DETERMINING THE EFFECTS OF PHYSICAL ACTIVITY ON ISCHEMIC HEART DISEASE
Annotatsiya
Abstarct Background: Patients with ischemic heart disease (IHD) often exhibit high levels of sedentary behaviour while overestimating their physical capabilities, which hinders effective rehabilitation. Purpose: To quantify the discrepancy between subjective and objective physical activity levels in urban and rural IHD patients, and to evaluate the efficacy of a personalised, mHealth-guided exercise intervention. Materials and Methods: This prospective cohort study included 183 IHD patients with stable angina (FC II-III), divided into urban (n=89) and rural (n=94) cohorts. Baseline physical activity was evaluated subjectively (ODA-23+ questionnaire, daily diaries) and objectively (cycle ergometry). Patients subsequently completed a 6-month tailored exercise program monitored via a mobile application ("HealthRunApp"). Results: Initially, despite ~65% of men subjectively rating their physical activity as medium or high, objective cycle ergometry revealed low or very low exercise tolerance in 80% of urban patients and 88.4% of rural women. Following the 6-month mHealth intervention, total work volume during cycle ergometry significantly increased across all groups (up to 1.9 times, p<0.01). Furthermore, exercise duration significantly increased (p<0.001), and pathological ischemic markers (ST segment shifts, extrasystoles) were drastically reduced (p<0.001). Conclusion: A personalised, mHealth-guided cardiac rehabilitation program successfully overcomes baseline cognitive dissonance regarding physical condition, effectively combats sedentary behaviour, and safely improves objective exercise tolerance in both urban and rural IHD patients. Keywords (MeSH): Coronary Artery Disease; Angina, Stable; Exercise Tolerance; Sedentary Behaviour; Cardiac Rehabilitation; Telemedicine; Rural Population; Urban Population