A systematic review on smartphone use for activity monitoring during exercise therapy in intermittent claudication.

OBJECTIVE:Supervised exercise therapy is recommended as first line in the management of intermittent claudication. Its use is often limited by accessibility, compliance and cost. Home-based exercise therapy (HBET) programs emerged as an alternative solution, but have shown inferior results. The use of structured monitoring with the use of external wearable activity monitors (WAM) has been shown to improve outcomes. Mobile applications (apps) can make use of built-in accelerometers of modern smartphones and become an alternative solution for monitoring patients during HBET, potentially providing wider accessibility. This review aims to assess current use of smartphone technology (ie, mobile apps) for monitoring or tracking patients' activity in exercise therapy for peripheral arterial disease (PAD). METHODS:The PubMed database was searched from January 2011 to September 2021. Eligible articles had to include a population of patients with PAD, conduct a mobile-health exercise intervention and use smartphone technology for monitoring or tracking patients' activity. Randomized controlled trials, prospective studies, and study protocols were included. RESULTS:A total of seven articles met the selection criteria. These articles described six different studies and five different mobile apps. Three were fitness apps (FitBit, Nike+ FuelBand, and Garmin Connect) that synchronized with commercially available WAMs to provide users with feedback. Two were PAD-specific apps (TrackPAD and Movn) developed specifically to assess patients' activity during exercise therapy. PAD-specific apps also incorporated coaching and educational elements such as weekly goal setting, claudication reminders, messaging, gamification, training advice, and PAD education. CONCLUSIONS:Current HBET programs use smartphone apps mainly via commercially available fitness apps that synchronize with WAM devices to register and access data. PAD-specific apps are scarce, but show promising features that can be used to monitor, train, coach, and educate patients during HBET programs. Larger studies combining these elements into HBET programs should provide future direction.