Digital health technologies in home-based cardiac rehabilitation: A scoping review

Advancements in digital health technologies (DHTs) hold promise for improving participation rates in home-based cardiac rehabilitation (HBCR). However, the current status of their application in the field of HBCR and existing knowledge gaps has remained unclear since 2019.

This review adheres to Arksey and O'Malley's framework for scoping reviews. PubMed, Web of Science, Embase, Cochrane Library, CINAHL, Scopus, IEEE Xplore, CNKI, Wanfang, and VIP databases were systematically searched from 2019 to 2025. Search results were reported following the PRISMA-ScR checklist. Descriptive analysis was employed to summarize and interpret the data.

Twenty-two studies were included, conducted across Europe (n = 10), Asia (n = 6), North America (n = 5), and Oceania (n = 1). A total of 2996 participants were involved, with sample sizes ranging from 8 to 449. The intervention group had a mean age of 61.5 ± 10.1 years, mainly including patients with coronary artery disease (CAD), post-percutaneous coronary intervention (PCI), and post-coronary artery bypass graft (CABG). The core component of HBCR interventions was exercise training (n = 21), delivered primarily at home (n = 13) with multidisciplinary teams (n = 17) and targeting individual participants (n = 18). Intervention duration was typically 12 weeks, with follow-up periods ranging from 12 to 52 weeks. Seven studies utilized theories, models, or frameworks and two employed behavior change techniques. The DHTs utilized included mobile applications (15/22, 68%), smartwatches (10/22, 45%), accelerometers (8/22, 36.4%), interactive web-based portals (7/22, 32%), email/short message service (SMS) (7/22, 32%), heart rate monitors (4/22, 18%), activity trackers (3/22, 14%), pedometers (2/22, 9.1%), ECG monitors (2/22,9.1%),etc. Common outcomes encompassed physical activity, physiological indicators, psychological health, quality of life, safety, adherence, feasibility.

The application of DHTs in HBCR holds broad prospects and warrants further research. Future studies could focus on specific subgroups and high-risk populations to verify whether technology-assisted HBCR can be extended to more diverse cohorts and exert sustained positive impacts on broader health outcomes.