Effectiveness of Wrist-Worn Wearable-Guided Cardiac Rehabilitation Delivered Through Fully Remote or Hybrid Programs in Patients With Cardiovascular Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Jun Hwan Choi, So Young Lee, Kyung Cheon Seo et al.
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In 30 seconds
This systematic review and meta-analysis assessed randomized trials of wrist-worn wearable-guided cardiac rehabilitation delivered remotely or in hybrid formats during phase II or III rehabilitation for adults with cardiovascular disease. Eighteen trials involving 1993 randomized participants were included, with 17 contributing to meta-analysis. Pooled results favored these programs for peak oxygen consumption (MD 1.69, 95% CI 0.46-2.92), 6-minute walk distance (MD 31.03, 95% CI 7.66-53.92), and daily steps (MD 1062.8, 95% CI 383.5-1825.0). However, prediction intervals for all three outcomes included the null, leaving uncertainty about consistency across future settings.
Key findings
- Peak oxygen consumption favored wearable-guided rehabilitation: MD 1.69, 95% CI 0.46-2.92; the 95% PI was -2.21 to 5.39 mL/kg/min.
- Six-minute walk distance favored the programs: MD 31.03, 95% CI 7.66-53.92; the 95% PI was -62.11 to 123.18 m.
- Daily steps favored the programs: MD 1062.8, 95% CI 383.5-1825.0; the 95% PI was -503.0 to 2860.0 steps/day.
- No clear pooled effects were observed for anaerobic threshold, BMI, waist circumference, grip strength, or quality of life.
Why it matters
Remote and hybrid wearable-guided rehabilitation may support exercise capacity and activity beyond center-based care, addressing a setting where participation in cardiac rehabilitation is suboptimal. Yet the prediction intervals indicate that benefits may not be consistent across comparable future settings. The findings therefore support interest in these delivery models while underscoring the need to understand which patients and program components contribute to benefit.
What to keep in mind
Prediction intervals included the null for all three primary outcomes, indicating uncertainty about consistency across settings. The multicomponent programs also prevent attributing observed effects to wearables alone.