scholarly journals Digital Interventions for Cardiac Rehabilitation: A Systematic Literature Review (Preprint)

2020 ◽  
Author(s):  
Shannon Wongvibulsin ◽  
Evagelia E Habeos ◽  
Pauline P Huynh ◽  
Helen Xun ◽  
Rongzi Shan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Training ◽  
Literature Review ◽  
Cardiac Rehabilitation ◽  
Digital Health ◽  
Physical Activity Counseling ◽  
Health Technologies ◽  
Digital Interventions ◽  
Activity Counseling ◽  
Core Components

BACKGROUND Cardiovascular disease (CVD) is the leading cause of death worldwide. Despite strong evidence supporting the benefits of cardiac rehabilitation (CR), over 80% of eligible patients do not participate. Digital health technologies (i.e. the delivery of care through the use of the internet, wearable devices, and mobile applications) have the potential to address the challenges associated with traditional facility-based CR programs but little is known about the comprehensiveness of these interventions to serve as digital approaches to CR. Overall, a systematic evaluation of the current literature on digital interventions for CR is lacking. OBJECTIVE The objective of this systematic literature review is to provide an in-depth analysis of the potential for digital health technologies to address the challenges associated with traditional CR. Through this review, we 1) summarize the current literature on digital interventions for CR, 2) identify the key components of CR that have been successfully addressed through digital interventions, and 3) describe gaps in research that need to be addressed for sustainable and scalable digital CR interventions. METHODS Our search strategy for identifying primary literature pertaining to CR with digital solutions (defined as technology employed to deliver remote care beyond the use of telephone) consisted of querying MEDLINE, Embase, CINAHL, and Cochrane databases for original studies published from January 1990 to October 2018 and consulting with an expert in the field of digital CR. RESULTS Our search returned 31 eligible studies, of which 22 were randomized controlled trials. The CR interventions reviewed primarily targeted physical activity counseling (100%; n=31), baseline assessment (97%; n=30) and exercise training (87%; n=27). The most common modalities used were smartphone/mobile devices (65%; n=20), online portals (58%; n=18), and email-SMS (35%; n=11). Approximately one third of studies addressed the CR core components of nutrition counseling, psychological management, and weight management. In contrast, less than a third of the studies addressed other CR core components including management of lipids, diabetes, smoking cessation, and blood pressure. CONCLUSIONS Digital technologies have the potential to increase access and participation in CR by mitigating the challenges associated with traditional, facility-based CR. However, interventions that have previously been evaluated are primarily focused on physical activity counseling and exercise training without the other core components of CR. Thus, further research is required with more comprehensive CR interventions and long-term follow-up in order to understand the clinical impact of digital interventions. CLINICALTRIAL

scholarly journals Fatigue After Liver Transplantation: Effects of a Rehabilitation Program Including Exercise Training and Physical Activity Counseling

2014 ◽  
Vol 94 (6) ◽  
pp. 857-865 ◽  
Author(s):  
Rita J.G. van den Berg-Emons ◽  
Berbke T.J. van Ginneken ◽  
Carla F.J. Nooijen ◽  
Herold J. Metselaar ◽  
Huug W. Tilanus ◽  
...  
Keyword(s):  
Physical Activity ◽  
Liver Transplantation ◽  
Exercise Training ◽  
Adverse Events ◽  
Physical Fitness ◽  
Body Fat ◽  
Rehabilitation Program ◽  
Liver Transplants ◽  
Physical Activity Counseling ◽  
Activity Counseling

Background It is hypothesized that increasing physical fitness and daily physical activity can lead to a reduction in fatigue. However, standard medical care following liver transplantation seldom includes rehabilitation that focuses on physical fitness and physical activity. Objective The aim of this study was to explore whether a rehabilitation program can reduce fatigue in recipients of liver transplants. Furthermore, effects on physical fitness, physical activity, and cardiovascular risk were studied, and adherence, satisfaction, and adverse events were assessed. Design This was an uncontrolled intervention study. Setting The study took place in an outpatient rehabilitation clinic. Patients Eighteen recipients of a liver transplant who were fatigued participated in a 12-week rehabilitation program including physical exercise training and counseling on physical activity. The primary outcome measure was fatigue. Other outcome measures were: aerobic capacity, muscle strength, body fat, daily physical activity, lipid profile, and glycemic control. All measurements were performed before and after the rehabilitation program. Adherence, satisfaction, and adverse events were registered. Results After the program, participants were significantly less fatigued, and the percentage of individuals with severe fatigue was 22% to 53% lower than before the program. In addition, aerobic capacity and knee flexion strength were significantly higher, and body fat was significantly lower after the program. Participants were able to perform physical exercise at the target training intensity, no adverse events were registered, and attendance (93%) and mean patient satisfaction (8.5 out of 10, range=7–10) were high. Limitations No control group was used in the study. Conclusions A rehabilitation program consisting of exercise training and physical activity counseling is well tolerated and seems promising in reducing fatigue and improving fitness among recipients of liver transplants.

