Efficacy of a technology enabled home-based cardiac rehabilitation Program on aerobic fitness, vascular health and cardiovascular disease risk factors

Although cardiac rehabilitation (CR) is part of the current multidisciplinary approach to the management of cardiovascular disease (CVD), uptake and adherence is low. Reasons are multifactorial and include, time, accessibility, transport issues and motivation. Advances in technology have the potential to enable the delivery of home-based CR (HBCR). The purpose of this PhD research program was to evaluate the efficacy of a technology enabled HBCR program (PATHway) compared to usual care (UC) Study 1 Heart rate (HR) monitoring using wrist-worn watches allows patients to monitor and adjust their exercise intensity to meet their rehabilitation goals. This study assessed the accuracy of commercially available wristwatch HR monitors. There was a significant correlation between wrist-worn monitors and the criterion measure (3-lead Holter monitor) at both rest and during exercise with appropriate limits of agreement. Study 2 Exercise training is one of the core elements of CR. This study assessed exercise session duration, physiological and perceptual responses of participants (n=53) using PATHway, a 6 month, home-based technology enabled CR program. Participants used the PATHway system for an average of 36 min per session at an intensity corresponding to 67% HRR. The average RPE per sessions was 5.2 on the 0-10 Borg scale. Study 3 Study 3 compared anthropometric measures, cardiorespiratory fitness, strength (sit-to-stand, isokinetic and isometric strength and hand grip), vascular structure (cIMT) and function (FMD) and blood biomarkers between CVD patients (n=120) randomized to PATHway and UC. There was no change in cardiorespiratory fitness, strength, vascular structure or function in either PATHway or UC at 6-months