{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:35:18Z","timestamp":1793424918073,"version":"4.5.0"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Among older adults with ischemic heart disease, participation in traditional ambulatory cardiac rehabilitation (CR) remains low. While mobile health CR (mHealth-CR) provides a novel opportunity to deliver care, age-specific impairments to technology use may limit uptake, and efficacy data are currently lacking.<\/jats:p><\/jats:sec>Objective<\/jats:title>To test whether mHealth-CR improves functional capacity in older adults.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>The RESILIENT phase 2, multicenter, randomized clinical trial recruited patients aged 65 years or older with ischemic heart disease (defined as a hospital visit for myocardial infarction or coronary revascularization) from 5 academic hospitals in New York, Connecticut, and Massachusetts between January 9, 2020, and April 22, 2024.<\/jats:p><\/jats:sec>Intervention<\/jats:title>Participants were randomized 3:1 to mHealth-CR or usual care. mHealth-CR consisted of commercially available software delivered on a tablet computer, coupled with remote monitoring and weekly exercise therapist telephone calls, delivered over a 3-month duration. As RESILIENT was a trial conducted in a routine care setting to inform decision-making, participants in both arms were also allowed to receive traditional CR at their cardiologist\u2019s discretion.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was change from baseline to 3 months in functional capacity, measured by 6-minute walk distance (6MWD). Secondary outcomes were health status (12-Item Short Form Health Survey [SF-12]), residual angina, and impairment in activities of daily living.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 400 participants (median age, 71.0 years [range, 65.0-91.0 years]; 291 [72.8%] male) were randomized to mHealth-CR (n\u2009=\u2009298) or usual care (n\u2009=\u2009102) and included in the intention-to-treat analysis. Of those, 356 participants (89.0%) returned in person for 6MWD assessment at 3 months. For the primary outcome, there was no adjusted difference in 6MWD between participants receiving mHealth-CR vs usual care (15.6 m; 95% CI, \u22120.3 to 31.5 m; P<\/jats:italic>\u2009=\u2009.06). Among subgroups, there was an improvement in 6MWD among women (36.6 m; 95% CI, 8.7-64.4 m). There were no differences in any secondary outcomes between groups (eg, adjusted difference in SF-12 physical component scores at 3 months: \u22121.9 points; 95% CI, \u22123.9 to 0.2 points). Based on inverse propensity score weighting, there was no effect of mHealth-CR on 6MWD among those who did not attend traditional CR (25.7 m; 95% CI, \u22128.7 to 60.2 m).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this randomized clinical trial of mHealth-CR vs usual care, mHealth-CR did not significantly increase 6MWD or result in improvements in secondary outcomes. The findings suggest the older adult population may require more age-tailored mHealth strategies to effectively improve outcomes.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT03978130<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.53499","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T16:00:53Z","timestamp":1736352053000},"page":"e2453499","source":"Crossref","is-referenced-by-count":31,"title":["Rehabilitation at Home Using Mobile Health for Older Adults Hospitalized for Ischemic Heart Disease"],"prefix":"10.1001","volume":"8","author":[{"given":"John A.","family":"Dodson","sequence":"first","affiliation":[{"name":"New York University Langone Medical Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samrachana","family":"Adhikari","sequence":"additional","affiliation":[{"name":"New York University Langone Medical Center, New 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