AACVPR News & Views - November/December 2017 - 9
INSIDE >> THE INDUSTRY
Behavioral Aspects of Rehabilitation
Technological Approaches to Enhance Care of Cardiac Patients
Diann E. Gaalema, PhD, Assistant Professor, Psychiatry, University of Vermont
O
ne of the continuing
challenges of cardiac
rehabilitation is
maximizing the
benefits the patients
garner from being in the program.
Appropriately engaging and
maintaining patients in the program
is vital. However, current metrics of
engagement are not encouraging.
For example, a recent study
suggests only a third of MI patients
in the United States are even
attending cardiac rehabilitation1.
This low level of uptake suggests
that cardiac rehabilitation may need
to be tweaked to encourage more
participation. Reducing participant
burden is one potential approach.
The traditional model of attending
an in-person session multiple times
a week during work hours is not
achievable by all. Technological
approaches could come into play
many ways, one of which could
be allowing interventions to be
delivered completely remotely or
by having patients attend in-person
occasionally while completing most
exercise at home.
The question of how best to use
technology to improve cardiac
rehabilitation engagement
continues. For example, there
was recently a request for grant
applications on this topic at NIH2,
and a quick search on Pubmed
shows at least 90 hits that have
both cardiac rehabilitation and
technology in the abstract3,
many of which are descriptions
of ongoing trials. This ongoing
research activity demonstrates the
continued challenge of integrating
technology into existing programs.
In the meantime, programs could
consider taking advantage of
popular technology to help their
patients achieve fitness goals
and remain engaged in cardiac
rehabilitation. For example, patients
are usually encouraged to exercise
at home, in addition to the exercise
they get in the cardiac rehabilitation
setting. Objective measurement
of the activity done at home could
provide patients with the feedback
necessary for them to reach their
goals and stay engaged. People,
lacking objective measurement,
are often very inaccurate when
estimating their physical activity
levels4. One way to objectively
measure activity levels is with a
fitness tracker. These physical
activity monitors have become
increasingly popular with the
general public. Recent estimates
suggest more than one in five
people in the United States will own
a fitness tracker by 20215. Cardiac
rehabilitation programs could
leverage this tool that many of their
patients will already own. However,
fitness trackers are not without
limitations. For example, studies
have demonstrated significant
variability in measurement between
different types of trackers6 and
calculations of calories burned are
generally considered not accurate7.
However, fitness trackers should
be sufficient for setting activity
goals within an individual. A patient
can wear one for a week or two
to determine their baseline level of
activity, and in consultation with
their health-care team determine
an activity-level goal and a sensible
progression schedule.
Conclusion
Technology can potentially increase
the efficacy and the reach of
cardiac rehabilitation. Research
continues on the best way to
integrate technology into existing
programs. In the meantime,
Continued on page 15
News&Views NOVEMBER/DECEMBER 2017 9
Table of Contents for the Digital Edition of AACVPR News & Views - November/December 2017
Contents
AACVPR News & Views - November/December 2017 - 1
AACVPR News & Views - November/December 2017 - 2
AACVPR News & Views - November/December 2017 - Contents
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AACVPR News & Views - November/December 2017 - 16
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