Principal Findings
weight loss
CVD
In this study, cardiac rehabilitation including remote technology decreased waist circumference more than conventional rehabilitation without remote technology during the 6- and 12-month follow-ups. Our waist circumference results were similar to those reported in previous studies [Previous obesity-related, technology-based systematic reviews and meta-analyses in rehabilitation settings compared experimental groups with heterogeneous control groups [Previous studies have demonstrated that a clinically significant change, 5% to 10% weight loss, is associated with health benefits [However, in our study, statistically significant changes were observed in waist circumference, which is a clinically meaningful outcome in cardiac rehabilitation because increased waist circumference is associated with CVD risk and CVD mortality [The largest reduction in waist circumference occurred during the first 6 months in the remote technology intervention group. This result was also sustained at the 12-month measurement, but waist circumference did not decrease further during the 6- to 12-month period. These results are consistent with those of previous studies demonstrating that the largest weight reduction occurs during the first 6 months of the intervention [This study focused on weight loss more broadly than previous studies, including physical function and QoL. Only the environmental domain achieved a statistically significant between-group difference at the 6-month measurement point. Within-group differences in the 6MWT at every measurement point and in the environmental domain in the remote technology intervention group at the 6-month measurement point showed statistically significant changes. To our knowledge, only one study [This study included social support from other rehabilitees and health care professionals twice a month. Rehabilitees also had their own Facebook groups; however, they were inactive in peer support, groups, and using Movendos. In this study, as the remote technology intervention and reference groups were randomized in the clusters, there was a possibility to evaluate whether there were statistically significant changes in the outcomes that occurred in the remote technology intervention (between clusters 2, 4, and 6) and reference (between clusters 1, 3, and 5) groups during the intervention (0-6 and 0-12 months). In this study, there were no statistically significant changes in any outcome between clusters. The sample size of the clusters was small, which could have affected the results. Therefore, the results of the cluster analyses were indicative. In the future, it is important to study the individual and group factors that affect the function of the group. A possible cluster effect should be considered in the future when planning and implementing rehabilitation interventions. For example, peer support has been found to be important in the process of weight loss, as rehabilitees learn together, share experiences, and feel a sense of belonging. They value the support of their peers in the same situation [