Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic Review
BackgroundThe known and established benefits of exercise in patients with heart failure (HF) are often hampered by low exercise adherence. Mobile health (mHealth) technology provides opportunities to overcome barriers to exercise adherence in this population. Obje...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-01-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e54524 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841551883653611520 |
|---|---|
| author | Pallav Deka Erin Salahshurian Teresa Ng Susan W Buchholz Leonie Klompstra Windy Alonso |
| author_facet | Pallav Deka Erin Salahshurian Teresa Ng Susan W Buchholz Leonie Klompstra Windy Alonso |
| author_sort | Pallav Deka |
| collection | DOAJ |
| description |
BackgroundThe known and established benefits of exercise in patients with heart failure (HF) are often hampered by low exercise adherence. Mobile health (mHealth) technology provides opportunities to overcome barriers to exercise adherence in this population.
ObjectiveThis systematic review builds on prior research to (1) describe study characteristics of mHealth interventions for exercise adherence in HF including details of sample demographics, sample sizes, exercise programs, and theoretical frameworks; (2) summarize types of mHealth technology used to improve exercise adherence in patients with HF; (3) highlight how the term “adherence” was defined and how it was measured across mHealth studies and adherence achieved; and (4) highlight the effect of age, sex, race, New York Heart Association (NYHA) functional classification, and HF etiology (systolic vs diastolic) on exercise adherence.
MethodsWe searched for papers in PubMed, MEDLINE, and CINAHL databases and included studies published between January 1, 2015, and June 30, 2022. The risk of bias was analyzed.
ResultsIn total, 8 studies (4 randomized controlled trials and 4 quasi-experimental trials) met our inclusion and exclusion criteria. A moderate to high risk of bias was noted in the studies. All studies included patients with HF in NYHA classification I-III, with sample sizes ranging from 12 to 81 and study durations lasting 4 to 26 weeks. Six studies had an equal distribution of male and female participants whose ages ranged between 53 and 73 years. Videoconferencing was used in 4 studies, while 4 studies used smartphone apps. Three studies using videoconferencing included an intervention that engaged participants in a group setting. A total of 1 study used a yoga program, 1 study used a walking program, 1 study combined jogging with walking, 1 study used a cycle ergometer, 2 studies combined walking with cycle ergometry, and 1 study used a stepper. Two studies incorporated resistance exercises in their program. Exercise programs varied, ranging between 3 and 5 days of exercise per week, with exercise sessions ranging from 30 to 60 minutes. The Borg rating of perceived exertion scale was mostly used to regulate exercise intensity, with 3 studies using heart rate monitoring using a Fitbit. Only 1 study implicitly mentions developing their intervention using a theoretical framework. Adherence was reported to the investigator-developed exercise programs. All studies were mostly feasibility or pilot studies, and the effect of age, sex, race, and NYHA classification on exercise adherence with the use of mHealth was not reported.
