Integrating Digital Exercise Monitoring into Hybrid Cardiac Rehabilitation: A Feasibility Study

Adherence to prescribed exercise remains a major challenge in cardiac rehabilitation (CR) for individuals with ischemic heart disease (IHD). This pilot randomized controlled trial evaluated the feasibility of UMFit App, a digital monitoring system integrating wearable technology and mobile health (mHealth) to improve exercise adherence and program compliance. Thirty patients with IHD (median age: 59 years; 97% male) were randomized into three groups: exercise telemonitoring (ExTele), self-monitoring (ExSelf), and usual care (control). The intervention combined a wrist-worn activity tracker, a smartphone application, and remote teleconsultations. Feasibility outcomes included research process, user acceptability, cost estimation, and preliminary health outcomes. The ExTele group showed a significant increase in weekly step count (+3,961.8 steps; p < 0.001), while the ExSelf group achieved the highest CR compliance rate (90%). Participants reported high acceptance of the system in terms of trust, usability, and perceived value. Exercise capacity improved across all groups (+1.8 METs, p < 0.0001; + 47.2 m in the six-minute walk test, p = 0.001), with the ExSelf group demonstrating a significant reduction in low-density lipoprotein (LDL) cholesterol (−0.9 mmol/L, p = 0.024). No adverse cardiac events were reported, indicating the intervention’s safety. These findings support the feasibility of a hybrid digital CR model integrating wearable and mHealth technologies. This approach also has broader potential for monitoring exercise performance, supporting rehabilitation, and enhancing adherence. Future studies with larger samples and AI-enhanced analytics are recommended to further personalize exercise interventions.