Applications of Digital Health Technologies in Knee Osteoarthritis: A Narrative Review (Preprint)

2021 ◽  
Author(s):  
Nirali Shah ◽  
Kerry Costello ◽  
Akshat Mehta ◽  
Deepak Kumar
Keyword(s):  
Physical Activity ◽  
Cost Effectiveness ◽  
Patient Education ◽  
Knee Osteoarthritis ◽  
Text Messaging ◽  
Digital Health ◽  
Health Technologies ◽  
Knee Oa ◽  
Physical Activity Interventions ◽  
Digital Interventions

BACKGROUND With increasing adoption of high-speed internet and mobile technologies by older adults, digital health (comprising websites, mobile applications, text messaging, tele-health, etc.) is a promising modality to enhance research and clinical care for people with osteoarthritis (OA), including those with knee replacement (KR). OBJECTIVE This narrative review summarizes key digital health technologies and the use of digital health for delivery of patient education, supervised and unsupervised exercise and/or physical activity interventions, psychological interventions, cost-effectiveness of digital health, and clinician and patient perspective toward digital health in the field of knee OA and KR. Remaining challenges and future opportunities for digital health technologies to improve care in knee OA and KR are also discussed. METHODS Search terms such as “mobile health”, “smartphone”, mobile application”, “mobile technology”, “ehealth”, “text message”, “internet”, “knee osteoarthritis” etc. were used in PubMed and EMBASE databases in February 2021. The search was limited to original articles published in English language within the prior ten years. In all, 91 relevant studies were included in this review. RESULTS Digital health technologies such as websites, mobile phone apps, telephone calls, text-messaging, social media, video-conferencing software, and custom multi-technology systems have been used to deliver healthcare in knee OA and KR populations. Digital patient education interventions improved disease related knowledge at shorter follow-up periods, especially when used as an adjunct to traditional methods of patient education. The benefits of digital health for exercise and physical activity interventions in people with knee OA appear mixed. Digital interventions that use more than one technology and/or strategies to engage the participants may be more promising than those that rely on a single modality. Digital interventions for chronic knee pain that include psychological treatments are effective. Digital health appears appropriate for enhancing in-person physical therapy care for people with knee OA but may not serve as replacement for in-person interventions. However, the cost-effectiveness of hybrid (i.e., digital and in-person) interventions needs further investigation for people with knee OA. Finally, both people with knee OA and clinicians had positive views on digital health, but raised privacy and security related concerns, and logistic and training related concerns, respectively. CONCLUSIONS For people with knee OA, blended interventions that integrate digital and in-person care are promising but need further investigations. For people pre- or post-KR, digital health appears to be similar to or better than in-person rehabilitation and cost-effective. Wider implementation of these promising technologies should be considered. Patient and clinician preferences should be incorporated early in the intervention design process for digital health.

scholarly journals Exercise and Physical Activity Counseling Needs among Cardiac Rehabilitation Patients

2021 ◽  
Vol 10 (1) ◽  
pp. 61-67
Author(s):  
Yusshy Kurnia Herliani ◽  
Urip Rahayu ◽  
Hasniatisari Harun
Keyword(s):  
Physical Activity ◽  
Cardiac Rehabilitation ◽  
Sampling Technique ◽  
Physical Activities ◽  
Cardiac Events ◽  
Physical Activity Counseling ◽  
Activity Counseling ◽  
Counseling Needs ◽  
Correlational Method ◽  
The Relationship

Cardiac rehabilitation (CR) has  decreased in recurrent cardiac events. However, information related the needs of cardiac rehabilitation patients such as exercise and physical activities counseling are very limited. This study aims to identify the needs of cardiac rehabilitation patients such as exercise, physical activity counselling, and the relationship between them. It also applied a quantitative approach combined with a descriptive correlational method. 38 cardiac rehabilitation patients were recruited as samples and were selected using the convenience sampling technique. Data collection was performed using questionnaires filled out by the respondents (with a retrospective technique) at the end of the CR program, and the results were evaluated through descriptive correlational statistics. The results revealed that patients with CR required exercise (92.1%) and nurses' counseling for physical activities (86.9%).  It also indicates that there is a statistically positive relationship between exercise and physical activities counseling among CR patients (r = 0.485, p < 0.01). Consequently, most CR patients desire nurses to take part in their exercise and physical activities. The needs of CR patients  on exercise and physical activity counseling were correlated positively. Therefore, information regarding exercise and physical activity for CR patients should be provided simultaneously to complement each other.