ConclusionsThe results show some preliminary evidence of the feasibility of using mHealth technology for building exercise adherence in patients with HF; however, theoretically sound and fully powered studies, including studies on minoritized communities, are lacking. In addition, the sustainability of adherence beyond the intervention period is unknown. |
| format | Article |
| id | doaj-art-8b4c85b6db3a48f1ad31e5e327ead2b1 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-8b4c85b6db3a48f1ad31e5e327ead2b12025-01-09T15:00:35ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-01-0127e5452410.2196/54524Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic ReviewPallav Dekahttps://orcid.org/0000-0002-3648-9843Erin Salahshurianhttps://orcid.org/0000-0001-7799-8698Teresa Nghttps://orcid.org/0000-0002-3961-5171Susan W Buchholzhttps://orcid.org/0000-0002-6311-9709Leonie Klompstrahttps://orcid.org/0000-0002-7493-0353Windy Alonsohttps://orcid.org/0000-0002-8711-6756 BackgroundThe known and established benefits of exercise in patients with heart failure (HF) are often hampered by low exercise adherence. Mobile health (mHealth) technology provides opportunities to overcome barriers to exercise adherence in this population. ObjectiveThis systematic review builds on prior research to (1) describe study characteristics of mHealth interventions for exercise adherence in HF including details of sample demographics, sample sizes, exercise programs, and theoretical frameworks; (2) summarize types of mHealth technology used to improve exercise adherence in patients with HF; (3) highlight how the term “adherence” was defined and how it was measured across mHealth studies and adherence achieved; and (4) highlight the effect of age, sex, race, New York Heart Association (NYHA) functional classification, and HF etiology (systolic vs diastolic) on exercise adherence. MethodsWe searched for papers in PubMed, MEDLINE, and CINAHL databases and included studies published between January 1, 2015, and June 30, 2022. The risk of bias was analyzed. ResultsIn total, 8 studies (4 randomized controlled trials and 4 quasi-experimental trials) met our inclusion and exclusion criteria. A moderate to high risk of bias was noted in the studies. All studies included patients with HF in NYHA classification I-III, with sample sizes ranging from 12 to 81 and study durations lasting 4 to 26 weeks. Six studies had an equal distribution of male and female participants whose ages ranged between 53 and 73 years. Videoconferencing was used in 4 studies, while 4 studies used smartphone apps. Three studies using videoconferencing included an intervention that engaged participants in a group setting. A total of 1 study used a yoga program, 1 study used a walking program, 1 study combined jogging with walking, 1 study used a cycle ergometer, 2 studies combined walking with cycle ergometry, and 1 study used a stepper. Two studies incorporated resistance exercises in their program. Exercise programs varied, ranging between 3 and 5 days of exercise per week, with exercise sessions ranging from 30 to 60 minutes. The Borg rating of perceived exertion scale was mostly used to regulate exercise intensity, with 3 studies using heart rate monitoring using a Fitbit. Only 1 study implicitly mentions developing their intervention using a theoretical framework. Adherence was reported to the investigator-developed exercise programs. All studies were mostly feasibility or pilot studies, and the effect of age, sex, race, and NYHA classification on exercise adherence with the use of mHealth was not reported. ConclusionsThe results show some preliminary evidence of the feasibility of using mHealth technology for building exercise adherence in patients with HF; however, theoretically sound and fully powered studies, including studies on minoritized communities, are lacking. In addition, the sustainability of adherence beyond the intervention period is unknown.https://www.jmir.org/2025/1/e54524 |
| spellingShingle | Pallav Deka Erin Salahshurian Teresa Ng Susan W Buchholz Leonie Klompstra Windy Alonso Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic Review Journal of Medical Internet Research |
| title | Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic Review |
| title_full | Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic Review |
| title_fullStr | Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic Review |
| title_full_unstemmed | Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic Review |
| title_short | Use of mHealth Technology for Improving Exercise Adherence in Patients With Heart Failure: Systematic Review |
| title_sort | use of mhealth technology for improving exercise adherence in patients with heart failure systematic review |
| url | https://www.jmir.org/2025/1/e54524 |
| work_keys_str_mv | AT pallavdeka useofmhealthtechnologyforimprovingexerciseadherenceinpatientswithheartfailuresystematicreview AT erinsalahshurian useofmhealthtechnologyforimprovingexerciseadherenceinpatientswithheartfailuresystematicreview AT teresang useofmhealthtechnologyforimprovingexerciseadherenceinpatientswithheartfailuresystematicreview AT susanwbuchholz useofmhealthtechnologyforimprovingexerciseadherenceinpatientswithheartfailuresystematicreview AT leonieklompstra useofmhealthtechnologyforimprovingexerciseadherenceinpatientswithheartfailuresystematicreview AT windyalonso useofmhealthtechnologyforimprovingexerciseadherenceinpatientswithheartfailuresystematicreview |