{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:21:41Z","timestamp":1790788901712,"version":"4.1.0"},"reference-count":57,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"\n Background<\/jats:title>\n Cardiac rehabilitation is known to reduce coronary artery disease (CAD) severity and symptoms, but adoption of a healthy postrehabilitation lifestyle remains challenging. Innovative eHealth solutions could help, but behavioral change\u2013based eHealth maintenance programs for patients with CAD are scarce. RehaPlus+ aims to improve postrehabilitation outcomes with a personalized eHealth intervention built on behavioral change concepts emphasizing healthy lifestyle changes, especially regular physical activity (PA).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to evaluate the effectiveness of the personalized eHealth program RehaPlus+ for promoting regular PA against usual care.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 169 patients with CAD who had undergone stent implantation or bypass surgery were recruited after completing center-based phase II rehabilitation. They were then divided, without blinding, into 2 groups using a quasi-experimental approach: a case manager\u2013assisted 24-week eHealth program (RehaPlus+; n=84) and a conventional physician-assisted outpatient program (usual care; n=85). The study was designed as a noninferiority trial. RehaPlus+ participants received motivational messages twice weekly for 6 months, and the usual care group engaged in a 6-month outpatient program (twenty-four 90-minute strength and endurance training sessions). The primary outcomes, evaluated using the self-assessed Bewegungs- und Sportaktivit\u00e4t questionnaire, were regular PA (\u2265150 min\/wk) and weekly activities of daily living (ADLs) 6 months after rehabilitation. Secondary outcomes involved PA during work and floors climbed weekly (measured by Bewegungs- und Sportaktivit\u00e4t questionnaire), psychological well-being (assessed by the 5-item World Health Organization Well-Being Index), cardiac self-efficacy, health-related quality of life (measured by the 36-Item Short Form Survey), and work ability (using the Work Ability Index).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Data of 105 patients (RehaPlus+: n=44, 41.9%; usual care: n=61, 58.1%; male patients: n=80, 76.2%; female patients: n=25, 23.8%; mean age 56.0, SD 7.3 years) were available at the 6-month follow-up. At 6 months after discharge from phase II cardiac rehabilitation, the RehaPlus+ group exhibited 182 (SD 208) minutes per week of PA and the usual care group exhibited 119 (SD 175) minutes per week of PA (P=.15), with no interaction effect (P=.12). The RehaPlus+ group showed an ADL level of 443 (SD 538) minutes per week compared to the usual care group with 308 (SD 412) minutes per week at the 6-month follow-up, with no interaction effect (P=.84). The differences observed in PA and ADL levels between the RehaPlus+ and usual care groups were within the predefined 1-sided noninferiority margin, indicating that the RehaPlus+ intervention is not inferior to usual care based on these outcomes. There were no differences between the groups for all secondary outcomes (P>.05).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n RehaPlus+ is not inferior to the usual care program, as both groups improved PA and ADLs to a similar extent. These findings emphasize the potential of eHealth interventions to assist in maintaining healthy lifestyles after rehabilitation.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n ClinicalTrials.gov NCT06162793; https:\/\/clinicaltrials.gov\/study\/NCT06162793<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/56480","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T11:37:19Z","timestamp":1721648239000},"page":"e56480","source":"Crossref","is-referenced-by-count":9,"title":["A Behavioral Change\u2013Based Mobile Intervention for Promoting Regular Physical Activity in Medical Rehabilitation Maintenance of Patients With Coronary Artery Disease: Controlled Trial"],"prefix":"10.2196","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1338-8560","authenticated-orcid":false,"given":"Melina","family":"Waranski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7428-5692","authenticated-orcid":false,"given":"Ren\u00e9","family":"Garbsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7046-8058","authenticated-orcid":false,"given":"Mona","family":"Kotewitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5613-6703","authenticated-orcid":false,"given":"Marc","family":"Teschler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7041-7424","authenticated-orcid":false,"given":"Boris","family":"Schmitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0258-2732","authenticated-orcid":false,"given":"Frank C","family":"Mooren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,10,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz425"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.983536"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.180945"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001800.pub2"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1177\/1179546817710028"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.85a.17037"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1097\/HJR.0b013e328334f42d"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/iby017"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5000"},{"key":"ref10","year":"2013","journal-title":"Guidelines for Cardiac Rehabilitation and Secondary Prevention Programs"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-012-9489-y"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1177\/0269215509353262"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1097\/HJR.0b013e3280128bce"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9149(98)00136-2"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/s0828-282x(09)70098-4"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2020.0213"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.15420\/cfr.2020.32"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2022.06.959"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010821"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2021.04.026"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308966"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwad145"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1093\/eurjcn\/zvad034"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s00108-011-2889-1"},{"key":"ref25","author":"Axelrod, DA","year":"2006","journal-title":"Clinical Research Methods for Surgeons. 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