Randomized controlled trial.

An increasing number of elderly patients with competing chronic conditions are undergoing heart surgery, leading to functional decline and impaired quality of life post-discharge, despite successful surgery outcomes. Sarcopenia, characterized by muscle loss and functional decline, is a significant cause of poor health in the elderly and has been associated with reduced quality of life, cognitive impairment, disability, and mortality. Elderly patients with heart disease are particularly susceptible to sarcopenia. Still, cardiac rehabilitation (CR) has been shown to combat sarcopenia and to improve physical capacity, independence in activities of daily living, and quality of life in elderly patients. It is well-established that early engagement in physical activity and patient education significantly contributes to long-term health and well-being.

Current CR is delayed for weeks after open heart surgery due to the regimen, leaving patients at risk of a decrease in physical performance during this critical period. Patients may benefit from immediate coaching to overcome psychological and physiological barriers to physical activity and exercise. Home-based mobile CR has been shown to be a cost-effective alternative for elderly patients with heart disease who are not willing to participate in regular centre-based rehabilitation programs. The emergence of innovative mobile health technologies provides an opportunity to offer immediate coaching and personalized exercise programs at home through mobile applications. Mobile health technology might bridge the substantial gap in care patients experience between discharge from hospital and start of centre-based CR. The potential benefits of early CR supported by mobile health in combating sarcopenia and loss of quality of life after cardiac surgery require further investigation.

The aim of this project is to investigate whether early remote CR using a mobile application improves physical ability and quality of life after cardiac surgery and to investigate the cross-sectoral transition from hospital to a municipal setting and its impact on physical activity, and adherence to CR programs.

This project is a bicentre study with a collaboration between the Cardiothoracic and Vascular Department, Aarhus University Hospital and Department of Cardiothoracic Surgery, Aalborg University Hospital.

• Rikke Daugaard, physiotherapist, MHSc, PhD student, Department of Clinical Medicine, Aarhus University, Denmark and Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark
• Ivy Susanne Modrau, MD, dr.med. (German), Associate Professor, Consultant Cardiac Surgeon, Senior researcher, Department of Clinical Medicine, Aarhus University, Denmark and Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Denmark
• Lotte Sorensen, Physiotherapist, Clinical Specialist, PhD, Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Denmark
• Thomas Maribo, Physiotherapist, Professor, PhD, Department of Public Health - Department of Health Services Research, Aarhus University and DEFACTUM, Aarhus, Denmark
• Lotte Ørneborg Rodkjær, Senior Researcher, PhD, Lecturer Infectious Diseases, Aarhus University Hospital and Department of Public Health, Aarhus University, Denmark
• Stian Ingemann-Molden, Physiotherapist, MHSc, Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark

The project has received funding from Novo Nordisk Fonden, Helsefonden and Eva & Henry Frænkels Mindefond.