Doi, S

Abstract Background Home-based cardiac rehabilitation (HBCR) is emerging in the COVID era, but few studies have addressed "gamification", the use of game elements in non-game contexts. Purpose This pilot study investigates the applicability of gamification application to HBCR. Methods Patients who were hospitalized with acute coronary syndrome and agreed to undergo HBCR using a smartphone/smartwatch immediately after discharge were candidates for the study. The smartphone application included gamification, whereby the patients earned points for achieving exercise within an appropriate heart rate range and received feedback based on their points. The primary endpoint was the frequency of performing HBCR with the application from discharge to the date of the first outpatient visit. Secondary endpoints were the frequency of complications and correlations in several parameters of the application. Results The study included data from 16 patients. The mean duration of intervention was 29 ± 6 days. Total smartphone application use was 59.9% (282/471 days). Peak VO2 increased significantly after HBCR (18.4 ± 4.1 vs. 21.1 ± 5.4 mL/min/kg, p = 0.004) and the patients had no complications. Total application use was significantly positively correlated (r = 0.665, p = 0.007) with the application use persistence index (calculated by dividing the duration of application use in the second half of the intervention by the duration of use in the first half). Conclusion The smartphone application with gamification can be safely applied to HBCR. Continued use of the application creates a virtuous circle for patients, and gamification may be one of the keys to this.