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Related Experiment Video

Updated: May 1, 2026

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation
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Smartphone Cardiac Rehabilitation, Assisted Self-Management (SCRAM) Versus Usual Care: Multicenter Randomized

Ralph Maddison1, Narayan Subedi1, Peixuan Li2,3

  • 1Institiute for Physical Activity and Nutrition, School of Exercise and Nutriton Sciences, Deakin University, 221 Burwood Highway, Burwood, Melbourne, Victoria, 3125, Australia, 61 3 924 46218.

JMIR Mhealth and Uhealth
|March 17, 2026
PubMed
Summary
This summary is machine-generated.

The Smartphone Cardiac Rehabilitation, Assisted Self-Management (SCRAM) program did not significantly improve maximal aerobic exercise capacity (VO2max) in cardiac patients. However, SCRAM showed resilience during COVID-19 disruptions and improved diastolic blood pressure.

Keywords:
cardiac rehabilitationcoronary heart diseasemHealthrandomized controlled trialruraltelerehabilitation

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Area of Science:

  • Cardiology
  • Digital Health
  • Rehabilitation Medicine

Background:

  • Center-based cardiac rehabilitation faces accessibility barriers, limiting patient participation.
  • The Smartphone Cardiac Rehabilitation, Assisted Self-Management (SCRAM) program was developed to address these limitations.
  • SCRAM offers a comprehensive, dual-phase telerehabilitation approach.

Purpose of the Study:

  • To evaluate the effectiveness of the SCRAM telerehabilitation program.
  • Primary objective: increase maximal aerobic exercise capacity (VO2max).

Main Methods:

  • A multicenter, parallel 2-arm randomized controlled trial (RCT) involving clinically stable coronary heart disease patients.
  • Participants received either SCRAM plus usual care or usual care alone.
  • SCRAM involved 24 weeks of remote exercise supervision, coaching, and behavior change support via smartphone.

Main Results:

  • The trial was underpowered due to recruitment challenges exacerbated by COVID-19.
  • SCRAM did not result in a statistically significant improvement in VO2max compared to usual care.
  • Patients in the SCRAM group showed a significant reduction in diastolic blood pressure.

Conclusions:

  • Despite not meeting the primary endpoint, SCRAM demonstrated resilience to COVID-19 disruptions.
  • Further research is required to confirm SCRAM's efficacy and its role in routine cardiac care.
  • Virtual cardiac rehabilitation models like SCRAM may enhance access and complement traditional center-based programs.