Digital home-based multidisciplinary cardiac rehabilitation: How to counteract physical inactivity during the COVID-19 pandemic

Effectiveness of eHealth Interventions on Moderate-to-Vigorous Intensity Physical Activity Among Patients in Cardiac Rehabilitation: Systematic Review and Meta-analysis

“…Interventions varied widely between and among the studies. Seventeen studies used multiple eHealth components [40,[43][44][45]47,48,[50][51][52][53]56,57,60,61,63,67,68], and 12 studies used a single eHealth component [41,42,46,49,54,55,58,59,62,[64][65][66]. Fourteen studies used wearable devices such as heart rate monitors to monitor heart rate or electrocardiography to adjust exercise prescription to reach the target heart rate zone for maintaining optimal levels of physical activity and cardiovascular health [40,43,45,48,60], pedometers or accelerometers to monitor and record physical activity remotely [47,51,52,57,63,64,67,68], and a VTAP device to remind and remain physically active [46].…”

“…The global risk of bias scores ranged from 0 to 6, with a mean score of 3.09. Figure 3 shows the risk of bias summary for non-RCTs [63][64][65][66][67][68], which is drawn with reference to the Review Manager 5.4.1 risk of bias assessment. Because these 6 studies were non-RCTs, the sequence generation and allocation were high risks or unclear risks.…”

“…Because these 6 studies were non-RCTs, the sequence generation and allocation were high risks or unclear risks. Four of these were pre-post studies [65][66][67][68], and there was no baseline comparison between groups; therefore, both baseline outcome measurements and characteristics were high risk. One study [67] did not blind outcome evaluators; therefore, there was a high risk of preventing contamination.…”

“…Eight studies [42,45,51,56,[59][60][61]65] assessed the impact of eHealth interventions on the time spent on vigorous-intensity physical activity (VPA); 7 [42,45,51,56,[59][60][61] were RCTs, and 1 study [65] had a pre-post design. Four [42,45,59,60] of them suggested a trend toward an increase, but the increase was not statistically significant; only 1 study [65] showed statistically significant differences between pre-post results within the group.…”

“…Eight studies [42,45,51,56,[59][60][61]65] assessed the impact of eHealth interventions on the time spent on vigorous-intensity physical activity (VPA); 7 [42,45,51,56,[59][60][61] were RCTs, and 1 study [65] had a pre-post design. Four [42,45,59,60] of them suggested a trend toward an increase, but the increase was not statistically significant; only 1 study [65] showed statistically significant differences between pre-post results within the group. According to the requirements for inclusion in the meta-analysis, 3 eligible studies [42,45,51] (n=424) were meta-analyzed, and the results demonstrated that eHealth interventions increased the time spent on VPA (SMD=0.20, 95% CI 0.00-0.39; P=.048; Q(2)=0.88; P=.64; I 2 =0%), as shown in Figure 6.…”