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Updated: Nov 24, 2025
A Real-World High-Intensity Interval Training Protocol for Cardiorespiratory Fitness Improvement
Published on: February 22, 2022
A Comparison of Exercise Intensity in Hybrid Versus Standard Phase Two Cardiac Rehabilitation
Steven J Keteyian1, Crystal Grimshaw, Clinton A Brawner
1Division of Cardiovascular Medicine (Drs Keteyian, Brawner, Kerrigan, and Ehrman, Ms Grimshaw and Reasons, and Mr Berry) and Department of Public Health Sciences (Dr Peterson), Henry Ford Health System, Detroit, Michigan.
Purpose:
To compare exercise training intensity during standard cardiac rehabilitation (S-CR) versus hybrid-CR (combined clinic- and remote home-/community-based).
Methods:
The iATTEND (improving ATTENDance to cardiac rehabilitation) trial is currently enrolling subjects and randomizing patients to S-CR versus hybrid-CR. This substudy involves the first 47 subjects who completed ≥18 CR sessions. Patients in S-CR completed all visits in a typical phase II clinic-based setting and patients in hybrid-CR completed up to 17 of their sessions remotely using telehealth (TH). Exercise training intensity in both CR settings is based on heart rate (HR) data from each CR session, expressed as percent HR reserve.
Results:
Among patients in both study groups, there were no serious adverse events or falls that required hospitalization during or within 3 hr after completing a CR session. Expressed as a percentage of HR reserve, the overall mean exercise training intensities during both the S-CR sessions and the TH-CR sessions from hybrid-CR were not significantly different at 63 ± 12% and 65 ± 10%, respectively (P = .29).
Conclusion:
This study showed that hybrid-CR delivered using remote TH results in exercise training intensities that are not significantly different from S-CR.
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