisation at a single centre were invited to use a physical activity monitor linked to a customized app at their initial assessment for the rehabilitation programme. Those who accepted were allocated to the treatment group. The control group was selected from a larger pool of 400 historical and concurrent patients. Propensity matching was used to associate each case with their closest control. The changes in self-reported physical activity were similar for both groups at the end of the CR programme (EOP). The digitally monitored group tended to achieve greater METS (metabolic equivalent of task - a measure of exercise intensity) at 12 weeks ( < 0.059); however, no difference was observed in the overall change in METS at EOP ( < 0.333). Although no difference was noted in diastolic blood pressure, a statistically significant drop in the systolic blood pressure in the digitally monitored group ( < 0.004) was detected. In this study, the innovative combination of technology and face-to-face CR showed promising results and assisted the individualization of delivered content. This intervention could easily be replicated and expanded. Challenges are the recruitment of the elderly population, those who may be less engaged with or have less access to technology, and the underrepresentation of women in the study sample.
可穿戴活动监测器，连同基于智能手机的健康与健身应用程序（应用），正变得越来越普及，其广泛使用为记录心血管疾病患者的心血管指标提供了额外机会。心脏康复（CR）项目对特定指标的使用有助于为患者促成个性化且量身定制的积极生活方式改变，并将患者置于其康复计划的中心位置。为了研究此类设备对参加CR项目患者的治疗效果的作用，开展了一项队列/病例对照研究。在单一中心接受经皮冠状动脉介入治疗或外科冠状动脉血运重建术的心肌梗死后患者，在其康复计划的初始评估时被邀请使用与定制应用程序相连的身体活动监测器。接受邀请的患者被分配到治疗组。对照组从400名历史和同期患者的更大群体中选取。采用倾向匹配法将每个病例与其最接近的对照进行关联。在CR项目结束时（EOP），两组自我报告的身体活动变化相似。数字监测组在12周时往往能达到更高的代谢当量（任务代谢当量——运动强度的一种度量）（<0.059）；然而，在EOP时代谢当量的总体变化中未观察到差异（<0.333）。虽然舒张压没有差异，但在数字监测组中检测到收缩压有统计学意义的下降（<0.004）。在本研究中，技术与面对面CR的创新结合显示出了有前景的结果，并有助于所提供内容的个性化。这种干预措施可以很容易地复制和扩展。挑战在于招募老年人群体，即那些可能较少接触或难以获得技术的人群，以及研究样本中女性代表性不足的问题。
