Background Cardiovascular diseases (CVDs) cause most deaths globally and can reduce quality of life (QoL) of rehabilitees with cardiac disease. The risk factors of CVDs are physical inactivity and increased BMI. With physical activity, it is possible to prevent CVDs, improve QoL, and help maintain a healthy body mass. Current literature shows the possibilities of digitalization and advanced technology in supporting independent self-rehabilitation. However, the interpretation of the results is complicated owing to the studies’ high heterogeneity. In addition, the added value of this technology has not been studied well, especially in cardiac rehabilitation. Objective We aimed to examine the effectiveness of added remote technology in cardiac rehabilitation on physical function, anthropometrics, and QoL in rehabilitees with CVD compared with conventional rehabilitation. Methods Rehabilitees were cluster randomized into 3 remote technology intervention groups (n=29) and 3 reference groups (n=30). The reference group received conventional cardiac rehabilitation, and the remote technology intervention group received conventional cardiac rehabilitation with added remote technology, namely, the Movendos mCoach app and Fitbit charge accelerometer. The 12 months of rehabilitation consisted of three 5-day in-rehabilitation periods in the rehabilitation center. Between these periods were two 6-month self-rehabilitation periods. Outcome measurements included the 6-minute walk test, body mass, BMI, waist circumference, and World Health Organization QoL-BREF questionnaire at baseline and at 6 and 12 months. Between-group differences were assessed using 2-tailed t tests and Mann-Whitney U test. Within-group differences were analyzed using a paired samples t test or Wilcoxon signed-rank test. Results Overall, 59 rehabilitees aged 41 to 66 years (mean age 60, SD 6 years; n=48, 81% men) were included in the study. Decrement in waist circumference (6 months: 1.6 cm; P=.04; 12 months: 3 cm; P<.001) and increment in self-assessed QoL were greater (environmental factors: 0.5; P=.02) in the remote technology intervention group than the reference group. Both groups achieved statistically significant improvements in the 6-minute walk test in both time frames (P=.01-.03). Additionally, the remote technology intervention group achieved statistically significant changes in the environmental domain at 0-6 months (P=.03) and waist circumference at both time frames (P=.01), and reference group achieve statistically significant changes in waist circumference at 0-6 months (P=.02). Conclusions Remote cardiac rehabilitation added value to conventional cardiac rehabilitation in terms of waist circumference and QoL. The results were clinically small, but the findings suggest that adding remote technology to cardiac rehabilitation may increase beneficial health outcomes. There was some level of systematic error during rehabilitation intervention, and the sample size was relatively small. Therefore, care must be taken when generalizing the study results beyond the target population. To confirm assumptions of the added value of remote technology in rehabilitation interventions, more studies involving different rehabilitees with cardiac disease are required. Trial Registration ISRCTN Registry ISRCTN61225589; https://www.isrctn.com/ISRCTN61225589

Background Overweight and obesity are major problems worldwide, and they lead to an increased risk for several diseases. The use of technology in the treatment of obesity is promising, but in the existing literature, there is considerable uncertainty regarding its efficacy. In this review, we included web- and mobile-based weight loss interventions that were implemented remotely in rehabilitation settings. Objective The aim of this systematic review is to study the effectiveness of physical activity-promoting web- and mobile-based distance weight loss interventions in rehabilitation settings on body composition in comparison with control groups that did not use technology. Methods Studies were searched from 9 databases. The inclusion criteria were as follows: population: age 18-65 years; intervention: physical activity-promoting web- and mobile-based distance weight loss interventions; comparison: control groups without the use of technology; outcome: changes in BMI, waist circumference, or body fat percentage; study design: randomized controlled trial. The quality of the studies was assessed by 2 researchers. Meta-analysis was performed, and we also conducted a meta-regression analysis to evaluate the factors associated with the changes in body composition outcomes if statistical heterogeneity was observed. Results The meta-analysis included 30 studies. The mean quality of the studies was 7 of 13 (SD 1.9; range 3-10). A statistically significant difference was observed in BMI (mean difference [MD] 0.83, 95% CI 0.51-1.15 kg/m2; P<.001), waist circumference (MD 2.45, 95% CI 1.83-3.07 cm; P<.001), and body fat percentage (MD 1.07%, 95% CI 0.74%-1.41%; P<.001) in favor of the weight loss groups using web- or mobile-based interventions. Meta-regression analyses found an association between personal feedback and BMI (P=.04), but other factors did not play a role in explaining statistical heterogeneity. Conclusions Web- and mobile-based distance weight loss interventions significantly reduced BMI, waist circumference, and body fat percentage. Future studies should focus on the comparability of the intervention content. Future studies are needed to better understand weight loss and identify which components are essential in achieving it. Trial Registration PROSPERO CRD42016035831; https://tinyurl.com/7c93tvd4

