Efficacy of an mHealth-guided tailored physical activity intervention on exercise tolerance and sedentary behaviour in ischaemic heart disease: A prospective cohort study

Abstract Background Ischaemic heart disease (IHD) remains a preeminent cause of global mortality [6]. The progressive nature of coronary atherosclerosis necessitates nuanced clinical interventions involving structured physical activity [7]. This study investigates the complex intersection of residential living conditions, baseline cardiovascular pathophysiology and the efficacy of an individualised, mobile health (mHealth)-guided physical activity program among patients diagnosed with IHD [8,13]. Materials and Methods This prospective cohort study was conducted at the Tashkent State Medical University clinic, enrolling 183 patients (98 men, 85 women; mean age 64.2 ± 5.1 years) diagnosed with stable exertion angina pectoris (functional class II-III). Patients were categorised into urban ( n = 89) and rural ( n = 94) cohorts. Subjective baseline activity was assessed using the ODA-23+ questionnaire and daily diaries, while objective exercise tolerance was evaluated via cycle ergometry [3,5]. Following baseline assessments, patients were prescribed a tailored exercise regimen managed via the ‘HealthRunApp’ and followed up at 6 months [30–32]. Results At baseline, arterial hypertension was highly prevalent (84.3% urban, 80.8% rural). Daily diaries revealed profound sedentarism; urban men averaged 11.4 ± 1.8 hr of sleep per day, while rural women averaged 5.7 ± 0.7 hr of television viewing. Subjective assessments demonstrated massive overestimation of physical condition: 64.7% of rural men self-rated their activity as medium to high [10,29]. However, objective cycle ergometry revealed that 80% of urban patients possessed low or very low exercise tolerance. Following the 6-month mHealth intervention, cycle ergometry duration significantly increased ( p < 0.001), total work volume improved dramatically across all cohorts ( p < 0.01) and ischaemic indicators significantly decreased ( p < 0.001). Conclusion While a severe baseline disconnect exists between self-perceived health literacy and objective physiological tolerance among IHD patients, the introduction of a tailored, continuously monitored mHealth cardiac rehabilitation programme successfully combats hypodynamia, safely improves exercise tolerance and enhances objective motor activity across both urban and rural demographics [6,27,29,34].

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