title: Evaluating the interactive web-based program, activate your heart, for cardiac rehabilitation patients: a pilot study.
abstract: BACKGROUND
  Conventional cardiac rehabilitation (CR) programs are traditionally based on time-constrained, structured, group-based programs, usually set in hospitals or leisure centers. Uptake for CR remains poor, despite the ongoing evidence demonstrating its benefits. Additional alternative forms of CR are needed. An Internet-based approach may offer an alternative mode of delivering CR that may improve overall uptake. Activate Your Heart (AYH) is a Web-based CR program that has been designed to support individuals with coronary heart disease (CHD).
  
  
  OBJECTIVE
  The aim of this pilot study was to observe the outcome for participants following the AYH program.
  
  
  METHODS
  We conducted a prospective observational trial, recruiting low-risk patients with CHD. Measures of exercise, exercise capacity, using the Incremental Shuttle Walk Test (ISWT), dietary habits, and psychosocial well-being were conducted by a CR specialist at baseline and at 8 weeks following the Web-based intervention.
  
  
  RESULTS
  We recruited 41 participants; 33 completed the program. We documented significant improvements in the ISWT distance (mean change 49.69 meters, SD 68.8, P<.001), and Quality of Life (QOL) (mean change 0.28, SD 0.4, P<.001). Dietary habits improved with an increased proportion of patients consuming at least 5 portions of fruit and vegetables per day, (22 [71%] to 29 [94%] P=.01) and an increased proportion of patients consuming at least 2 portions of oily fish per week (14 [45%] to 21 [68%], P=.01). We did not detect changes in anxiety and depression scores or exercise behavior.
  
  
  CONCLUSIONS
  We observed important improvements in exercise capacity, QOL, and dietary habits in a group of participants following a Web-based CR program. The program may offer an alternative approach to CR. A mobile version has been developed and we need to conduct further trials to establish its value compared to supervised CR.
authors.affiliation: Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom. christopher.brough@uhl-tr.nhs.uk.
authors.forename: Christopher
authors.identifier: http://orcid.org/0000-0001-5623-2669
authors.initials: C
authors.lastname: Brough
authors.forename: Sally
authors.identifier: http://orcid.org/0000-0003-3327-2830
authors.initials: S
authors.lastname: Boyce
authors.forename: Linzy
authors.identifier: http://orcid.org/0000-0003-4940-8835
authors.initials: L
authors.lastname: Houchen-Wolloff
authors.forename: Louise
authors.identifier: http://orcid.org/0000-0002-1256-8248
authors.initials: L
authors.lastname: Sewell
authors.forename: Sally
authors.identifier: http://orcid.org/0000-0002-9834-0366
authors.initials: S
authors.lastname: Singh
mesh_terms: D001007:Anxiety / Q000209:etiology / Q000628:therapy; D003327:Coronary Disease / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000628:therapy; D004032:Diet; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D013813:Therapy, Computer-Assisted / Q000379:methods*
keywords: Activate Your Heart; Internet; Web-based; cardiac rehabilitation; coronary heart disease