BACKGROUND Cardiovascular diseases (CVDs) cause the most deaths globally. The risk factors for CVDs are physical inactivity and increased BMI, and cardiac rehabilitees typically have a risk of reduced quality of life. With physical activity, it is possible to prevent CVDs, improve quality of life, and help maintain a healthy body mass. The current literature shows the possibilities of digitalization and advanced technology in supporting independent self-rehabilitation. However, the interpretation of the results is complicated by the high heterogeneity of the studies. In addition, the added value of technology has not been well studied, especially in cardiac rehabilitation. OBJECTIVE The aim of this study was to examine the effectiveness of added remote technology in cardiac rehabilitation on physical function, anthropometrics, and quality of life in CVD participants compared with conventional rehabilitation METHODS Participants were cluster randomized (CRT) into three remote technology intervention groups (n=29) and three reference groups (n=30). The reference groups received conventional cardiac rehabilitation, and the intervention groups received self-rehabilitation intervention with added remote technology, namely, Movendos m-coach-application and a Wrist-worn Fitbit Charge-accelerometer. The twelve months of rehabilitation consisted of three five-day in-rehabilitation periods in the rehabilitation center. Between these periods were two 6-month self-rehabilitation periods. Outcome measurements were the 6-minute walk test, body mass, body mass index, waist circumference, and the Quality of Life-BREF questionnaire at baseline, 6 months and 12 months. Between-group change differences were assessed using independent samples t tests and Mann‒Whitney U test. Within-group change differences were analyzed using a paired samples t test or Wilcoxon signed-rank test. RESULTS Fifty-nine participants (60 ± 6.0 years; 81% men) were included in the study. Waist circumference decreased more [6 months (1.6 cm; P=.04); 12 months (3.0 cm; P<.01)] and self-assessed quality of life increased more (environmental factors; 0.5; P<.05) in the remote technology intervention group than in the reference group. The remote technology intervention group also achieved a statistically significant change in the 6MWT (35.8 m; P=.04) during first 6-month period, but there were no statistically significant changes between groups. CONCLUSIONS Remote cardiac rehabilitation brought added value to conventional cardiac rehabilitation in terms of waist circumference and quality of life. The results were clinically small, but the findings may suggest that adding remote technology to cardiac rehabilitation may increase beneficial health outcomes. The results are indicative of the small intervention and control groups. According to this study, remote rehabilitation may be recommended for cardiac patients. CLINICALTRIAL Registration number ISRCTN61225589

BACKGROUND Overweight and obesity are major problems worldwide and they lead to an increased risk for several diseases. The use of technology in the treatment of obesity is promising, but there is considerable uncertainty regarding its efficacy in the current literature. OBJECTIVE The aim of this systematic review was to study the effectiveness of technology-based distance weight loss interventions in health care on body composition in comparison to control groups that do not use technology. The aim of the meta-regression was to evaluate the factors associated with the changes in body composition outcomes in a comprehensive PICOS -framework. METHODS Studies were searched from eight databases. The inclusion criteria were developed based on the PICOS-framework (population: 18-65 years; intervention: technology-based distance weight loss interventions; comparison: control groups without technology; outcome: BMI, waist circumference or body fat percentage; study design: randomized controlled trial). Meta-analysis and meta-regression were performed. RESULTS The meta-analysis included 30 studies. The quality of the studies was moderate (7/13). A statistically significant difference was observed in BMI (MD 0.83; 95% CI 0.51 to 1.15; P < .0001), waist circumference (MD 2.45; 95% CI 1.83 to 3.07; P < .0001), and body fat percentage (MD 1.07; 95% CI 0.74 to 1.41; P < .0001) in favor of the weight loss groups using technology. According to the findings of the meta-regression, interventions with personal feedback and higher quality of the studies may have been associated with a reduction in waist circumference and lower body fat percentage. CONCLUSIONS Technology-based distance weight loss interventions significantly reduced BMI, waist circumference, and body fat percentage. Future studies should focus on the comparability of the intervention content but also on the relations between the type of technology, behavioral change models, and biopsychosocial factors. CLINICALTRIAL This systematic review is registered in Prospero (CRD42016035831).