scholarly journals The Effects of Unsupervised Exercise Training on Physical Activity and Physiological Factors after Supervised Cardiac Rehabilitation

2006 ◽  
Vol 9 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Kazuhiro P. Izawa ◽  
Satoshi Watanabe ◽  
Koichiro Oka ◽  
Toru Kobayashi ◽  
Naohiko Osada ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Physiological Factors

Physical Activity Counseling Content and Competency: A Systematic Review

2008 ◽  
Vol 5 (3) ◽  
pp. 398-417 ◽  
Author(s):  
Jeff David Breckon ◽  
Lynne Halley Johnston ◽  
Andrew Hutchison
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Transtheoretical Model ◽  
Treatment Fidelity ◽  
Cognitive Outcome ◽  
Physical Activity Counseling ◽  
Counseling Training ◽  
Activity Counseling ◽  
High Degree ◽  
Training Delivery

Background:Physical activity (PA) counseling is becoming commonplace in primary care settings, although there is a high degree of variation in the quality and quantity of this intervention. The purpose of this review was to examine the theory on which the intervention is based and the level of treatment fidelity applied at all stages of the intervention.Methods:A systematic review was carried out for interventions that reported an element of PA counseling. Results were mapped according to a treatment fidelity framework of intervention design, training, delivery, receipt, and enactment.Results:Most studies were underpinned by the transtheoretical model. Few studies described the frequency or duration of PA counseling training or competence level of the interventionist. The most common outcome measures were behavioral and physiological, with few studies including a cognitive outcome measure.Conclusions:Most research focuses on outcome and significance rather than intervention processes, with limited consideration of treatment fidelity. The design, training, delivery, and receipt of PA counseling should be reported more thoroughly.

Digital health technologies for long term self-management of osteoporosis: a systematic review and meta-analysis (Preprint)

2021 ◽  
Author(s):  
Ghada Alhussein ◽  
Leontios Hadjileontiadis
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Self Management ◽  
Current Status ◽  
Future Research ◽  
Common Chronic Disease ◽  
Health Technologies ◽  
Management Interventions

BACKGROUND Osteoporosis is the fourth most common chronic disease in the world. Adopting preventative measures and effective self-management interventions help in improving bone health. Mobile health (mHealth) technologies can play a key role in osteoporosis patient care and self- management. OBJECTIVE This study presents a systematic review and meta-analysis of the currently available mHealth applications targeting osteoporosis self-management, aiming to determine the current status, gaps and challenges the future research could address, proposing appropriate recommendations. METHODS In this systematic review and meta-analysis, we searched PubMed, Scopus, EBSCO, Web of Science, and IEEExplore databases between Jan 1, 2010 and May 31, 2021, for all English publications that describe apps dedicated to or being useful for osteoporosis, targeting self-management, nutrition, physical activity, risk assessment, delivered on smartphone devices for young and older adults. In addition, a survey of all osteoporosis-related apps available in iOS and Android app stores as of May 31, 2021 was also conducted. Primary outcomes of interest were the prevention or reduction of unhealthy behaviours or improvement in healthy behaviours of the six behaviours. Outcomes were summarised in a narrative synthesis and combined using random-effects meta-analysis. RESULTS In total, 3906 unique articles were identified. Of these, 32 articles met the inclusion criteria and were reviewed in depth. The 32 studies were comprising 14 235 participants, of whom on average 69.5% were female, with a mean age of 49.8 years (SD 17.8). The app search identified 23 relevant apps for osteoporosis self-management. The meta-analysis revealed that mHealth supported interventions resulted in a significant reduction in pain (Hedge’s g -1.09, 95%CI -1.68 to -0.45) and disability (Hedge’s g -0.77, 95%CI -1.59 to 0.05). The post-treatment effect of the digital intervention was significant for physical function (Hedge’s g 2.54, 95%CI -4.08 to 4.08); yet nonsignificant for wellbeing (Hedge’s g 0.17, 95% CI -1.84 to 2.17), physical activity (Hedges’ g 0.09, 95%CI -0.59 to 0.50), anxiety (Hedge’s g -0.29, 95%CI -6.11 to 5.53), fatigue (Hedge’s g -0.34, 95%CI -5.84 to 5.16), calcium (Hedge’s g -0.05, 95%CI -0.59 to 0.50) and vitamin D (Hedge’s g 0.10, 95% CI -4.05 to 4.26) intake, and trabecular score (Hedge’s g 0.06, 95%CI -1.00 to 1.12). CONCLUSIONS Osteoporosis apps have the potential to support and improve the management of the disease and its symptoms; they also appear to be a valuable tool for patients and health professionals. However, the majority of the apps that are currently available lack clinically validated evidence of their efficacy and they most focus on a limited number of symptoms. A more holistic and personalized approach, within a co-creation design ecosystem, is needed.

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