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All patients underwent a 3-week inpatient rehabilitation program. PAL (in total activity minutes\/week) was measured with a validated (online) questionnaire (Freiburger Questionnaire on PA) after 3, 6, 9, and 12 months. App usage (online time, completion of a course) was recorded automatically and used to evaluate the app user behavior (adherence). A variety of socio-economic factors (age, sex, education level, income etc.) were collected to identify possible barriers of app use. Except for sex, no significant difference was observed for socio-economic factors regarding app usage behavior. Median PAL significantly increased after rehabilitation in the total cohort from 360 min\/week (before rehabilitation) to 460 min\/week 6 months after rehabilitation, then declined to 420 min\/week 9 months after rehabilitation before falling below baseline level after 12 months. There was no significant difference in PAL between app users (45%, 91\/202) and non-users (55%, 111\/202), although app users tended to retain higher activity levels after 3 and 6 months, respectively. Overall, our study emphasizes the effectiveness of a 3-week rehabilitation program on PAL and the acceptance and usability of a smartphone-based after-care program in this patient group. The adherence to this 3-months after-care app program was acceptable (30%), with modest evidence supporting the effectiveness of app use to sustain PAL in the short term.<\/jats:p>","DOI":"10.1371\/journal.pdig.0000359","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T17:20:58Z","timestamp":1697476858000},"page":"e0000359","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Can mobile-health applications contribute to long-term increase in physical activity after medical rehabilitation?\u2013A pilot-study"],"prefix":"10.1371","volume":"2","author":[{"given":"Fabian","family":"Borst","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6898-5799","authenticated-orcid":true,"given":"Monika","family":"Reuss-Borst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Boschmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,10,16]]},"reference":[{"issue":"9838","key":"pdig.0000359.ref001","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/S0140-6736(12)60898-8","article-title":"The pandemic of physical inactivity: global action for public health","volume":"380","author":"HW Kohl","year":"2012","journal-title":"The Lancet"},{"issue":"24","key":"pdig.0000359.ref002","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"FC Bull","year":"2020","journal-title":"British journal of sports medicine"},{"issue":"10051","key":"pdig.0000359.ref003","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1016\/S0140-6736(16)30383-X","article-title":"The economic burden of physical inactivity: a global analysis of major non-communicable diseases","volume":"388","author":"D Ding","year":"2016","journal-title":"The Lancet"},{"issue":"1","key":"pdig.0000359.ref004","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1016\/S2214-109X(22)00464-8","article-title":"The cost of inaction on physical inactivity to public health-care systems: a population-attributable fraction analysis","volume":"11","author":"AC Santos","year":"2023","journal-title":"The Lancet Global Health"},{"issue":"4","key":"pdig.0000359.ref005","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s40279-013-0128-8","article-title":"Resistance exercise versus aerobic exercise for type 2 diabetes: a systematic review and meta-analysis","volume":"44","author":"Z Yang","year":"2014","journal-title":"Sports medicine (Auckland, N.Z.)"},{"issue":"2","key":"pdig.0000359.ref006","doi-asserted-by":"crossref","first-page":"e13137","DOI":"10.1111\/obr.13137","article-title":"What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? 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