Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study

PLoS One. 2016 Aug 23;11(8):e0161268. doi: 10.1371/journal.pone.0161268. eCollection 2016.

Abstract

We introduce a cardiac rehabilitation program (CRP) that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR) with the target heart rate zone (THZ). The HR is estimated using video images of a fingertip taken by the smartphone's built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up. In the exercise with intensity guidance, the app estimates HR from the pulse obtained using the smartphone's built-in camera and compares the estimated HR with the THZ. Based on this comparison, the app adjusts the exercise intensity to shift the patient's HR to the THZ during exercise. In the post-exercise period, the app manages the ratio of the estimated HR to the THZ and provides a questionnaire on factors such as chest pain, shortness of breath, and leg pain during exercise, as objective and subjective evaluation indicators. As a key issue, HR estimation upon signal corruption due to motion artifacts is also considered. Through the smartphone-based CRP, we estimated the HR accuracy as mean absolute error and root mean squared error of 6.16 and 4.30bpm, respectively, with signal corruption due to motion artifacts being detected by combining the turning point ratio and kurtosis.

MeSH terms

  • Cardiac Rehabilitation / instrumentation*
  • Cardiac Rehabilitation / methods
  • Exercise / physiology*
  • Feasibility Studies
  • Heart / physiology*
  • Heart Rate / physiology*
  • Humans
  • Smartphone

Grants and funding

This work was supported by Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI12C0110), K-HY; and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2013R1A1A1005775 and NRF-2015M3A9D7067215), JL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.