Background Cardiac rehabilitation is a class IA recommendation for patients with cardiovascular diseases. Physical activity is the core component and core competency of a cardiac rehabilitation program. However, many patients with cardiovascular diseases are failing to meet cardiac rehabilitation guidelines that recommend moderate-to-vigorous intensity physical activity. Objective The major objective of this study was to review the evidence of the effectiveness of eHealth interventions in increasing moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation. The secondary objective was to examine the effectiveness of eHealth interventions in improving cardiovascular-related outcomes, that is, cardiorespiratory fitness, waist circumference, and systolic blood pressure. Methods A comprehensive search strategy was developed, and a systematic search of 4 electronic databases (PubMed, Web of Science, Embase, and Cochrane Library) was conducted for papers published from the start of the creation of the database until November 27, 2022. Experimental studies reporting on eHealth interventions designed to increase moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation were included. Multiple unblinded reviewers determined the study eligibility and extracted data. Risk of bias was evaluated using the Cochrane Collaboration Tool for randomized controlled trials and the Cochrane Effective Practice and Organization of Care group methods for nonrandomized controlled trials. A random-effect model was used to provide the summary measures of effect (ie, standardized mean difference and 95% CI). All statistical analyses were performed using Stata 17. Results We screened 3636 studies, but only 29 studies were included in the final review, of which 18 were included in the meta-analysis. The meta-analysis demonstrated that eHealth interventions improved moderate-to-vigorous intensity physical activity (standardized mean difference=0.18, 95% CI 0.07-0.28; P=.001) and vigorous-intensity physical activity (standardized mean difference=0.2, 95% CI 0.00-0.39; P=.048) but did not improve moderate-intensity physical activity (standardized mean difference=0.19, 95% CI –0.12 to 0.51; P=.23). No changes were observed in the cardiovascular-related outcomes. Post hoc subgroup analyses identified that wearable-based, web-based, and communication-based eHealth intervention delivery methods were effective. Conclusions eHealth interventions are effective at increasing minutes per week of moderate-to-vigorous intensity physical activity among patients in cardiac rehabilitation. There was no difference in the effectiveness of the major eHealth intervention delivery methods, thereby providing evidence that in the future, health care professionals and researchers can personalize convenient and affordable interventions tailored to patient characteristics and needs to eliminate the inconvenience of visiting center-based cardiac rehabilitation programs during the COVID-19 pandemic and to provide better support for home-based maintenance of cardiac rehabilitation. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42021278029; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=278029

BACKGROUND Cardiac rehabilitation is a class IA recommendation for patients with cardiovascular diseases. Physical activity is the core component and core competency of cardiac rehabilitation program. However, many patients with cardiovascular diseases are failing to meet cardiac rehabilitation guidelines that recommend moderate-to-vigorous intensity physical activity. OBJECTIVE The major objective of this study was to review the evidence of the effectiveness of eHealth interventions to increase moderate-to-vigorous intensity physical activity among cardiac rehabilitation participants and provide evidence-based support for health care professionals and researchers. The secondary objective was to examine the effectiveness on improving cardiovascular-related outcomes, namely cardiorespiratory fitness, waist circumference and systolic blood pressure. METHODS A comprehensive search strategy was developed for four electronic databases (PubMed, Web of Science, Embase and The Cochrane Library), through December 16, 2021. Experimental studies reporting on eHealth interventions designed to increase moderate-to-vigorous intensity physical activity among cardiac rehabilitation participants were included. Multiple, not-blind reviewers determined study eligibility and extracted data. Risk of bias was evaluated using the Cochrane Collaboration Tool for randomized controlled trials and using the Effective Practice and Organization of Care Cochrane Review Group for non-randomized controlled trials. A random-effect model was used to provide summary measures of effect (standardized mean difference and 95% confidence interval). All statistical analyses were performed using Stata 17. RESULTS We screened 2,560 records; 22 studies (n = 2,194) were included in the review of which 16 were in meta-analysis. The meta-analysis demonstrated eHealth interventions improved moderate-to-vigorous intensity physical activity (standardized mean differences = 0.16, 95% confidence interval: 0.05 to 0.27, P = 0.004) and vigorous intensity physical activity (standardized mean differences = 0.2, 95% confidence interval: 0.00 to 0.39, P = 0.048), but did not improve moderate intensity physical activity (standardized mean differences = 0.19, 95% confidence interval: -0.12 to 0.51, P = 0.233). No changes were observed in cardiovascular-related outcomes. Post hoc subgroup analysis identified that wearable-based, web-based and communication-based eHealth intervention delivery methods were effective. CONCLUSIONS eHealth interventions are effective at increasing minutes per week of moderate-to-vigorous intensity physical activity among cardiac rehabilitation participants. Moreover, the effectiveness of the major eHealth intervention delivery methods was no difference, providing evidence that in the future, the health care professionals and researchers can personalize convenient and affordable interventions tailored to patient characteristics and needs. To eliminates the inconvenience of visiting center-based cardiac rehabilitation during the COVID-19 pandemic and to better provide support for home-based maintenance cardiac rehabilitation. CLINICALTRIAL The PROSPERO registration number is CRD42021278029 and registration date is September 17, 2021.

Negative pressure wound therapy (NPWT) with or without instillation has been extensively applied for patients with multiple wound types. Whether NPWT with instillation is superior to NPWT alone is not known. This study aims to compare the efficacy between negative pressure wound therapy with instillation (NPWTi) and standard negative pressure wound therapy for wounds. The authors searched for randomised controlled trials (RCTs) in PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials investigating clinical outcomes of negative pressure wound therapy with instillation vs standard negative pressure wound therapy for wounds. The registration number (protocol) on PROSPERO is CRD42022287178. Eight RCTs involved 564 patients met the inclusion criteria and were included finally. NPWTi showed a significant fewer surgeries and dressing changes (RR and 95% CI, −9.31 [−17.54, −1.08], P < 0.05), and smaller wound area after treatment (RR and 95% CI, −9.31 [−17.54, −1.08], P < 0.05) compared with NPWT. No significant difference was observed on healing rate, time to heal, length of stay, dehiscence, reinfection, reoperation and readmission between NPWTi and NPWT. The addition of instillation to NPWT could improve clinical outcomes regarding the number of surgeries and dressing changes, and wound area after treatment in patients with multiple wound types. However, because of the heterogeneity these conclusions still need to be further validated by more well‐designed RCTs with large sample sizes.