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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

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Published on: April 19, 2019

Cardiac Telerehabilitation Using a Smartwatch and a Gamified Smartphone App: Single-Arm Pre-Post Feasibility Study.

Yusaku Arima¹, Toshiki Kaihara¹, Megumi Nakamura¹

¹Department of Cardiology, St. Marianna University School of Medicine, Sugao 2-16-1, Miyamae-ku, Kawasaki, 2168511, Japan, 81 44-977-8111, 81 44-977-9486.

|June 11, 2026

Summary

Gamified cardiac telerehabilitation (CTR) using a smartphone app and smartwatch is feasible for acute coronary syndrome (ACS) patients. While app use was moderate, adherence to exercise intensity targets needs improvement for better outcomes.

Keywords:

acute coronary syndrome cardiac telerehabilitation digital health gamification smartphone app wearable technology

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Area of Science:

Cardiology
Digital Health
Rehabilitation Medicine

Background:

Home-based cardiac rehabilitation (CR) using digital health technologies, or cardiac telerehabilitation (CTR), offers a practical alternative to center-based programs, especially post-COVID-19.
Sustained patient participation in CR remains a significant challenge.
Gamification may enhance motivation and adherence in CTR, but its effectiveness in patients with acute coronary syndrome (ACS) is under-researched.

Purpose of the Study:

To evaluate the feasibility, acceptability, and safety of a gamified smartphone app and smartwatch intervention for CTR in patients post-ACS.
To assess participation motivation, adherence to prescribed exercise intensity, and short-term physiological outcomes.

Main Methods:

A single-arm, pre-post feasibility study involving 16 patients with ACS post-percutaneous coronary intervention.
Participants used a gamified smartphone app and smartwatch for 1 month, earning points for exercising within their target heart rate (HR) zone.
Exercise involved walking 3-5 days/week for ≥30 minutes at an intensity of Borg scale 11-13.

Main Results:

The overall app use rate was 59.9%, with a target HR exercise adherence rate of 50%.
Peak oxygen consumption increased significantly (18.4 to 21.1 mL/kg/min).
Perceived hassle during exercise decreased, and no adverse events related to the app were reported.

Conclusions:

Short-term use of a gamified, smartwatch-linked app for CTR after ACS is feasible and safe.
Adherence to gamified exercise standards was lower than app usage, indicating a need to refine gamification rules and target HR thresholds.