An m-Health system for education and motivation in cardiac rehabilitation: the experience of HeartCycle guided exercise

Dario Salvi (Corresponding Author), Manuel Ottaviano, Salla Muuraiskangas, Alvaro Martínez-Romero, Cecilia Vera-Muñoz, Andreas Triantafyllidis, Maria Fernanda Cabrera Umpiérrez, Maria Teresa Arredondo Waldmeyer, Erik Skobel, Christian Knackstedt, Hilkka Liedes, Anita Honka, Jean Luprano, John GF Cleland, Wim Stut, Carolyn Deighan

    Research output: Contribution to journalArticleScientificpeer-review

    39 Citations (Scopus)


    Introduction: Home-based programmes for cardiac rehabilitation play a key role in the recovery of patients with coronary artery disease. However, their necessary educational and motivational components have been rarely implemented with the help of modern mobile technologies. We developed a mobile health system designed for motivating patients to adhere to their rehabilitation programme by providing exercise monitoring, guidance, motivational feedback, and educational content. Methods: Our multi-disciplinary approach is based on mapping "desired behaviours" into specific system's specifications, borrowing concepts from Fogg's Persuasive Systems Design principles. A randomised controlled trial was conducted to compare mobile-based rehabilitation (55 patients) versus standard care (63 patients). Results: Some technical issues related to connectivity, usability and exercise sessions interrupted by safety algorithms affected the trial. For those who completed the rehabilitation (19 of 55), results show high levels of both user acceptance and perceived usefulness. Adherence in terms of started exercise sessions was high, but not in terms of total time of performed exercise or drop-outs. Educational level about heart-related health improved more in the intervention group than the control. Exercise habits at 6 months follow-up also improved, although without statistical significance. Discussion: Results indicate that the adopted design methodology is promising for creating applications that help improve education and foster better exercise habits, but further studies would be needed to confirm these indications.
    Original languageEnglish
    Article number303316
    Number of pages14
    JournalJournal of Telemedicine and Telecare
    Issue number4
    Publication statusPublished - 2018
    MoE publication typeA1 Journal article-refereed



    • m-Health
    • cardiac rehabilitation
    • coronary artery diseases
    • education and motivation


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