Physical Activity in Cardiac Rehabilitation Patients: Insights from Continuous Remote Patient Monitoring

Background and/or Objectives: Adherence to outpatient rehab home exercise programs and prescribed physical activity (PA) has been reported to wane over time. Devices that allow remote patient monitoring have the potential to clearly identify adherence, or not, to prescribed home therapies and exercise. Cardiac rehabilitation (CR) is a structured exercise program designed to improve cardiovascular health and promotes long-term PA adherence. However, evidence is limited on how well PA levels are maintained post-CR, particularly with objective, continuous monitoring in real-world settings. This study aims to objectively evaluate PA patterns during and post CR, highlighting challenges of long-term PA adherence and opportunities to improve.

Design: Prospective cohort study

Setting : Outpatient cardiac rehabilitation gym and community

Participants : 11 patients enrolled in a standard ~36-session CR program at NYU Rusk Rehabilitation (Phase 1: 3–4 months) and followed for six months post-discharge (Phase 2).

Interventions: Not applicable

Main Outcome Measures: Objective daily PA - step counts, sedentary time, and time spent in light, moderate, and vigorous-intensity PA.

Results: The nonparametric Wilcoxon signed-rank test revealed statistically significant differences in sedentary time (p=0.005) and time spent in light (p=0.01), moderate (p=0.002), and vigorous-intensity (p=0.001) activity between rehabilitation and non-rehabilitation days. Additionally, preliminary results indicate a significant decline in PA levels post-discharge, with increased sedentary time (0.002), reduced moderate (p=0.003) and vigorous (p=0.001) activity in the first two months of Phase 2 compared to Phase 1.

Conclusions: While CR effectively facilitates adherence to recommended PA levels, this study highlights a significant decline in PA on non-rehab days and immediately post program completion. These findings underscore the need for strategies to promote long-term PA maintenance, such as remote monitoring, behavioral coaching, and structured post-CR support programs. The results will inform future research including hybrid CR program, and the development of post-CR interventions aimed at sustaining PA levels, ultimately improving cardiovascular outcomes and reducing relapse risks in cardiac patients.