Effectiveness of Mobile Health–Based Exercise Interventions for Patients with Peripheral Artery Disease: Systematic Review and Meta-Analysis

Abstract

Background Peripheral artery disease (PAD) affects over 236 million people worldwide, and exercise interventions are commonly used to alleviate symptoms of this condition. However, no previous systematic review has evaluated the effects of mobile health (mHealth)–based exercise interventions for patients with PAD. Objective This study aimed to assess the effect of mHealth-based exercise interventions on walking performance, functional status, and quality of life in patients with PAD. Methods A systematic review and meta-analysis were conducted. We searched in seven databases to identify randomized controlled trials of patients with PAD published in English up to December 4, 2020. Studies were included if patients participated in mHealth-based exercise interventions and were assessed for walking performance. We analyzed pooled effect size on walking performance, functional status, and quality of life based on the standardized mean differences between groups. Results A total of seven studies were selected for the systematic review, and six studies were included in the meta-analysis. The duration of interventions in the included studies was 12 to 48 weeks. In the pooled analysis, when compared with the control groups, the mHealth-based exercise intervention groups were associated with significant improvements in pain-free walking (95% CI 0.13-0.88), maximal walking (95% CI 0.03-0.87), 6-minute walk test (6MWT) distance (95% CI 0.59-1.24), and walking distance (95% CI 0.02-0.49). However, benefits of the interventions on walking speed, stair-climbing ability, and quality of life were not observed. Conclusions mHealth-based exercise interventions for patients with PAD were beneficial for improving pain-free walking, maximal walking, and 6MWT distance. We found that exercise interventions using mHealth are an important strategy for improving the exercise effectiveness and adherence rate of patients with PAD. Future studies should consider the use of various and suitable functions of mHealth that can increase the adherence rates and improve the effectiveness of exercise.

mHealth Research for Weight Loss, Physical Activity, and Sedentary Behavior: Bibliometric Analysis

“…It also facilitates the tracking of activity, behavior, and weight, allowing for real-time recording, feedback, and accountability [ 27 ]. Previous studies have shown that mHealth technologies support a reduction in obesity, improving physical activity and reducing the risk of developing life-threatening complications [ 28 - 30 ].…”

Functional Status and Health-Related Quality of Life in Patients with Peripheral Artery Disease: A Cross-Sectional Study

“…The percentages of participants who showed difficulty in walking a distance of 200 m, walking at an average speed, and climbing three flights of stairs were 37.7%, 54.7%, and 59.4%, respectively. According to previous meta-reviews, structured exercise interventions improved objective walking performance and subjective functional status [13,33]. Therefore, to improve the HRQOL for PAD patients, healthcare providers should establish strategies to improve walking performance and subjective functional status through structured exercise interventions.…”

Is It Really Home-Based? A Commentary on the Necessity for Accurate Definitions across Exercise and Physical Activity Programmes

“…The degree of supervision can range from directly monitoring the exercise in person, to facilitating a programme with scheduled check-ins, to an absence of any supervision. Frequency of in-person check ins can range from weekly to monthly, and more recently, remote check ins via telephone or video calls have been implemented [2,[11][12][13][14]. The COVID-19 pandemic has not only highlighted the need for this remote option, but also participant receptivity to such methods by alleviating for example time and travel burdens.…”