Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial

Gade, Josefine Dam; Spindler, Helle; Hollingdal, Malene; Refsgaard, Jens; Dittmann, Lars; Frost, Lars; Mahboubi, Kiomars; Dinesen, Birthe

doi:10.2196/20776

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…However, physical capacity or physical activity can be measured by other methods. In a RCT with patients with HF enrolled in a telerehabilitation program, Gade et al [ 24 ], whose study was not included in this review, measured physical activity using a Fitbit step counter for 1 year. The study found no increase in the number of steps.…”

Section: Discussionmentioning

confidence: 99%

“…However, a significant correlation was found between the increased number of steps and the reduction in the ejection fraction. Furthermore, it was found that a step counter can be a useful tool to help patients monitor their own physical activity [ 24 ]. These findings suggest that measurement of patients’ physical activity can be carried out using technologies such as a step counter instead of tests.…”

Section: Discussionmentioning

confidence: 99%

“…Other types of technologies used were different types of ECG recorders, blood pressure meter, weight scale, saturation device, respirometer video, oximeter sphygmomanometer, computer, and others ( Table 1 ) [ 7 , 13 - 23 ]. However, other studies on telerehabilitation use among patients with HF and patients with other cardiac disorders utilized technologies such as pedometers, sleep sensors, tablets, online portals, and apps [ 24 - 26 ]. This suggests that other studies will employ additional, more advanced, and newer technologies than the ones mentioned in this review, such as wearables.…”

Section: Discussionmentioning

confidence: 99%

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Effects of Telerehabilitation Interventions on Heart Failure Management (2015-2020): Scoping Review

Schacksen¹,

Henneberg²,

Muthulingam³

et al. 2021

JMIR Rehabil Assist Technol

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Background Heart failure is one of the world’s most frequently diagnosed cardiovascular diseases. An important element of heart failure management is cardiac rehabilitation, the goal of which is to improve patients’ recovery, functional capacity, psychosocial well-being, and health-related quality of life. Patients in cardiac rehabilitation may lack sufficient motivation or may feel that the rehabilitation process does not meet their individual needs. One solution to these challenges is the use of telerehabilitation. Although telerehabilitation has been available for several years, it has only recently begun to be utilized in heart failure studies. Especially within the past 5 years, we now have several studies focusing on the effectiveness of telerehabilitation for heart failure management, all with varying results. Based on a review of these studies, this paper offers an assessment of the effectiveness of telerehabilitation as applied to heart failure management. Objective The aim of this scoping review was to assess the effects of telerehabilitation in the management of heart failure by systematically reviewing the available scientific literature within the period from January 1, 2015, to December 31, 2020. Methods The literature search was carried out using PubMed and EMBASE. After duplicates were removed, 77 articles were screened and 12 articles were subsequently reviewed. The review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews) guidelines. As measures of the effectiveness of telerehabilitation, the following outcomes were used: patients’ quality of life, physical capacity, depression or anxiety, and adherence to the intervention. Results A total of 12 articles were included in this review. In reviewing the effects of telerehabilitation for patients with heart failure, it was found that 4 out of 6 randomized controlled trials (RCTs), a single prospective study, and 4 out of 5 reviews reported increased quality of life for patients. For physical capacity, 4 RCTs and 3 systematic reviews revealed increased physical capacity. Depression or depressive symptoms were reported as being reduced in 1 of the 6 RCTs and in 2 of the 5 reviews. Anxiety or anxiety-related symptoms were reported as reduced in only 1 review. High adherence to the telerehabilitation program was reported in 4 RCTs and 4 reviews. It should be mentioned that some of the reviewed articles described the same studies although they employed different outcome measures. Conclusions It was found that there is a tendency toward improvement in patients’ quality of life and physical capacity when telerehabilitation was used in heart failure management. The outcome measures of depression, anxiety, and adherence to the intervention were found to be positive. Additional research is needed to determine more precise and robust effects of telerehabilitation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of Telerehabilitation Interventions on Heart Failure Management (2015-2020): Scoping Review

Schacksen¹,

Henneberg²,

Muthulingam³

et al. 2021

JMIR Rehabil Assist Technol

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, older adults with HF often suffer from frailty and fatigue; therefore, it may be harder for them to reach the optimal step levels. In a recent study that examined the walking activity of adults with HF using a step counter over a year, younger age, higher ejection fraction, and lower HF classification were found to be significantly correlated with the number of daily steps [ 68 ]. Whether modest increases in steps result in health benefits among older adults with HF remains to be seen and may signify a need for additional supportive or palliative interventions that relieve physical or mental symptom burden to ensure optimal quality of life among patients with HF [ 69 ].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a Sensor-Controlled Digital Game for Heart Failure Self-management: Randomized Controlled Trial

