title: The remote exercise monitoring trial for exercise-based cardiac rehabilitation (REMOTE-CR): a randomised controlled trial protocol.
abstract: BACKGROUND
  Exercise is an essential component of contemporary cardiac rehabilitation programs for the secondary prevention of coronary heart disease. Despite the benefits associated with regular exercise, adherence with supervised exercise-based cardiac rehabilitation remains low. Increasingly powerful mobile technologies, such as smartphones and wireless physiological sensors, may extend the capability of exercise-based cardiac rehabilitation by enabling real-time exercise monitoring for those with coronary heart disease. This study compares the effectiveness of technology-assisted, home-based, remote monitored exercise-based cardiac rehabilitation (REMOTE) to standard supervised exercise-based cardiac rehabilitation in New Zealand adults with a diagnosis of coronary heart disease.
  
  
  METHODS
  A two-arm, parallel, non-inferiority, randomised controlled trial will be conducted at two sites in New Zealand. One hundred and sixty two participants will be randomised at a 1:1 ratio to receive a 12-week program of technology-assisted, home-based, remote monitored exercise-based cardiac rehabilitation (intervention), or an 8-12 program of standard supervised exercise-based cardiac rehabilitation (control).The primary outcome is post-treatment maximal oxygen uptake (V̇O2max). Secondary outcomes include cardiovascular risk factors (blood lipid and glucose concentrations, blood pressure, anthropometry), self-efficacy, intentions and motivation to be active, objectively measured physical activity, self-reported leisure time exercise and health-related quality of life. Cost information will also be collected to compare the two modes of delivery. All outcomes are assessed at baseline, post-treatment, and 6 months, except for V̇O2max, blood lipid and glucose concentrations, which are assessed at baseline and post-treatment only.
  
  
  CONCLUSIONS
  This novel study will compare the effectiveness of technology-supported exercise-based cardiac rehabilitation to a traditional supervised approach. If the REMOTE program proves to be as effective as traditional cardiac rehabilitation, it has potential to augment current practice by increasing access for those who cannot utilise existing services.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials RegistryStudy ID number: ACTRN12614000843651. Registered 7 August 2014.
authors.affiliation: National Institute for Health Innovation, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. r.maddison@auckland.ac.nz.
authors.forename: Ralph
authors.initials: R
authors.lastname: Maddison
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Rawstorn
authors.forename: Anna
authors.initials: A
authors.lastname: Rolleston
authors.forename: Robyn
authors.initials: R
authors.lastname: Whittaker
authors.forename: Ralph
authors.initials: R
authors.lastname: Stewart
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Benatar
authors.forename: Ian
authors.initials: I
authors.lastname: Warren
authors.forename: Yannan
authors.initials: Y
authors.lastname: Jiang
authors.forename: Nicholas
authors.initials: N
authors.lastname: Gant
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D003327:Coronary Disease / Q000534:rehabilitation*; D015444:Exercise; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D009520:New Zealand; D010101:Oxygen Consumption; D010349:Patient Compliance; D011788:Quality of Life; D012107:Research Design; D012307:Risk Factors; D020377:Self Efficacy; D013686:Telemetry