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

Irene Nabutovsky, Daniel Breitner, Alexis Heller, Yoav Levine, Merav Moreno, Mickey Scheinowitz, Chedva Levin, Robert Klempfner

Research output: Contribution to journalArticlepeer-review

Abstract

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 (VO2peak), 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, VO2peak 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.

Original languageEnglish
Pages (from-to)33-39
Number of pages7
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume44
Issue number1
StatePublished - 1 Jan 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • adherence
  • cardiovascular disease
  • motivation
  • telecardiac rehabilitation
  • telemedicine

ASJC Scopus subject areas

  • Rehabilitation
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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