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Updated: Jul 29, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Home-Based Cardiac Rehabilitation Among Patients Unwilling to Participate in Hospital-Based Programs
Irene Nabutovsky1, Daniel Breitner, Alexis Heller
1Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Drs Nabutovsky and Klempfner, Messrs Breitner and Levine, and Ms Heller); Cardiac Prevention and Rehabilitation Institute, Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Israel (Drs Nabutovsky and Klempfner and Ms Moreno); Department of Biomedical Engineering, Faculty of Engineering, Sylvan Adams Sports Institute, School for Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, and Neufeld Cardiac Research Institute, Sheba Medical Center, Tel-Hashomer, Israel (Dr Scheinowitz); and Faculty of School of Life and Health Sciences, The Jerusalem College of Technology, Jerusalem, Israel (Dr Levin).
Insights
Home-based cardiac rehabilitation (HBCR) significantly improves cardiorespiratory fitness in patients unwilling to attend center-based programs. Adherence and activity levels were high, demonstrating HBCR
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.
Purpose:
Asynchronous home-based cardiac rehabilitation (HBCR) is a viable alternative to center-based cardiac rehabilitation (CBCR). However, to achieve significant functional improvement, a high level of adherence and activity must be achieved. The effectiveness of HBCR among patients who actively avoid CBCR has not been effectively investigated. This study aimed to investigate the effectiveness of the HBCR program among patients unwilling to participate in CBCR.
Methods:
A randomized prospective study enrolled 45 participants to a 6-mo HBCR program and the remaining 24 were allocated to regular care. Both groups were digitally monitored for physical activity (PA) and self-reported outcomes. Change in peak oxygen uptake (VO 2peak ), the primary study outcome, was measured by the cardiopulmonary exercise test, immediately before program start and 4 mo thereafter.
Results:
The study included 69 patients, 81% men, aged 55.9 ±12 yr, enrolled in a 6-mo HBCR program to follow a myocardial infarction (25.4%) or coronary interventions (41.3%), heart failure hospitalization (29%), or heart transplantation (10%). Weekly aerobic exercise totaled a median of 193.2 (110.2-251.5) min (129% of set exercise goal), of which 112 (70-150) min was in the heart rate zone recommended by the exercise physiologist.After 4 mo, VO 2peak improved by 10.2% in the intervention group versus -2.7% in the control group (+2.46 ± 2.67 vs -0.72 ± 3.02 mL/kg/min; P < .001).
Conclusion:
The monthly PA of patients in the HBCR versus conventional CBCR group were well within guideline recommendations, showing a significant improvement in cardiorespiratory fitness. Risk level, age, and lack of motivation at the beginning of the program did not prevent achieving goals and maintaining adherence.
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