Mobile application as a tool for outpatient rehabilitation: experience and outcomes in patients after coronary artery bypass graft surgery

Aim. To assess the effectiveness and safety of remote monitoring of physical rehabilitation using a mobile application in patients after coronary artery bypass graft (CABG) surgery in comparison with the traditional model of outpatient cardiac rehabilitation. Materials and Methods. A total of 150 patients undergoing outpatient rehabilitation after CABG surgery were included in the study. Patients were randomized into three groups: 1) those underwent rehabilitation using a mobile application; 2) those who used pedometers for home-based monitoring of physical activity; 3) those who received standard rehabilitation under the supervision of a healthcare provider at their place of residence. The effectiveness and safety of supervised training were assessed during follow-up clinic visits at 4 and 12 months after CABG surgery by determining clinical and functional indicators, including physical activity levels, quality of life, and the frequency and severity of complications. Results. Remote monitoring of outpatient cardiac rehabilitation, conducted at home using a smartphone-based mobile application, and pedometers to dose physical activity without the mobile application demonstrated safety, as confirmed by the absence of destabilization episodes. The use of the mobile application for outpatient rehabilitation monitoring showed comparable effectiveness to the pedometer-based program in achieving target blood pressure levels within one year after CABG surgery (96% and 89%, respectively, compared with 49% without monitoring; p = 0.03). Only the mobile application group demonstrated a significant reduction in resting heart rate (from 71 [CI 64–76] to 65 [CI 62–70] beats per minute). All outpatient rehabilitation programs, whether remotely monitored or not, proved ineffective in achieving target lipid profile values. Conclusion. Remote monitoring in cardiac rehabilitation contributes to improved blood pressure control, reduced heart rate, and increased exercise tolerance within one year after CABG surgery.

1. Aronov DM, Bubnova MG. Efficiency of physical rehabilitation of patients with heart failure after myocardial infarction. Russian Journal of Cardiology. 2025;30(1):5950. (In Russ). https://doi.org/10.15829/1560-4071-2025-5950

2. Aronov DM. History of cardiac rehabilitation in Russia. Kardiologiia. 2018;58(11S):14–21. (In Russ.). https://doi.org/10.18087/cardio.2604

3. Aronov DM, Bubnova MG, Ivanova GE. The organizational bases of cardiac rehabilitation in Russia: present-day stage. CarDiosomatics. 2012;3(4):5– 11. (In Russ.).

4. Cardiovascular prevention 2017. National guidelines. Russian Journal of Cardiology. 2018;(6):7–122. (In Russ.). https://doi.org/10.15829/1560- 4071-2018-6-7-122

5. Mishina IE, Berezina EV, Blinova KA, Parfenov AS, Lebedeva OV, Khoroshilova OV, et al. Telemedicine-assisted cardiac rehabilitation: A controlled cohort clinical trial. Meditsinskiy sovet = Medical Council. 2024;(23):27–34. (In Russ.) https://doi.org/10.21518/ms2024-474

6. Vladimirsky VE, Vladimirsky EV, Lebedeva OD, Fesyun AD, Yakovlev MYu, Lunina AN. Cardiac rehabilitation: investigation of efficacy, results, perspectives. Problems of Balneology, Physiotherapy and Exercise Therapy. 2023;100(5):45–55. (In Russ.). https://doi.org/10.17116/kurort202310005145

7. Mishina IE, Arkhipova SL, Chistyakova YuV, Malkova AN, Astafieva MS, Vassilieva NV. Life quality in patients who undergone cardiorehabilitation course after acute coronary syndrome. Bulletin of the Ivanovo state medical academy. 2018;23(4):29–33. (In Russ.).

8. Montone RA, Rinaldi R, Niccoli G, Andò G, Gragnano F, Piccolo R, et al. Optimizing Management of Stable Angina: A Patient-Centered Approach Integrating Revascularization, Medical Therapy, and Lifestyle Interventions. J Am Coll Cardiol. 2024;84(8):744–760. https://doi.org/10.1016/j.jacc.2024.06.015

9. Bokeriya LA, Aronov DM, Barbarash OL, Bubnova MG, Knyazeva TA, Lyamina NP, et al. Russian clinical guidelines. Coronary artery bypass grafting in patients with ischemic heart disease: rehabilitation and secondary prevention. Cardiosomatics. 2016;7(3–4):5–71. (In Russ.).

10. Erokhin S, Kozlovskikh B, Zaichenko A. Comparison of coronary artery bypass grafting by oncab and opcab technique. Internauka. 2023;(3–1):50–53. (In Russ.)

11. Ezhov MV, Kukharchuk VV, Sergienko IV, Alieva AS, Antsiferov MB, Ansheles AA, et al. Disorders of lipid metabolism. Clinical Guidelines 2023. Russian Journal of Cardiology. 2023;28(5):5471. (In Russ.) https://doi.org/10.15829/1560-4071-2023-5471

12. Brown TM, Pack QR, Aberegg E, Brewer LC, Ford YR, Forman DE, et al. Core Components of Cardiac Rehabilitation Programs: 2024 Update: A Scientific Statement From the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2024;150(18):e328–e347. https://doi.org/10.1161/CIR.0000000000001289

13. Douma ER, Kop WJ, Kupper N. Associations Between Psychological Factors and Adherence to Health Behaviors After Percutaneous Coronary Intervention: The Role of Cardiac Rehabilitation. Ann Behav Med. 2024;58(5):328–340. https://doi.org/10.1093/abm/kaae008

14. Suslin SA, Kiryakova OV, Sheshunova SV, Ignatov MYu, Kashirin AK. Characteristics of cardiology services for the adult population of a large city in modern conditions. Current problems of health care and medical statistics. 2025;(1):1031–1050. (In Russ.). https://doi.org/10.24412/2312-2935-2025-1-1031-1050

15. Zvereva TN, Babichuk AV, Potapenko AA, Pomeshkina SA, Argunova YuA. Analysis of compliance of ambulatory cardiologists and patients to rehabilitation programs after coronary artery bypass grafting. Medical alphabet. 2022;(30):24–27. (In Russ.). https://doi.org/10.33667/2078-5631-2022-30-24-27