Impact of wearable physical activity monitoring devices with exercise prescription or advice in the maintenance phase of cardiac rehabilitation: systematic review and meta-analysis
Open accessAbstract
Physical activity (PA) is a component of cardiac rehabilitation (CR). However, life-long engagement in PA is required to maintain benefits gained. Wearable PA monitoring devices (WPAM) are thought to increase PA. There appear to be no reviews which investigate the effect of WPAM in cardiac populations. We firstly aimed to systematically review randomised controlled trials within the cardiac population that investigated the effect WPAM had through the maintenance phase of CR. We specifically examined the effect on cardiorespiratory fitness (CRF), amount and intensity of daily PA, and sedentary time. Secondly, we aimed to collate outcome measures reported, reasons for drop out, adverse events, and psychological impact from utilising a WPAM. A systematic search (up to January 2019) of relevant databases was completed, followed by a narrative synthesis, meta-analysis and qualitative analysis. Nine studies involving 1,352 participants were included. CRF was improved to a greater extent in participants using WPAM with exercise prescription or advice compared with controls (MD 1.65 mL/kg/min;95% confidence interval [CI; 0.64–2.66]; p = 0.001; I 2 = 0%). There was no significant between group difference in six-minute walk test distance. In 70% of studies, step count was greater in participants using a WPAM with exercise prescription or advice, however the overall effect was not significant (SMD 0.45;95% [CI; − 0.17-1.07] p = 0.15; I 2 = 81%). A sensitivity analysis resulted in significantly greater step counts in participants using a WPAM with exercise prescription or advice and reduced the heterogeneity from 81 to 0% (SMD 0.78;95% [CI;0.54–1.02]; p < 0.001; I 2 = 0%). Three out of four studies reporting on intensity, found significantly increased time spent in moderate and moderate-vigorous intensity PA. No difference between groups was found for sedentary time. Three of six studies reported improved psychological benefits. No cardiac adverse events related to physical activity were reported and 62% of non-cardiac adverse events were primarily musculoskeletal injuries. Reasons for dropping out included medical conditions, lack of motivation, loss of interest, and technical difficulties. Our meta-analysis showed WPAM with exercise prescription or advice are superior to no device in improving CRF in the maintenance phase of CR and no cardiac adverse events were reported with WPAM use. Our qualitative analysis showed evidence in favour of WPAM with exercise prescription or advice for both CRF and step count. WPAM with exercise prescription or advice did not change sedentary time. Psychological health and exercise intensity may potentially be enhanced by WPAM with exercise prescription or advice, however further research would strengthen this conclusion. PROSPERO Registration Number: CRD42019106591.
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Home-based cardiac telerehabilitation using wearable sensors is equivalent or better than centre-based rehabilitation and can increase access to cardiac rehabilitation and reduce the cost.
“Home-based cardiac telerehabilitation using wearable sensors is equivalent or better than centre-based rehabilitation and can increase access to cardiac rehabilitation and reduce the cost”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [86]
A systematic review and meta-analysis of nine trials in patients with cardiovascular disease found that wearable monitors of physical activity that included exercise prescription or advice were superior to no device in improving fitness and step count in the maintenance phase of cardiac rehabilitation.
“Furthermore, a systematic review and meta-analysis of nine trials of patients with cardiovascular disease demonstrated that wearable monitors of physical activity that included exercise prescription or advice were superior to no device in improving fitness and step count in the maintenance phase of cardiac rehabilitation86.”
From Smart wearable devices in cardiovascular care: Where we are and how to move forward (2021) · cites this paper as [86]
A meta-analysis of 9 trials that evaluated wearable monitors of physical activity in patients with cardiovascular disease showed that exercise prescription and monitoring via a wearable device was superior to no device, and increased adherence to rehabilitation plans.
“Furthermore, a meta-analysis of 9 trials that evaluated wearable monitors of physical activity in patients with cardiovascular disease showed that exercise prescription and monitoring via a wearable device was superior to no device, and increased adherence to rehabilitation plans.44”
From Unlocking Tomorrow’s Health Care: Expanding the Clinical Scope of Wearables by Applying Artificial Intelligence (2024) · cites this paper as [44]
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- [58]Kennelly J Handler A Reducing racial/ethnic disparities in reproductive and perinatal outcomes:the evidence for population-based intervention 2011 New York Springer
- [68]Butler L Furber S Phongsavan P Mark A Bauman A Effects of a pedometer-based intervention on physical activity levels after cardiac rehabilitation. A randomised controlled trial J Cardiopulm Rehabil and Prev 2009 29 105 114 10.1097/HCR.0b013e31819a01ff 19305235 · DOI
Cited by
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Smart wearable devices in cardiovascular care: Where we are and how to move forward
Bayoumy, K., Gaber, M., Elshafeey, A., Mhaimeed, O., Dineen, E. H., Marvel, F. A., Martin, S. S., Muse, E. D., Turakhia, M. P., Tarakji, K. G., et al. (2021) · Nature Reviews Cardiology · doi:10.1038/s41569-021-00522-7 · Cited by 829 · see citing works
Ferguson, T., Olds, T., Curtis, R., Blake, H., Crozier, A. J., Dankiw, K., Dumuid, D., Kasai, D., O'Connor, E., Virgara, R., et al. (2022) · The Lancet Digital Health · doi:10.1016/s2589-7500(22)00111-x · Cited by 560 · see citing works
Hutchesson, M. J., Gough, C., Müller, A. M., Short, C. E., Whatnall, M. C., Ahmed, M., Pearson, N., Yin, Z., Ashton, L. M., Maher, C., et al. (2021) · Obesity Reviews · doi:10.1111/obr.13295 · Cited by 60 · see citing works
Marvasti, T. B., Gao, Y., Murray, K. R., Hershman, S., McIntosh, C., & Moayedi, Y. (2024) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2024.07.009 · Cited by 35 · see citing works
- Authors
- Hannan, A. L., Harders, M. P., Hing, W., Climstein, M., Coombes, J. S., & Furness, J.
- Affiliations
- Bond University (AU)
- The University of Sydney (AU)
- The University of Queensland (AU)
- Corresponding author
- Hannan, Amanda L.
- Venue
- BMC Sports Science, Medicine and Rehabilitation
- Published
- 2019-07-30
- Volume
- 11
- Issue
- 1
- Pages
- 14-14
- ISSN
- 2052-1847 (ISSN-L)
- PMC
- PMC6668165
- OpenAlex
- W2966673978
- Cited by
- 119
- References
- 90
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 24 · 2023: 17 · 2022: 19 · 2021: 21 · 2020: 4 · 2019: 1
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Sports Science Medicine and Rehabilitation (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Bond University Research Portal (Bond University) (submittedVersion, cc-by)
- Cross Connect (Southern Cross University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Bond University
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- wearable activity trackers, cardiac rehabilitation, exercise prescription, physical activity maintenance, cardiorespiratory fitness, step count, moderate-to-vigorous physical activity, sedentary time, psychological impact, adverse events, dropout, musculoskeletal injuries, 6-minute walk test, exercise adherence, digital health interventions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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