The effects of web application program for shoulder exercise and the recommendations for physical activities in patients after cardiac implantable electronic devices implantation
Main Article Content
Abstract
Background: Web application for shoulder exercise and physical activity recommendations after cardiac implantable electronic devices (CIED) implantation is used to inform an appropriate time for shoulder exercise programs and physical activities after CIED implantation to medical personnel and patients. However, the effects of this application and its recommendations have not been discovered.
Objective: This study aimed to examine the satisfaction of medical personnel in using the web application and to study the conditions of frozen shoulder syndrome and the deposition of CIED or its electrodes’ incidence from inappropriate physical activities in patients after three-month CIED implantation.
Methods: The web application was developed and tested to operate correctly. Medical personnel’s satisfaction following a 5-point Likert scale was evaluated. All patients’ records who underwent CIED implantation at the hospital in 2023 were reviewed. The diagnoses of frozen shoulder syndrome and the deposition of CIED or its electrodes’ incidence from inappropriate physical activities of patients after three-month CIED implantation were reviewed. Descriptive statistical analysis was conducted.
Results: Ten medical personnel reported an average score of 4.79. Among 327 patients with CIED implantation, 0.3% were diagnosed with frozen shoulder syndrome. And there was no incidence of the deposition of CIED or its electrodes from inappropriate physical activities in patients reported.
Conclusion: The web application program for shoulder exercise and physical activity recommendations in patients after CIED implantation worked effectively and accurately. The users expressed satisfaction and it also helped the patients to move their shoulders and have appropriate physical activities.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Rao A, Bennett S. Cardiac implantable electronic devices: an overview for primary care. Br J Gen Pract. 2022; 72(721): 402-4.
Palmisano P, Guerra F, Dell'Era G, Ammendola E, Ziacchi M, Laffi M, et al. Impact on all-cause and cardiovascular mortality of cardiac implantable electronic device complications: Results from the POINTED registry. JACC Clin Electrophysiol. 2020; 6(4): 382-92.
Golian M, Sadek MM, Aydin A, Davis D, Green M, Klein A, et al. A Randomized trial of lenient versus strict arm instruction post cardiac device surgery (LENIENT). Am Heart J. 2023; 259: 52-7.
Findikoglu G, Yildiz BS, Sanlialp M, Alihanoglu YI, Kilic ID, Evregul H, et al. Limitation of motion and shoulder disabilities in patients with cardiac implantable electronic devices. Int J Rehabil Res. 2015; 38(4): 287-93.
Saelim B, Makarawate P. Effect of follow up of shoulder exercise program for rehabilitative post pacemaker patients for a period of 3 months. J Med Tech Phy Ther. 2015; 27(1): 61-7.
Cosgun MS, Cosgun C. Efficacy and safety of different exercises in preventing cardiac implantable electronic device-related shoulder impairment. Pacing Clin Electrophysiol. 2022; 45(3): 384-92.
Wongcharoen W, Petvipusit W, Prasertwitayakij N, Gunaparn S, Meemajam S, Pisespongsa C, et al. Effect of early pendulum exercise on shoulder function after cardiac rhythm management device implantation. J Interv Card Electrophysiol. 2019; 55(3): 343-7.
Songsaengrit B, Yasud M. The development of web application for shoulder exercise program in patients after cardiac rhythm management devices implantation. Srinagarind Med J. 2018; 33(6): 572-9. (in Thai)
Özcan DS, Balcı KG, Polat CS, Özcan ÖU, Köseoğlu BF, Balcı MM. Shoulder problems and related conditions in patients with implantable cardioverter defibrillators. Ann Med Res. 2019; 26(9): 1861-7.
Rickert C, Ahlich S, Gosheger G, Kalisch T, Liem D, Schneider KN, et al. How shoulder immobilization after surgery influences daily activity - a prospective pedometer-based study. Int Orthop. 2024; 48(3): 793-9.
Sahu P, Acharya S, Totade M. Evolution of pacemakers and implantable cardioverter defibrillators (ICDs) in cardiology. Cureus. 2023; 15(10): e46389.
Haugaa KH, Potpara TS, Boveda S, Deharo JC, Chen J, Dobreanu D, et al. Patients' knowledge and attitudes regarding living with implantable electronic devices: results of a multicentre, multinational patient survey conducted by the European Heart Rhythm Association. Europace. 2018; 20(2): 386-91.
American Association of Cardiovascular & Pulmonary Rehabilitation. Guidelines for cardiac rehabilitation and secondary prevention programs. 6th ed. Human Kinetics, 2021.
American College of Sports Medicine, editor. Guidelines for exercise testing and prescription. 6th ed. Williams & Wilkins, 2018.
Pedretti RFE, Iliou MC, Israel CW, Abreu A, Miljoen H, Corrà U, et al. Comprehensive multicomponent cardiac rehabilitation in cardiac implantable electronic devices recipients: a consensus document from the European Association of Preventive Cardiology (EAPC; Secondary prevention and rehabilitation section) and European Heart Rhythm Association (EHRA). Eur J Prev Cardiol. 2021; 28(15): 1736-52
Margulescu AD, Anderson MH. A review of driving restrictions in patients at risk of syncope and cardiac arrhythmias associated with sudden incapacity: differing global approaches to regulation and risk. Arrhythmia Electrophysiol Rev. 2019; 8(2): 90-8.
Levine GN, Steinke EE, Bakaeen FG, Bozkurt B, Cheitlin MD, Conti JB, et al. Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2012; 125(8): 1058-72.
Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021; 42(1): 17-96.
Chotipiboonsub P. Factors affecting the use of health application. JISB. 2024; 10(1): 43-55.
Hayeese W, Chaimongkol N, Sriyasak A, Yeepaloh M. The development of an android application: The effects of health education delivery through the application in caring for islamic preterm infants after discharge from a hospital. Princess of Naradhiwas University Journal. 2021; 13(1): 39-55. (in Thai)
Somsiri V, Susang J. The effects of giving planned instruction on knowledge, perceived self care abilities and self-care behavior in coronary heart disease patients receiving percutaneous coronary intervention at Songkhlanakarind hospital. Princess of Naradhiwas University Journal. 2011; 3(3): 33-46. (in Thai)
Singkiboot S, Thoraphan R, Pibarnwong P. The development of a monitoring and early warning signs detecting application on the knowledge, behavior, and FBS of persons with diabetes. Journal of Health and Nursing Education. 2024; 30(2): 56-74. (in Thai)
Tupcharoen P, Pakdevong N. Development and feasibility study of self-management application for head and neck cancer patients undergoing radiotherapy or concurrent chemoradiotherapy. APHEIT Journal of Nursing and Health. 2022; 4(1): e2722. (in Thai)
Cardiac Rehabilitation Society of Thailand. Cardiac rehabilitation guideline [online] 2010 [cited 2024 Oct 10]. Available from: http://www.thaiheart.org/images/column_1291454908/RehabGuideline.pdf
Rattanamanee N, Phasunon P. Response rate in quantitative research. Journal of Humanities and Social Sciences Thonburi University. 2019;13(3):181–8. (in Thai)