title: A Web-Based Program Improves Physical Activity Outcomes in a Primary Care Angina Population: Randomized Controlled Trial Physical activity, sedentary behavior and total wellness changes among sedentary adults: a 4-week randomized controlled trial Aerobic Interval Training Reduces the Burden of Atrial Fibrillation in the Short Term: A Randomized Trial Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial Use of Consumer Wearable Devices to Promote Physical Activity: A Review of Health Intervention Studies Effects of a home-based activation intervention on self-management adherence and readmission in rural heart failure patients: the PATCH randomized controlled trial The effectiveness of physical activity monitoring and distance counseling in an occupational setting – Results from a randomized controlled trial (CoAct) Medium-Term Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial Effectiveness of a pedometer-based program using a socio-cognitive intervention on physical activity and quality of life in a setting of cardiac rehabilitation. Telephone support oriented by accelerometric measurements enhances adherence to physical activity recommendations in noncompliant patients after a cardiac rehabilitation program. The comparison of a technology-based system and an in-person behavioral weight loss intervention. Exercise-based cardiac rehabilitation increases daily physical activity of patients following myocardial infarction: subanalysis of two randomised controlled trials. Individualized vs. group exercise in improving quality of life and physical activity in patients with cardiac disease and low exercise capacity: results from the DOPPELHERZ trial
abstract: Background Angina affects more than 50 million people worldwide . Secondary prevention interventions such as cardiac rehabilitation are not widely available for this population . An Internet-based version could offer a feasible alternative . Objective Our aim was to examine the effectiveness of a Web-based cardiac rehabilitation program for those with angina . Methods We conducted a r and omized controlled trial , recruiting those diagnosed with angina from general practitioners ( GPs ) in primary care to an intervention or control group . Intervention group participants were offered a 6-week Web-based rehabilitation program ( “ ActivateYourHeart ” ) . The program was introduced during a face-to-face appointment and then delivered via the Internet ( no further face-to-face contact ) . The program contained information about the secondary prevention of coronary heart disease ( CHD ) and set each user goals around physical activity , diet , managing emotions , and smoking . Performance against goals was review ed throughout the program and goals were then reset/modified . Participants completed an online  exercise diary and communicated with rehabilitation specialists through an email link/synchronized chat room . Participants in the control group continued with GP treatment as usual , which consisted of being placed on a CHD register and attending an annual review . Outcomes were measured at 6-week and 6-month follow-ups during face-to-face assessment s. The primary outcome measure was change in daily steps at 6 weeks , measured using an accelerometer . Secondary outcome measures were energy expenditure ( EE ) , duration of sedentary activity ( DSA ) , duration of moderate activity ( DMA ) , weight , diastolic/systolic blood pressure , and body fat percentage . Self-assessed question naire outcomes included fat/fiber intake , anxiety/depression , self-efficacy , and quality of life ( QOL ) . Results A total of 94 participants were recruited and r and omized to the intervention ( n=48 ) or the usual care  ( n=46 ) group ; 84 and 73 participants completed the 6-week and 6-month follow-ups , respectively . The mean number of log-ins to the program was 18.68 ( SD 13.13 , range 1 - 51 ) , an average of 3 log-ins per week per participant . Change in daily steps walked at the 6-week follow-up was + 497 ( SD 2171 ) in the intervention group and –861 ( SD 2534 ) in the control group ( 95 % CI 263 - 2451 , P=.02 ) . Significant intervention effects were observed at the 6-week follow-up in EE ( + 43.94 kcal , 95 % CI 43.93 - 309.98 , P=.01 ) , DSA ( –7.79 minutes , 95 % CI –55.01 to –7.01 , P=.01 ) , DMA ( + 6.31 minutes , 95 % CI 6.01 - 51.20 , P=.01 ) , weight ( –0.56 kg , 95 % CI –1.78 to –0.15 , P=.02 ) , self-efficacy ( 95 % CI 0.30 - 4.79 , P=.03 ) , emotional QOL score ( 95 % CI 0.01 - 0.54 , P=.04 ) , and angina frequency ( 95 % CI 8.57 - 35.05 , P=.002 ) . Significant benefits in angina frequency ( 95 % CI 1.89 - 29.41 , P=.02 ) and social QOL score ( 95 % CI 0.05 - 0.54 , P=.02 ) were also observed at the 6-month follow-up . Conclusions An Internet-based secondary prevention intervention could be offered to those with angina . A larger pragmatic trial is required to provide definitive evidence of effectiveness and cost-effectiveness . