Hybrid versus traditional cardiac rehabilitation models: a systematic review and meta-analysis

The common drawbacks of standard cardiac rehabilitation (CR) models include low participation rate, high cost, and dependence on on-site exercise sessions. Therefore, hybrid CR protocols have been developed.

We aimed to test whether hybrid CR models are superior or equivalent to the traditional CR models in patients after myocardial infarction, heart failure, and cardiac surgery, using a meta-analysis framework.

Data from relevant original studies indexed in the Medline, Scopus, Cochrane Central, and Web of Science data-bases were extracted and analysed. The standardised mean difference (SMD) was used as a summary effect estimate, along with 95% confidence interval (CI).

Based on data from 1195 patients, the summary effect size showed similar improvement in functional capacity in hybrid and standard CR programmes (SMD = -0.04, 95% CI -0.18 to 0.09, p = 0.51). No significant difference was detected between the two models in terms of changes in exercise duration (SMD = -0.14, 95% CI -0.51 to 0.24, p = 0.47), systolic (SMD = -0.01, 95% CI -0.14 to 0.12, p = 0.91), and diastolic (SMD = -0.03, 95% CI -0.16 to 0.11, p = 0.7) blood pres-sure, or health-related quality of life (SMD = -0.08, 95% CI -0.23 to 0.07, p = 0.27). In terms of blood lipids, no significant difference was noted between hybrid and traditional CR models in all assessed lipid profile parameters, except for triglycerides (favouring the traditional CR model).

Hybrid CR protocols showed comparable efficacy to the traditional model. Further well-designed studies are required to validate these findings, especially regarding the long-term outcomes.