The Royal Liverpool and Broadgreen University Hospitals NHS: Cardiac Rehabilitation

Dr Barnaby Hirons, Professor Michael Fisher, Kirstie Tew, MSc.

Executive Summary


Physical Activity is a key component of Cardiac Rehabilitation (CR). However, provision is limited to weekly or bi-weekly structured exercise training and general advice on physical activity in a free-living environment. Our unique innovation provides a way to optimise free-living physical activity, as recommended by the British Association of Cardiac Rehabilitation and Prevention (BACPR), in a bespoke and precise fashion.

We undertook a pilot study with the Royal Liverpool and Broadgreen University Hospitals NHS Trust in order to establish the efficacy and feasibility of using on-body monitoring and contextualised feedback with CR patients.


  • Patients wore the validated wearable monitor for 5-full days in the first and final weeks of their Phase 3 outpatient-based CR programmes.
  • Data was passed through Ki’s proprietary algorithms and reported back to patients in the context of their recovery.
  • Patients received bespoke feedback on their own ideal intensity range and their free-living activities which were beneficial to them.
  • Activities performed above their ideal recovery intensity were highlighted to show where they were working too hard.
  • Following the completion of the pilot, focus groups were conducted and patients reported their desire to understand how to be active, and what the ideal intensity was, for them to benefit.

Key Findings

  • Continuous monitoring of free-living physical activity was shown to be feasible and highly acceptable to CR patients.
  • Patients increased their physical activity at the ideal intensity and duration.
  • Contextualised feedback was associated with a 27% increase in the proportion of physical activity at the ideal intensity.

We were asked to present the results of our study at the BACPR conference in 2014, with our poster chosen for its “outstanding quality.”