Radhakrishnan¹,

Julien²,

Baranowski³

et al. 2021

JMIR Serious Games

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Background Poor self-management of heart failure (HF) contributes to devastating health consequences. Our innovative sensor-controlled digital game (SCDG) integrates data from sensors to trigger game rewards, progress, and feedback based on the real-time behaviors of individuals with HF. Objective The aim of this study is to compare daily weight monitoring and physical activity behavior adherence by older adults using an SCDG intervention versus a sensors-only intervention in a feasibility randomized controlled trial. Methods English-speaking adults with HF aged 55 years or older who owned a smartphone and could walk unassisted were recruited from Texas and Oklahoma from November 2019 to August 2020. Both groups were given activity trackers and smart weighing scales to track behaviors for 12 weeks. The feasibility outcomes of recruitment, retention, intervention engagement, and satisfaction were assessed. In addition to daily weight monitoring and physical activity adherence, the participants’ knowledge, functional status, quality of life, self-reported HF behaviors, motivation to engage in behaviors, and HF-related hospitalization were also compared between the groups at baseline and at 6, 12, and 24 weeks. Results A total of 38 participants with HF—intervention group (IG; 19/38, 50%) and control group (CG; 19/38, 50%)—were enrolled in the study. Of the 38 participants, 18 (47%) were women, 18 (47%) were aged 65 years or older, 21 (55%) had been hospitalized with HF in the past 6 months, and 29 (76%) were White. Furthermore, of these 38 participants, 31 (82%)—IG (15/19, 79%) and CG (16/19, 84%)—had both weight monitoring and physical activity data at the end of 12 weeks, and 27 (71%)—IG (14/19, 74%) and CG (13/19, 68%)—participated in follow-up assessments at 24 weeks. For the IG participants who installed the SCDG app (15/19, 79%), the number of days each player opened the game app was strongly associated with the number of days the player engaged in weight monitoring (r=0.72; P=.04) and the number of days with physical activity step data (r=0.9; P<.001). The IG participants who completed the satisfaction survey (13/19, 68%) reported that the SCDG was easy to use. Trends of improvement in daily weight monitoring and physical activity in the IG, as well as within-group improvements in HF functional status, quality of life, knowledge, self-efficacy, and HF hospitalization in both groups, were observed in this feasibility trial. Conclusions Playing an SCDG on smartphones was feasible and acceptable for older adults with HF for motivating daily weight monitoring and physical activity. A larger efficacy trial of the SCDG intervention will be needed to validate trends of improvement in daily weight monitoring and physical activity behaviors. Trial Registration ClinicalTrials.gov NCT03947983; https://clinicaltrials.gov/ct2/show/NCT03947983

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“…Other types of technologies used were different types of ECG recorders, blood pressure meter, weight scale, saturation device, respirometer video, oximeter sphygmomanometer, computer, and others (Table 1) [7,[13][14][15][16][17][18][19][20][21][22][23]. However, other studies on telerehabilitation use among patients with HF and patients with other cardiac disorders utilized technologies such as pedometers, sleep sensors, tablets, online portals, and apps [24][25][26]. This suggests that other studies will employ additional, more advanced, and newer technologies than the ones mentioned in this review, such as wearables.…”

Section: Principal Findingsmentioning

confidence: 99%

Effects of Telerehabilitation Interventions on Heart Failure Management (2015-2020): Scoping Review (Preprint)

Schacksen¹,

Henneberg²,

Muthulingam³

et al. 2021

Preprint

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BACKGROUND Heart failure is one of the world’s most frequently diagnosed cardiovascular diseases. An important element of heart failure management is cardiac rehabilitation, which aims to improve patients’ recovery, functional capacity, psychosocial well-being, and health-related quality of life. Patients in cardiac rehabilitation may lack sufficient motivation or feel that the rehabilitation process does not meet their individual needs. One solution to these challenges is the use of telerehabilitation. Although telerehabilitation has been available for several years, it is only in recent years that it has been utilized in heart failure studies. Especially within the past five years, we now have several studies focusing on the effectiveness of telerehabilitation for heart failure management, and the studies show varying results. Based on these studies, this paper provides a review and assessment of the general effectiveness of telerehabilitation as applied to heart failure management. OBJECTIVE The aim of this scoping review is to assess the effects of telerehabilitation in the management of heart failure by systematically reviewing the available scientific literature within the period from January 1st 2015 to December 31st 2020. METHODS The literature search was performed using PubMed and EMBASE. After duplicates were removed, 77 articles were screened and reviewed, of which 12 articles were included in this review. As measures of the effectiveness of telerehabilitation, the following outcomes were used: patient’s quality of life, physical capacity, depression/anxiety, and adherence to the intervention. RESULTS In reviewing the effects of telerehabilitation for heart failure patients, it was found that, 4 out of 6 randomized control trials, the single prospective study, and 4 out of 5 reviews reported increased quality of life for patients. For physical capacity, 4 randomized control trials and 3 systematic reviews revealed increased physical capacity. Depression or depressive symptoms was reported as reduced in 1 of the 6 randomized control trials and in 2 of the 5 reviews. Anxiety or anxiety-related symptoms was only reported as reduced in only 1 review. High adherence to the telerehabilitation program was reported in 4 randomized control trials and 4 reviews. It should be mentioned that some of the reviewed articles described the same studies although they used different outcome measures. CONCLUSIONS Telerehabilitation is still a relatively new approach to heart failure patients. It was found that there is a tendency toward improvement in patients’ quality of life and physical capacity. The outcome measures of depression, anxiety and adherence to the intervention were found to be positive. More research is needed to determine more precise and robust effects on the respective outcomes in telerehabilitation.

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Predictors of Walking Activity in Patients With Systolic Heart Failure Equipped With a Step Counter: Randomized Controlled Trial

Cited by 4 publications

References 20 publications

Effects of Telerehabilitation Interventions on Heart Failure Management (2015-2020): Scoping Review

Effects of Telerehabilitation Interventions on Heart Failure Management (2015-2020): Scoping Review

Feasibility of a Sensor-Controlled Digital Game for Heart Failure Self-management: Randomized Controlled Trial

Effects of Telerehabilitation Interventions on Heart Failure Management (2015-2020): Scoping Review (Preprint)

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