Smartphone apps, fitness trackers and wearable devices help people with heart disease get more physical activity in their daily lives, according to an analysis of previous research published today in the Journal of the American Heart Association, an open-access, peer-reviewed journal of the American Heart Association.
Physical activity is crucial for preventing additional cardiovascular events among people with cardiovascular disease, however, “many people with cardiovascular disease can’t participate in traditional cardiac rehabilitation programs because of time, distance or financial barriers,” said Ajith Vemuri, Ph.D., the study’s lead author and a staff scientist in neurology at Penn State Health Milton S. Hershey Medical Center in Hershey, Pennsylvania.
“Smartphones and wearables are already in people’s pockets and on their wrists. When we show that these devices can effectively support routine care, we can start designing cost-effective, personalized digital interventions that reach a much wider population,” he said.
Digital devices can set personalized daily step goals, generate reminders or motivational messages, give feedback on progress or link home-based rehabilitation programs to health care professionals to help guide and monitor treatment. Some of the applications also included gamification (such as quizzes or rewards), coaching and goal review, allowing people to track their progress and adjust their activity goals.
“These devices are not just gadgets,” added Ramin Zand, M.D., M.P.H., the study’s senior author and a professor of neurology and public health at Penn State College of Medicine in Hershey, Pennsylvania. “When included in a treatment plan, they can support routine care and help patients take small yet important steps toward better cardiovascular health.”
In this meta-analysis, researchers reviewed 14 clinical trials including more than 1,000 participants. The analysis found that compared to peers who did not use digital tools, people using smartphone apps or wearable technologies walked nearly 1,100 more steps daily and engaged in about 4 more minutes of moderate-to-vigorous movement per day.
“We noticed that these benefits occurred even though the tools varied and used simple behavior-change methods, such as self-monitoring, feedback and goal setting,” said Zand. “These tools did not significantly improve peak oxygen consumption or walking distance. This means that while digital programs can motivate patients to be more active, longer studies are needed to see if these changes lead to lasting improvement in fitness and overall health outcomes.”
An April 2021 American Heart Association scientific statement, Harnessing Mobile Health Technology for Secondary Cardiovascular Disease Prevention in Older Adults, noted that mobile health technology can encourage lifestyle behavior changes and medication adherence among adults with existing heart disease and those who are 60 years and older.
“Research has shown that fewer than one-third of people with cardiovascular disease are physically active,” said Damon L. Swift, Ph.D., FAHA, the immediate past-chair of the American Heart Association’s Lifestyle Physical Activity Committee and an associate professor of kinesiology at the University of Virginia in Charlottesville. “Combining mobile and wearable technologies with standard preventive measures provides a unique opportunity to potentially further reduce the risk of advanced cardiovascular disease or a second or third CVD event. There is a health benefit from going from inactive to somewhat active and there is reduced risk of death for even getting up to about 7,000 steps per day. Therefore, wearable technology may have a positive impact on cardiovascular disease by encouraging people to be a little more active.”
The analysis included 1,057 participants across 14 trials. Participants in 13 of the trials were adults 18 years or older, while one study’s participants included adolescents ages 12 and older. All participants reviewed for this analysis had diagnosed cardiovascular disease, such as coronary heart disease, heart failure or history of heart attack or stroke. Limitations of the analysis include the lack of a clear picture about sustainability of healthy habits. Also, most people in the trials had coronary heart disease, which means the results may not apply to all cardiovascular conditions.
