A1 Journal article (refereed)
Effectiveness of Distance Technology in Promoting Physical Activity in Cardiovascular Disease Rehabilitation : Cluster Randomized Controlled Trial, A Pilot Study (2021)

Hakala, S., Kivistö, H., Paajanen, T., Kankainen, A., Anttila, M.-R., Heinonen, A., & Sjögren, T. (2021). Effectiveness of Distance Technology in Promoting Physical Activity in Cardiovascular Disease Rehabilitation : Cluster Randomized Controlled Trial, A Pilot Study. JMIR Rehabilitation and Assistive Technologies, 8(2), Article e20299. https://doi.org/10.2196/20299

JYU authors or editors

Publication details

All authors or editors: Hakala, Sanna; Kivistö, Heikki; Paajanen, Teemu; Kankainen, Annaliisa; Anttila, Marjo-Riitta; Heinonen, Ari; Sjögren, Tuulikki

Journal or series: JMIR Rehabilitation and Assistive Technologies

eISSN: 2369-2529

Publication year: 2021

Volume: 8

Issue number: 2

Article number: e20299

Publisher: JMIR Publications Inc.

Publication country: Canada

Publication language: English

DOI: https://doi.org/10.2196/20299

Publication open access: Openly available

Publication channel open access: Open Access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/77011

Web address of parallel published publication (pre-print): https://preprints.jmir.org/preprint/20299


Physical activity is beneficial for cardiovascular rehabilitation. Digitalization suggests using technology in the promotion of physical activity and lifestyle changes. The effectiveness of distance technology interventions has previously been found to be similar to that of conventional treatment, but the added value of the technology has not been frequently studied.

The aim of this pilot study was to investigate whether additional distance technology intervention is more effective in promoting physical activity than non-technology–based treatment in 12 months of cardiac rehabilitation.

The cardiovascular disease rehabilitation intervention consisted of three 5-day inpatient periods in a rehabilitation center and two 6-month self-exercise periods at home in between. Participants were recruited from among cardiac patients who attended the rehabilitation program and were cluster-randomized into unblinded groups: conventional rehabilitation control clusters (n=3) and similar rehabilitation with additional distance technology experimental group clusters (n=3). Experimental groups used Fitbit Charge HR for self-monitoring, and they set goals and reported their activity using Movendos mCoach, through which they received monthly automated and in-person feedback. Physical activity outcomes for all participants were measured using the Fitbit Zip accelerometer and the International Physical Activity Questionnaire.

During the first 6 months, the experimental group (n=29) engaged in light physical activity more often than the control group (n=30; mean difference [MD] 324.2 minutes per week, 95% CI 77.4 to 571.0; P=.01). There were no group differences in the duration of moderate to vigorous physical activity (MD 12.6 minutes per week, 95% CI –90.5 to 115.7; P=.82) or steps per day (MD 1084.0, 95% CI –585.0 to 2752.9; P=.20). During the following 6 months, no differences between the groups were observed in light physical activity (MD –87.9 minutes per week, 95% CI –379.2 to 203.3; P=.54), moderate to vigorous physical activity (MD 70.9 minutes per week, 95% CI –75.7 to 217.6; P=.33), or steps per day (MD 867.1, 95% CI –2099.6 to 3833.9; P=.55).

The use of additional distance technology increased the duration of light physical activity at the beginning of cardiac rehabilitation (for the first 6 months), but statistically significant differences were not observed between the two groups for moderate or vigorous physical activity or steps per day for both 6-month self-exercise periods.

Keywords: cardiovascular diseases; rehabilitation; medical rehabilitation; physical activeness; exercise therapy; remote services; e-healthcare; randomised controlled trials; clinical trials

Free keywords: cardiac rehabilitation; rehabilitation; cardiovascular diseases; technology; exercise; randomized controlled trial; clinical trial

Contributing organizations

Ministry reporting: Yes

Preliminary JUFO rating: 1

Last updated on 2022-10-01 at 15:19