Guided physical exercise of cardiac patients during rehabilitation: Adherence and changes in physiological variables

A system to provide cardiac patients with the possibility to perform safe and beneficial exercise during their rehabilitation was developed within the EU project Heartcycle. Within the system, algorithms use physiological signals from a wearable device (embedded in a shirt) to guide the patient through the exercise. After having been technically validated, the system was deployed for clinical evaluation with 63 patients in Germany (21), Great Britain (25) and Spain (17). The paper describes the first findings of this evaluation study with respect to: technical feasibility, adherence of the patients to the prescribed exercise protocol, and changes in physiological observables as the patients follow their exercise plan. Technically, the system functioned well, and overall the adherence of those patients that actually started using the system was stable, or even improving, in the vast majority of cases. An increase was especially seen in adherence to the protocol set for the warm-up phase of the exercise. This is an important finding for a group of patients that is known to have declining adherence to rehabilitation recommendations in the long term. The recovery analysis showed that especially the recovery of the heart rate as measured in the first minute after the exercise end showed improvement over time.