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 90110503 ; http://www.controlled-trials.com/IS RCT N90110503/IS RCT N90110503 ( Archived by WebCite at http://www.webcitation.org/6RYVOQFKM ) Background The construct of total wellness includes a holistic approach to the body , mind and spirit components of life . While the health benefits of reducing sedentary behavior and increasing physical activity are well documented , little is known about the influence on total wellness of an internet-based physical activity monitor design ed to help people to achieve higher physical activity levels . Purpose The purpose of this four-week , personal activity monitor-based intervention program was to reduce sedentary behavior and increase physical activity levels in daily living for sedentary adults and to determine if these changes would also be associated with improvement in total wellness . Methods Twenty-two men and 11 women ( 27 years ± 4.0 ) were r and omly assigned to either an intervention ( n = 18 ) or control group ( n = 15 ) . The intervention group interacted with an online personal activity monitor ( Gruve Solution ™ ) design ed to reduce sedentary time  and increase physical activity during activities of daily living . The control group did not interact with the monitor , as they were asked to follow their normal daily physical activities and sedentary behavior routines . The Wellness Evaluation of Lifestyle ( WEL ) inventory was used to assess total wellness . Sedentary time , light , walking , moderate and vigorous intensity physical activities were assessed for both intervention and control groups at baseline and at week-4 by the 7-day Sedentary and Light Intensity Physical Activity Log ( 7-day SLIPA Log ) and the International Physical Activity Question naire ( IPAQ ) . Results Significant increases in pre-post total wellness scores ( from 64 % ± 5.7 to 75 % ± 8.5 ) ( t ( 17 ) = -6.5 , p < 0.001 ) were observed in the intervention group by the end of week four . Intervention participants decreased their sedentary time ( 21 % , 2.3 hours/day ) and increased their light ( 36.7 % , 2.5 hours/day ) , walking ( 65 % , 1057 MET-min/week ) , moderate ( 67 % , 455 MET-min/week ) and vigorous intensity ( 60 % , 442 MET-min/week ) physical activity ( all p < 0.001 ) . No significant differences for total wellness were observed between the groups at baseline and no pre-post significant differences were observed for any outcome variable in the control group . Conclusion Total wellness is improved when sedentary , but sufficiently physically active adults , reduce sedentary time and increase physical activity levels ( i.e. light , waking , moderate and vigorous ) Background — Exercise training is an effective treatment for important atrial fibrillation ( AF ) comorbidities . However , a high level of endurance exercise is associated with an increased AF prevalence . We assessed the effects of aerobic interval training ( AIT ) on time in AF , AF symptoms , cardiovascular health , and quality of life in AF patients . Methods and Results — Fifty-one patients with nonpermanent AF were r and omized to AIT ( n=26 ) consisting of four 4-minute intervals at 85 % to 95 % of peak heart rate 3 times a week for 12 weeks or to a control group ( n=25 ) continuing their regular exercise habits . An implanted loop recorder measured time in AF continuously from 4 weeks before to 4 weeks after the intervention period . Cardiac function , peak oxygen uptake ( O2peak ) , lipid status , quality of life , and AF symptoms were evaluated before and after the 12-week intervention period . Mean time in AF increased from 10.4 % to 14.6 % in the control group and was reduced from 8.1 % to 4.8 % in the exercise group ( P=0.001 between groups ) . AF symptom frequency ( P=0.006 ) and AF symptom severity ( P=0.009 ) were reduced after AIT . AIT improved O2peak , left atrial and ventricular ejection fraction , quality -of-life measures of general health and vitality , and lipid values compared with the control group . There was a trend toward fewer cardioversions and hospital admissions after AIT . Conclusions — AIT for 12 weeks reduces the time in AF in patients with nonpermanent AF . This is followed by a significant improvement in AF symptoms , O2peak , left atrial and ventricular function , lipid levels , and QoL. Clinical Trial Registration — URL : http://www . clinical trials.gov . Unique identifier : NCT01325675 Objective Cardiac rehabilitation ( CR ) is pivotal in preventing recurring events of myocardial infa rct ion ( MI ) . This study aims to investigate the effect of a smartphone-based home service delivery ( Care Assessment Platform ) of CR ( CAP-CR ) on  CR  use and health outcomes compared with a traditional , centre-based programme ( TCR ) in post-MI patients . Methods In this unblinded r and omised controlled trial , post-MI patients were r and omised to TCR ( n=60 ; 55.7±10.4 years ) and CAP-CR ( n=60 ; 55.5±9.6 years ) for a 6-week CR and 6-month self-maintenance