Uso de M-Health associado a programa de reabilitação cardiovascular sobre capacidade funcional, aderência e fatores de risco cardiovasculares: revisão sistemática e metanálise

Abstract

Introduction: Smartphone applications for health (M-Health) seem to overcome barriers to access to Cardiovascular Rehabilitation Programs (CRP), favored by their high degree of acceptability and can positively influence the frequency of physical exercise in weight loss. Objective: Analyze the influence of the association between M-Health and CRP in cardiorespiratory fitness, adherence to CRP and in management of cardiovascular risk factors, when compared to cardiac patients inserted in isolated CRP (without association with M-Health). Design: Systematic Review and Meta-Analysis Methods: The following databases were used: Medline via Ovid, EMBASE, Central, PEDro and SPORTDiscus via EBSCOhost from the oldest record until December 20, 2019. Among the inclusion criteria are cardiac patients older than 18 years submitted to M- Health associated with CRP. Results: 14 randomized controlled trials (RCTs) were eligible. The risk of bias was considered moderate and the interventions with M-Health consisted of text messages, e-mails, and applications. In the primary endpoint, thirteen of these studies assessed VO2 peak, 6MWT and IPAQ; in secondary outcomes, eight studies addressed cardiovascular risk management and nine assessed adherences to interventions and feedback questionnaires. For quantitative analysis, there were estimates of effects favorable to the association of M-Health for the variables: cardiorespiratory fitness, resting heart rate, diastolic blood pressure and triglycerides. Conclusion: There is high quality of evidence and strength of recommendation favorable to the intervention of M-Health in improving cardiorespiratory fitness and triglycerides. This favorable effect extends to the behavior of heart rate and diastolic blood pressure, despite lower levels of quality of evidence.