Maximidou Theodoros, Mons Ute
Cardiovascular Epidemiology of Aging, Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany.
Am J Prev Cardiol. 2025 Jun 6;23:101015. doi: 10.1016/j.ajpc.2025.101015. eCollection 2025 Sep.
To assess the benefits of wearable activity trackers in the treatment and care of patients with coronary artery disease (CAD), we performed a systematic review and meta-analysis.
We systematically searched databases and trial registries until March 2025 for randomized controlled trials employing wearable devices (such as activity tracker, pedometer or accelerometer) in cardiac rehabilitation (CR) interventions in patients with CAD. The outcome data were pooled using fixed-effects meta-analysis. Subgroup analyses were conducted for risk of bias, length of follow up, type of wearable and presence of additional interventions. To assess the robustness of the main findings we carried out sensitivity analyses using random effects models and exclusion of outliers. Outcomes of interest were indicators of prognosis and prognostic factors.
We included a total of 23 studies and synthesized data from 20 studies in meta-analyses. Meta-analysis of steps per day showed a statistically significant difference favouring the intervention (MD 1060 steps/day, 95 % CI 650 to 1460). Subgroup analyses indicated smaller effects for studies with longer follow-up periods, and for those with high risk of bias. Sensitivity analyses showed robustness of these results. Meta-analyses of rehospitalizations (RR 0.70, 95 % CI 0.52 to 0.95), 6 min walking test (MD 13.06 m, 95 % CI 0.10 to 26.03), and absolute VOpeak (MD 0.22 L/min, 95 % CI 0.02 to 0.49) also yielded statistically significant differences favouring the intervention. Findings from other physical performance measures favoured the intervention group without reaching significance. Anthropometric outcomes presented no consistent effect.
Our results indicate that wearables significantly enhance effectiveness of CR by increasing physical activity, improving exercise capacity, and reducing rehospitalizations in CAD patients. This suggests that wearable-supported CR programs may positively affect prognosis in CAD. However, further research is needed to corroborate these findings and to ascertain the sustainability of these effects over the long term.
In our study, we found that wearable activity trackers significantly increased steps per day, improved exercise capacity and reduced rehospitalizations in patients with coronary artery disease compared to usual care. These findings suggest that the implementation of wearable activity trackers into cardiac rehabilitation might improve clinical outcomes and potentially reduce the burden of the disease.
为评估可穿戴活动追踪器在冠状动脉疾病（CAD）患者治疗和护理中的益处，我们进行了一项系统评价和荟萃分析。
我们系统检索了数据库和试验注册库，直至2025年3月，以查找在CAD患者心脏康复（CR）干预中使用可穿戴设备（如活动追踪器、计步器或加速度计）的随机对照试验。使用固定效应荟萃分析汇总结果数据。对偏倚风险、随访时间、可穿戴设备类型和是否存在额外干预进行亚组分析。为评估主要结果的稳健性，我们使用随机效应模型并排除异常值进行敏感性分析。感兴趣的结果是预后指标和预后因素。
我们共纳入23项研究，并在荟萃分析中综合了20项研究的数据。每日步数的荟萃分析显示干预组有统计学显著差异（平均差1060步/天，95%置信区间650至1460）。亚组分析表明，随访期较长的研究以及偏倚风险较高的研究效果较小。敏感性分析显示这些结果具有稳健性。再住院率（风险比0.70，95%置信区间0.52至0.95）、6分钟步行试验（平均差13.06米，95%置信区间0.10至26.03）和绝对峰值摄氧量（平均差0.22升/分钟，95%置信区间0.02至0.49）的荟萃分析也得出了有利于干预组的统计学显著差异。其他身体性能指标的结果有利于干预组，但未达到显著水平。人体测量结果未呈现一致效应。
我们的结果表明，可穿戴设备通过增加身体活动、提高运动能力和减少CAD患者的再住院率，显著提高了CR的有效性。这表明可穿戴设备支持的CR项目可能对CAD患者的预后产生积极影响。然而，需要进一步研究来证实这些发现，并确定这些效果的长期可持续性。
在我们的研究中，我们发现与常规护理相比，可穿戴活动追踪器显著增加了冠状动脉疾病患者的每日步数，提高了运动能力并减少了再住院率。这些发现表明，将可穿戴活动追踪器应用于心脏康复可能会改善临床结果，并有可能减轻疾病负担。