period . CAP-CR , delivered in participants ’ homes , included health and exercise monitoring , motivational and educational material delivery , and weekly mentoring consultations . CAP-CR uptake , adherence and completion rates were compared with TCR using intention-to-treat analyses . Changes in clinical outcomes ( modifiable lifestyle factors , biomedical risk factors and health-related quality of life ) across baseline , 6 weeks and 6 months were compared within , and between , groups using linear mixed model regression . Results CAP-CR had significantly higher uptake ( 80 % vs 62 % ) , adherence ( 94 % vs 68 % ) and completion ( 80 % vs 47 % ) rates than TCR ( p<0.05 ) . Both groups showed significant improvements in 6-minute walk test from baseline to 6 weeks ( TCR : 537±86–584±99 m ; CAP-CR : 510±77–570±80 m ) , which was maintained at 6 months . CAP-CR  showed slight weight reduction ( 89±20–88±21 kg ) and also demonstrated significant improvements in emotional state ( K10 : median ( IQR ) 14.6 ( 13.4–16.0 ) to 12.6 ( 11.5–13.8 ) ) , and quality of life ( EQ5D-Index : median ( IQR ) 0.84 ( 0.8–0.9 ) to 0.92 ( 0.9–1.0 ) ) at 6 weeks . Conclusions This smartphone-based home care CR programme improved post-MI CR uptake , adherence and completion . The home-based CR programme was as effective in improving physiological and psychological health outcomes  as traditional CR . CAP-CR is a viable option towards optimising use of CR services . Trial registration number ANZCTR12609000251224 Background Although many wearable devices for monitoring and tracking physical activity are available to consumers , relatively few research studies have been conducted to determine their efficacy in promoting health . Methods In this article , data on the use of consumer wearable devices in promoting healthy behaviors  are summarized based upon bibliographic search es in PubMed and Psychology and Behavioral Sciences Collection with relevant search terms through September 2016 . Results A total of 274 articles were identified in the bibliographic search es . By screening abstract s or full-text articles , six pre/post test trials and seven r and omized controlled trials were identified . In initial trials , consumer wearable devices have been shown to increase physical activity and help users lose weight . However , the number of studies completed to date is small and limited by small sample sizes , short study duration s , and uncertain generalizability of the findings . Conclusions Future studies should utilize r and omized controlled trial research design s , larger sample sizes , and longer study periods to better establish the efficacy of wearable devices in promoting physical activity . Additional research is needed to determine the feasibility and effectiveness of wearable devices in promoting physical activity and weight loss in community setting s including communities affected by health disparities . Studies focusing on children and adolescents are also needed Background Heart failure ( HF ) patients discharged from rural hospitals have higher 30-day readmission rates .  Self-management ( SM ) reduces readmissions , but adherence to SM guidelines is low in the rural HF population . We tested a home-based intervention to enhance patient activation and lead to improved SM adherence . Methods In this two-group , repeated measures r and omized control trial , the main outcomes were patient reported and clinical outcomes associated with SM adherence , and all-cause readmission at 30 , 90 and 180 days . Results The study included 100 HF patients discharged from a rural critical access hospital . The intervention group received a 12-week SM training and coaching program delivered by telephone and tailored on subjects ’ activation levels . At α = .10 , the PATCH intervention showed significantly greater improvement compared to usual care in patient-reported SM adherence : weighing themselves , following a low-sodium diet , taking prescribed medication , and exercising daily ( all p < .0005 ) at 3 and 6 months after discharge . In contrast , groups did not differ in physical activity assessed by actigraphy or in clinical biomarkers . Contrary to expectation , the 30-day readmission rate was significantly higher ( p = .088 ) in the intervention group ( 19.6 % ) than in the control group ( 6.1 % ) , with no differences at 90 or 180 days . Conclusion It is feasible to conduct a r and omized controlled trial in HF patients discharged from rural critical access hospitals . Significantly higher patient-reported SM adherence was not accompanied by lower clinical biomarkers or readmission rates . Further research is needed to underst and mechanisms that influence outcomes and healthcare utilization in this population .Trial registration Clinical Trial Registration Information : Clinical Trials.gov ; NCT01964053 Background Lack of physical activity ( PA ) is a known risk factor for many health conditions . The workplace is a setting