title: An m-Health system for education and motivation in cardiac rehabilitation: the experience of HeartCycle guided exercise.
abstract: Introduction Home-based programmes for cardiac rehabilitation play a key role in the recovery of patients with coronary artery disease. However, their necessary educational and motivational components have been rarely implemented with the help of modern mobile technologies. We developed a mobile health system designed for motivating patients to adhere to their rehabilitation programme by providing exercise monitoring, guidance, motivational feedback, and educational content. Methods Our multi-disciplinary approach is based on mapping "desired behaviours" into specific system's specifications, borrowing concepts from Fogg's Persuasive Systems Design principles. A randomised controlled trial was conducted to compare mobile-based rehabilitation (55 patients) versus standard care (63 patients). Results Some technical issues related to connectivity, usability and exercise sessions interrupted by safety algorithms affected the trial. For those who completed the rehabilitation (19 of 55), results show high levels of both user acceptance and perceived usefulness. Adherence in terms of started exercise sessions was high, but not in terms of total time of performed exercise or drop-outs. Educational level about heart-related health improved more in the intervention group than the control. Exercise habits at 6 months follow-up also improved, although without statistical significance. Discussion Results indicate that the adopted design methodology is promising for creating applications that help improve education and foster better exercise habits, but further studies would be needed to confirm these indications.
authors.affiliation: 1 Life Supporting Technologies, Departamento de Tecnología Fotónica y Biongeniería, Universidad Politécnica de Madrid, Madrid, Spain.
authors.forename: Dario
authors.initials: D
authors.lastname: Salvi
authors.affiliation: 1 Life Supporting Technologies, Departamento de Tecnología Fotónica y Biongeniería, Universidad Politécnica de Madrid, Madrid, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Ottaviano
authors.affiliation: 2 VTT Technical Research Centre of Finland Ltd, Oulu, Finland.
authors.forename: Salla
authors.initials: S
authors.lastname: Muuraiskangas
authors.affiliation: 3 Universitat Politècnica de València, Valencia, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Martínez-Romero
authors.affiliation: 1 Life Supporting Technologies, Departamento de Tecnología Fotónica y Biongeniería, Universidad Politécnica de Madrid, Madrid, Spain.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Vera-Muñoz
authors.affiliation: 4 Laboratory of Medical Informatics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Triantafyllidis
authors.affiliation: 1 Life Supporting Technologies, Departamento de Tecnología Fotónica y Biongeniería, Universidad Politécnica de Madrid, Madrid, Spain.
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Cabrera Umpiérrez
authors.affiliation: 1 Life Supporting Technologies, Departamento de Tecnología Fotónica y Biongeniería, Universidad Politécnica de Madrid, Madrid, Spain.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Arredondo Waldmeyer
authors.affiliation: 5 Clinic for Cardiac and Pulmonary Rehabilitation, Rosenquelle, Aachen, Germany.
authors.forename: Erik
authors.initials: E
authors.lastname: Skobel
authors.affiliation: 6 Department of Cardiology, RWTH Aachen University, Aachen, Germany.|7 Maastricht University Medical Centre, Dept. of Cardiology, Maastricht, The Netherlands.
authors.forename: Christian
authors.initials: C
authors.lastname: Knackstedt
authors.affiliation: 8 VTT Technical Research Centre of Finland Ltd, Tampere, Finland.
authors.forename: Hilkka
authors.initials: H
authors.lastname: Liedes
authors.affiliation: 8 VTT Technical Research Centre of Finland Ltd, Tampere, Finland.
authors.forename: Anita
authors.initials: A
authors.lastname: Honka
authors.affiliation: 9 Centre Suisse d'Electronique et de Microtechnique SA, Neuchatel, Switzerland.
authors.forename: Jean
authors.initials: J
authors.lastname: Luprano
authors.affiliation: 10 Hull York Medical School, University of Hull, Hull, UK.
authors.forename: John Gf
authors.initials: JG
authors.lastname: Cleland
authors.affiliation: 11 Philips Research, Eindhoven, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Stut
authors.affiliation: 12 Heart Manual Department, NHS Lothian, Scotland, UK.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Deighan
mesh_terms: D000328:Adult; D000368:Aged; D000072038:Cardiac Rehabilitation / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010446:Peptide Fragments; D012648:Self Care / Q000379:methods; D017216:Telemedicine / Q000379:methods*; D014568:Urokinase-Type Plasminogen Activator
chemical_list: C000621142:PAItrap peptide; D010446:Peptide Fragments; D014568:Urokinase-Type Plasminogen Activator
keywords: cardiac rehabilitation; coronary artery diseases; education and motivation; m-Health