Liverpool University Hospitals NHS: Phase 4 Cardiac Rehabilitation Pilot

¹Dr Tom Rayner, ¹Dr Priyanka Meenamkuzhy-Hariharan, ²Miss Kirstie Tew, ^1,3Professor Michael Fisher

¹Liverpool University Hospitals NHS Foundation Trust, Prescot St, Liverpool, L7 8XP, UK; ²KiActiv®; ³University of Liverpool, Liverpool, UK

Executive Summary

Background

Cardiac rehabilitation (CR) is effective in reducing premature death and improves physical and psychosocial health and quality of life (QoL) (BACPR, 2012; NICE, 2013). Much, although not all, of this benefit is thought to be due to physical activity (PA). However, participation is sub-optimal, with only 35-50% of eligible individuals taking up CR (NACR, 2019). 

We aimed to test the hypothesis that a technology-enabled service incorporating accurate physical activity data from a wearable, personalised online feedback and remote mentor support, in addition to CR, leads to increases in PA.

Methodology

Patients referred for CR between September 2020 and April 2021 eligible for inclusion were commenced on the KiActiv^® Health 12-week CR programme (n=17) in addition to a pandemic-limited conventional CR service. Baseline characteristics were assessed. Area under the curve (AUC) and incremental AUC calculations determined average total PA and additional PA achieved over multiple domains. QoL and mental health questionnaires completed before and after CR were compared using paired t-tests

Results

Eighty-two percent of patients completed the programme (n=14). The mean age for the cohort was 58 and 82% were male. Clients wore the PA monitor and visited the online platform on 95% and 31% of days during the programme, respectively. Improvements in PA were seen in one or more, three or more and four or more domains for 92.9%, 78.6% and 64.3% of participants, respectively. There were increases in non-sedentary time, moderate activity, calorie burn and moderate bouts in patients on the programme (Figure 1).

All patients reported an improvement in at least one domain of QoL, with statistically significant improvements in physical fitness and overall health (p<0.05). Symptom scores for questionnaire-reported depression and anxiety decreased, though not statistically significantly.

Discussion

Engagement with the KiActiv^® Health CR programme was excellent, and was associated with improvements in PA, self-reported mental health and QoL. Randomised data is required to compare this intervention to usual practice and provide evidence of causation.

After peer review, we were asked to present the results of our pilot study at the BACPR conference in 2022.