often used to promote activity and health . We investigated the effectiveness of an intervention on  PA and productivity-related outcomes in an occupational setting . Methods We conducted a r and omized controlled trial of 12 months duration with two 1:1 allocated parallel groups of insurance company employees . Eligibility criteria included permanent employment and absence of any condition that risked the participant ’s health during PA . Subjects in the intervention group monitored their daily PA with an accelerometer , set goals , had access to an online service to help them track their activity levels , and received counseling via telephone or web messages for 12 months . The control group received the results of a fitness test and an information leaflet on PA at the beginning of the study . The intervention ’s aim was to increase PA , improve work productivity , and decrease sickness absence . Primary outcomes were PA ( measured as MET minutes per week ) , work productivity ( quantity and quality of work ; QQ index ) , and sickness absence ( SA ) days at 12 months . Participants were assigned to groups using block r and omization with a computer-generated scheme . The study was not blinded . Results There were 544 r and omized participants , of which 521 were included in the analysis ( 64 % female , mean age 43 years ) . At 12 months , there was no significant difference in physical activity levels between the intervention group ( n = 264 ) and the control group ( n = 257 ) . The adjusted mean difference was −206 MET min/week [ 95 % Bayesian credible interval −540 to 128 ; negative values favor control group ] . There was also no significant difference in the QQ index ( −0.5 [ −4.4 to 3.3 ] ) or SA days ( 0.0 [ −1.2 to 0.9 ] ) . Of secondary outcomes , body weight ( 0.5 kg [ 0.0 to 1.0 ] ) and percentage of body fat ( 0.6 % [ 0.2 % to 1.1 % ] ) were slightly higher in the intervention group . An exploratory subgroup analysis revealed no subgroups in which the intervention affected physical activity . No adverse events were reported . Conclusions The intervention was not found effective , and this study does not provide support for the effectiveness of the workplace PA intervention used here . Trial registration Clinical Trials.gov identifier : Background Cardiac telerehabilitation has been introduced as an adjunct or alternative to conventional center-based cardiac rehabilitation to increase its long-term effectiveness . However , before large-scale implementation and reimbursement in current health care systems is possible , well- design ed studies on the effectiveness of this new additional treatment strategy are needed . Objective The aim of this trial was to assess the medium-term effectiveness of an Internet-based , comprehensive , and patient-tailored telerehabilitation program with short message service ( SMS ) texting support for cardiac patients . Methods This multicenter r and omized controlled trial consisted of 140 cardiac rehabilitation patients r and omized ( 1:1 ) to a 24-week telerehabilitation program in combination with conventional cardiac rehabilitation ( intervention group ; n=70 ) or to conventional cardiac rehabilitation alone ( control group ; n=70 ) . In the telerehabilitation program , initiated 6 weeks after the start of ambulatory rehabilitation , patients were stimulated to increase physical activity levels . Based on registered activity data , they received semiautomatic telecoaching via email and SMS text message encouraging them to gradually achieve predefined exercise training goals . Patient-specific dietary and /or smoking cessation advice was also provided as part of the telecoaching . The primary endpoint was peak aerobic capacity ( VO2 peak ) . Secondary endpoints included accelerometer-recorded daily step counts , self-assessed physical activities by International Physical Activity Question naire ( IPAQ ) , and health-related quality of life ( HRQL ) assessed by the HeartQol question naire at baseline and at 6 and 24 weeks . Results Mean VO2 peak increased significantly in intervention group patients ( n=69 ) from baseline ( mean 22.46 , SD 0.78 mL/[min*kg ] ) to 24 weeks ( mean 24.46 , SD 1.00 mL/[min*kg ] , P<.01 ) versus control group patients ( n=70 ) , who did not change significantly ( baseline : mean 22.72 , SD 0.74 mL/[min*kg ] ; 24 weeks : mean 22.15 , SD 0.77 mL/[min*kg ] , P=.09 ) . Between-group analysis of aerobic capacity confirmed a significant difference between the intervention group and control group in favor of the intervention group ( P<.001 ) . At 24 weeks , self-reported physical activity improved more in the intervention group compared to the control group ( P=.01 ) as did the global HRQL score ( P=.01 ) . Conclusions This study showed that an additional 6-month patient-specific , comprehensive telerehabilitation program can lead to a bigger improvement in both physical fitness ( VO2 peak ) and associated HRQL compared to center-based cardiac rehabilitation