A recent study examining the impact of integrating an mHealth app with wearable devices in cardiac rehabilitation programs found no significant increase in physical activity levels among patients six months post-intervention. Despite delivering tailored text messages, the app failed to sustain long-term improvements. However, previous research indicates that digitally enabled cardiac rehab, including virtual and hybrid services, can be as effective as in-person care, offering comparable benefits such as blood pressure control, walking ability, and anxiety levels.
A recent study investigating the impact of integrating an mHealth application with wearable devices in cardiac rehabilitation programs found that it did not lead to increased physical activity levels among patients six months after the intervention.
Cardiac rehabilitation programs, designed to enhance cardiovascular health after heart-related events or procedures, involve exercise guidance, heart health education, and stress reduction counseling, as outlined by the American Heart Association.
The study, known as the Virtual AppLication-supported Environment To Increase Exercise (VALENTINE) study, was led by Michigan Medicine researchers. Its primary objective was to assess whether an mHealth app delivering personalized text messages could effectively raise physical activity levels for low- and moderate-risk patients participating in center-based cardiac rehabilitation while sustaining these improvements over half a year. The study’s findings were published in npj Digital Medicine.
Between October 23, 2020, and March 25, 2022, the research team screened 940 patients for eligibility, with 220 individuals included in the primary analysis—109 received the mHealth intervention, while 111 were part of the control group.
Patients in the intervention group received an mHealth app integrated with their wearable devices, enabling activity tracking, goal setting, and personalized text messages to encourage physical activity. On average, they received 163.1 activity-related text messages and 82.9 exercise-related messages during the study.
Results showed that the baseline six-minute walk distance was 492.1 meters for the control group and 510.8 meters for the intervention group. After six months, the six-minute walk distance had increased to 505.9 meters for the control group and 530.3 meters for the intervention group.
The study authors noted, “In a univariate regression analysis, mean change in 6 min walk distance for the intervention group as compared to the control group was + 31.1 meters for Apple Watch users and −7.4 meters for Fitbit users, which was not statistically significant.”
However, there was a statistically significant change in the mean change in the six-minute walk distance at three months compared to baseline for Fitbit users in the intervention group, although this change was not maintained at the six-month mark.
Dr. Jessica R. Golbus, the study’s first author, commented, “Overall, this study suggests that the intervention did not have a long-term impact on physical activity that was sustained over time but may have intermediate or potentially device-specific effects.” Dr. Golbus is a clinical instructor of internal medicine-cardiology at the University of Michigan Medical School.
Further research is necessary to pinpoint the types of text messages that can most effectively influence specific patient groups. Dr. Golbus added, “We will then use that information to design and deliver a future digital health intervention in which participants receive only the most effective text messages.”
Despite the mixed results of this study, previous research has indicated that digitally enabled cardiac rehabilitation can be just as effective as in-person care. An April 2022 study revealed that virtual and hybrid cardiac rehabilitation services produced similar patient benefits as traditional in-person services.
This study collected data on cardiac rehabilitation patients between October 2019 and May 2021, categorizing outcomes into in-person, hybrid, and virtual care groups for comparison. Results showed that hybrid and virtual cardiac rehabilitation produced similar clinical benefits in terms of blood pressure control, walking ability, and anxiety levels compared to in-person care.
