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Updated: Jan 20, 2026
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Home-Based Cardiac Rehabilitation Alone and Hybrid With Center-Based Cardiac Rehabilitation in Heart Failure: A
Hafiz M Imran1,2,3, Muhammad Baig4, Sebhat Erqou1,3
1Providence Veterans Affairs Medical Center Providence RI.
Insights
Home-based cardiac rehabilitation (HBCR) and hybrid cardiac rehabilitation (CR) improve heart failure patients' functional capacity. Only HBCR significantly enhanced health-related quality of life (hr-QOL) compared to usual care.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Public Health
Background:
- Center-based cardiac rehabilitation (CBCR) improves heart failure (HF) outcomes.
- Home-based cardiac rehabilitation (HBCR) increases access for patients unable to attend CBCR.
- Hybrid CR combines CBCR and HBCR for flexibility and rigor.
Purpose of the Study:
- To synthesize recent data comparing HBCR, hybrid CR, and usual care in HF patients.
- To compare functional capacity and health-related quality of life (hr-QOL) outcomes.
- To evaluate the effectiveness of different CR models.
Main Methods:
- A meta-analysis of 31 randomized controlled trials (RCTs) involving 1791 HF participants.
- Systematic search of 5 databases for RCTs published up to January 31, 2019.
- Pooled summary estimates using fixed- or random-effects meta-analyses; standardized mean differences for hr-QOL.
Main Results:
- HBCR improved peak oxygen uptake (2.39 mL/kg/min) and hr-QOL (SMD: 0.38) versus usual care.
- Hybrid CR showed greater peak oxygen uptake improvement (9.72 mL/kg/min) but not hr-QOL versus usual care.
- HBCR and hybrid CR showed similar improvements in functional capacity and hr-QOL compared to each other.
Conclusions:
- Both HBCR and hybrid CR significantly enhance functional capacity in HF patients.
- HBCR demonstrated a significant improvement in hr-QOL over usual care, unlike hybrid CR.
- HBCR and hybrid CR are viable alternatives for patients unable to participate in CBCR.
Abstract:
Background Center-based cardiac rehabilitation (CBCR) has been shown to improve outcomes in patients with heart failure (HF). Home-based cardiac rehabilitation (HBCR) can be an alternative to increase access for patients who cannot participate in CBCR. Hybrid cardiac rehabilitation (CR) combines short-term CBCR with HBCR, potentially allowing both flexibility and rigor. However, recent data comparing these initiatives have not been synthesized. Methods and Results We performed a meta-analysis to compare functional capacity and health-related quality of life (hr-QOL) outcomes in HF for (1) HBCR and usual care, (2) hybrid CR and usual care, and (3) HBCR and CBCR. A systematic search in 5 standard databases for randomized controlled trials was performed through January 31, 2019. Summary estimates were pooled using fixed- or random-effects (when I2>50%) meta-analyses. Standardized mean differences (95% CI) were used for distinct hr-QOL tools. We identified 31 randomized controlled trials with a total of 1791 HF participants. Among 18 studies that compared HBCR and usual care, participants in HBCR had improvement of peak oxygen uptake (2.39 mL/kg per minute; 95% CI, 0.28-4.49) and hr-QOL (16 studies; standardized mean difference: 0.38; 95% CI, 0.19-0.57). Nine RCTs that compared hybrid CR with usual care showed that hybrid CR had greater improvements in peak oxygen uptake (9.72 mL/kg per minute; 95% CI, 5.12-14.33) but not in hr-QOL (2 studies; standardized mean difference: 0.67; 95% CI, -0.20 to 1.54). Five studies comparing HBCR with CBCR showed similar improvements in functional capacity (0.0 mL/kg per minute; 95% CI, -1.93 to 1.92) and hr-QOL (4 studies; standardized mean difference: 0.11; 95% CI, -0.12 to 0.34). Conclusions HBCR and hybrid CR significantly improved functional capacity, but only HBCR improved hr-QOL over usual care. However, both are potential alternatives for patients who are not suitable for CBCR.
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