Home-Based Cardiac Rehabilitation Among Patients Unwilling to Participate in Hospital-Based Programs

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Sports Science

Background:

• Asynchronous home-based cardiac rehabilitation (HBCR) presents a viable alternative to traditional center-based cardiac rehabilitation (CBCR).
• Effective functional improvement in HBCR necessitates high patient adherence and activity levels.
• The efficacy of HBCR for patients who actively avoid CBCR remains under-investigated.

Purpose of the Study:

• To assess the effectiveness of an asynchronous HBCR program.
• To evaluate HBCR in patients with a stated unwillingness to participate in CBCR.

Main Methods:

• A randomized prospective study design.
• Enrollment of 69 patients into a 6-month HBCR program or regular care (control).
• Digital monitoring of physical activity (PA) and self-reported outcomes, with cardiopulmonary exercise testing to measure peak oxygen uptake (V̇O₂peak) at baseline and 4 months.

Main Results:

• The HBCR group demonstrated a significant 10.2% improvement in V̇O₂peak compared to a -2.7% change in the control group (P < .001).
• Patients in the HBCR group achieved 129% of their set exercise goal, with 70% of aerobic exercise within recommended heart rate zones.
• Risk level, age, and initial motivation did not impede goal achievement or adherence in the HBCR group.

Conclusions:

• Asynchronous HBCR is effective in improving cardiorespiratory fitness, even for patients reluctant to attend center-based programs.
• HBCR programs can achieve high adherence and activity levels, meeting or exceeding exercise guidelines.
• The findings support HBCR as a successful rehabilitation strategy for a diverse patient population.