alone . These results are supportive in view of possible future implementation in st and ard cardiac care BACKGROUND Physical activity contributes to improve health and quality of life . However , the prevalence of sedentary lifestyle is elevated after an acute coronary syndrome . METHODS A r and omized controlled trial was performed to evaluate the impact of a pedometer-based program associated with a socio-cognitive intervention on physical activity behaviour , cardiovascular risk factors , and quality of life during the year after an acute coronary syndrome event . During hospitalization , we r and omized 32 patients to an experimental group and 33 patients to a usual care group . The experimental intervention included 6 consultations with a clinical nurse specialist during 12 months . RESULTS Groups characteristics were comparable . At baseline , the percentage of participants considered in the active range category was similar between groups ( 31 % vs 41 % ; P = 0.915 ) . However , the proportion of participants who were still active was greater in the experimental group than in the usual care group at 6 , 9 , and 12 months follow-up ( 75 % vs 41 % ; 68 % vs 36 % , and 83 % vs 55 % , respectively ; P < 0.05 ) . After 12 months , changes in overall quality of life and in health and the functioning scores were different between groups ( interaction effects [ groups by time ] P = 0.048 and P = 0.036 , respectively ) . CONCLUSIONS The use of a pedometer concomitantly with a socio-cognitive intervention improves adherence to physical activity and quality of life during the year after an acute coronary syndrome event . This finding is relevant because physical activity and quality of life are a great concern in preventive cardiology . These results support applying this innovative approach in cardiac rehabilitation programs OBJECTIVE To assess the efficacy of a strategy , based on telephone support oriented by accelerometer measurements , on the adherence to physical activity ( PA ) recommendations in cardiac patients not achieving PA recommendations . DESIGN Prospect i ve and r and omized study . SETTING A cardiac rehabilitation program ( CRP ) at a clinic . PARTICIPANTS Stable , noncompliant cardiac ( coronary artery disease , heart failure , post-cardiovascular surgery ) patients ( weekly moderate-intensity PA < 150 min ) were r and omly assigned to an intervention group ( n=19 ) or a control group ( n=10 ) . INTERVENTIONS The intervention group wore an accelerometer for 8 weeks . Every 15 days , feedback and support were provided by telephone . The control group wore the accelerometer during the 8th week of the intervention only . MAIN OUTCOME MEASURES Active energy expenditure ( EE ) ( in kilocalories ) and the time spent doing light , moderate , or intense PA ( minutes per week ) . RESULTS In the intervention group , the time spent at moderate-intensity PA increased from 95.6±80.7 to 137.2±87.5 min/wk between the 1st and 8th week ( P=.002 ) , with 36.8 % of the sample achieving the target amount of moderate-intensity PA . During the 8th week , the EE averaged 543.7±144.1 kcal and 266.7±107.4 kcal in the intervention group and control group , respectively ( P=.004 ) . CONCLUSIONS Telephone support based on accelerometer recordings appeared to be an effective strategy to improve adherence to PA in noncompliant patients . This intervention could be implemented after a CRP as an inexpensive , modern , and easy-to-use strategy The purpose of this study was to compare a technology-based system , an in-person behavioral weight loss intervention , and a combination of both over a 6-month period in overweight adults . Fifty-one subjects ( age : 44.2 ± 8.7 years , BMI : 33.7 ± 3.6 kg/m(2 ) ) participated in a 6-month behavioral weight loss program and were r and omized to one of three groups : st and ard behavioral weight loss ( SBWL ) , SBWL plus technology-based system ( SBWL+TECH ) , or technology-based system only ( TECH ) . All groups reduced caloric intake and progressively increased moderate intensity physical activity . SBWL and SBWL+TECH attended weekly meetings . SBWL+TECH also received a TECH that included an energy monitoring armb and and website to monitor energy intake and expenditure . TECH used the technology system and received monthly telephone calls . Body weight and physical activity were assessed at 0 and 6 months . Retention at 6 months was significantly different ( P = 0.005 ) between groups ( SBWL : 53 % , SBWL+TECH : 100 % , and TECH : 77 % ) . Intent-to-treat ( ITT ) analysis revealed significant weight losses at 6 months in SBWL+TECH ( -8.8 ± 5.0 kg , -8.7 ± 4.7 % ) , SBWL ( -3.7 ± 5.7 kg , -4.1 ± 6.3 % ) , and TECH ( -5.8 ± 6.6 kg , -6.3 ± 7.1 % ) ( P < 0.001 ) . Self-report physical activity increased significantly in SBWL ( 473.9 ± 800.7 kcal/week ) , SBWL+TECH ( 713.9 ± 1,278.8 kcal/week ) , and TECH ( 1,066.2 ± 1,371 kcal/week ) ( P < 0.001 ) , with no differences between groups ( P = 0.25 ) . The TECH used in conjunction with monthly telephone calls , produced similar , if not greater weight losses and changes in physical activity than the st and ard in-person behavioral program at 6 months . The use of this technology may provide an effective short-term clinical alternative to st and ard in-person behavioral weight loss interventions , with the longer term effects warranting investigation OBJECTIVE To assess the effects of an exercise-based cardiac rehabilitation programme on daily physical activity levels of patients following myocardial infa rct ion . DESIGN Sub analysis of two r and omised , prospect i ve controlled trials . SETTING Outpatient clinic of a secondary hospital . PARTICIPANTS Fifty consecutive patients r and omised to the exercise group { n=25 ; 23 males ; mean age 54 [ st and ard deviation ( SD ) 9 ] years } or the control group [ n=25 ; 20 males ; mean age 58 ( SD 9 ) years ] . INTERVENTIONS The exercise group participated in an 8-week aerobic exercise programme plus usual medical care and follow-up . The control group received usual medical care and follow-up . MAIN OUTCOME MEASURES The primary outcome measure was change in time spent undertaking moderate-to-vigorous physical activity per day , assessed by accelerometer over 7 consecutive days . Secondary outcome measures were cardiorespiratory fitness , body mass , and resting blood pressure and heart rate . RESULTS Moderate-to-vigorous physical activity levels increased significantly in the exercise group [ 43.2 ( SD 36.3 ) to 53.5 ( SD 31.9 ) minutes/day , P=0.030 ] , and remained unchanged in the control group [ 40.8 ( SD 26.2 ) to 36.8 ( SD 26.5 ) minutes/day , P=0.241 ] from baseline to the end of the programme . Cardiorespiratory fitness increased significantly in the exercise group ( mean difference 2.8 ; 95 % of the difference 1.3 to 4.4ml/kg/minute , P=0.001 ) after the 8-week programme . CONCLUSIONS In patients under optimal medication following myocardial infa rct ion , participation in an 8-week exercise-based cardiac rehabilitation programme was found to improve physical activity levels consistent with health-related benefits . Future studies are needed to determine whether the increase in physical activity is maintained in the long term Abstract Purpose : Important goals of cardiac rehabilitation maintenance programs ( CMP ) are to increase leisure time physical activity ( LTPA ) and improve health-related quality of life ( HRQoL ) . Elderly patients with cardiac disease and low exercise capacity are simultaneously the most severely affected and have the most to gain from exercise-based rehabilitation . Individualized combined exercise ( ICE ) may be an effective modality to achieve these goals . We compared six months of ICE to CMP in their effects on LTPA and HRQoL. Methods : Sixty patients ( 70 ± 9 years , 39 % female ) with cardiac disease and low exercise capacity ( < 6 MET ) were r and omly allocated to six months of once-weekly ICE or CMP . The patients in ICE performed moderate endurance and resistance exercise on machines , based on intensities from individual peak exercise testing . Patients in CMP performed weekly sessions of calisthenics , flexibility , coordination and relaxation activities . LTPA and HRQoL were assessed with accelerometry and question naires at baseline and six months . Results : Sixty patients completed the trial . ICE  increased vigorous PA ( ICE : Δ + 12 MET-min/d , CMP : Δ –5 MET-min/d , p = .02 ) and steps per day ( ICE : + 1586 steps/d , CMP : –838 steps/d , p < .01 ) compared to CMP after six months . ICE significantly improved in several components of HRQoL ( vitality , emotional health , social health , positive and negative affect ( all p < .05 ) compared to CMP . Conclusions : ICE result ed in significant improvements in physical activity levels and health related quality of life in moderate to high-risk patients compared to CMP . Implication s for rehabilitation Relatively low volumes and intensities of exercise may lead to substantial improvements in both physical activity levels and health-related quality of life Exercise modes in cardiac rehabilitation maintenance programs should not be limited to calisthenics and large group-based exercise Supplemental resistance exercise may improve health-related quality of life and increase physical activity levels in patients with low exercise capacity Moderate to high-risk elderly patients also benefit from individualized endurance-resistance
target: Conclusion This review indicates that current research on activity monitoring devices may be overstated due to the variability in adherence .
  Results showed that physical activity tracking in women and in young adults have been understudied
background: Background Activity monitoring devices are currently being used to facilitate and monitor physical activity .
  No prior review has examined adherence to the use of activity monitoring devices amongst adults with cardiovascular disease .