What is the clinical evidence from this study?

Study design: RCT. Population: Post-Coronary Artery Bypass Grafting (CABG) (n=110). Intervention: Home-based telerehabilitation (HBTCR) vs. Center-based cardiac rehabilitation (CBCR) and usual care. Primary outcome: Change in Hamilton Anxiety Scale (HAMA) score from baseline (Mean difference -0.4, 95% CI -1.8 to 1.0, p=0.58).

What question did this study set out to answer?

To compare home-based telerehabilitation (HBTCR) with center-based cardiac rehabilitation (CBCR) for improving anxiety, depression, and quality of life in post-CABG patients.

April 27, 2026BMC Cardiovascular Disorders0 citationsOpen Access

The impact of home-based telerehabilitation versus center-based cardiac rehabilitation on anxiety, depression, and quality of life after coronary artery bypass grafting: a randomized controlled trial

LYLiu YWannan Medical College XWXugang WangHebei Medical University HLHongying LiHebei Medical University

Key Result

Home-based telerehabilitation was as effective as center-based cardiac rehabilitation in reducing anxiety (mean difference -0.4) and depression after coronary artery bypass grafting.

Key Points

To compare home-based telerehabilitation (HBTCR) with center-based cardiac rehabilitation (CBCR) for improving anxiety, depression, and quality of life in post-CABG patients.
Prospective randomized controlled trial with 110 post-CABG patients
Participants assigned to 12-week HBTCR, CBCR, or usual care
Primary outcomes measured by Hamilton Anxiety (HAMA) and Depression (HAMD-17) scores, secondary outcome using SF-36 for quality of life.
HBTCR group showed mean HAMA change of -8.3, HAMD-17 change of -9.5; CBCR group showed -7.9 for HAMA and -9.1 for HAMD-17; both P < 0.001 versus usual care.
Quality of life improved significantly across all SF-36 domains in HBTCR and CBCR compared to control (P < 0.01).
No significant difference between HBTCR and CBCR in psychological outcomes.

Study Design

Type

RCT (n=110)

Blinding

Single-blind (outcome assessors and data analysts blinded)

Randomization

1:1:1 ratio via computer-based program

Multicenter

Structured PICO

Does a home-based telerehabilitation program improve anxiety, depression, and quality of life compared to center-based cardiac rehabilitation or usual care in post-CABG patients?

Population

110 clinically stable patients aged 30-75 years, 4-8 weeks post-Coronary Artery Bypass Grafting (CABG). Exclusions: severe and unstable comorbidities (e.g., uncontrolled heart failure, recent stroke, severe orthopedic limitations), significant cognitive impairment or psychiatric disorders.

Intervention

12-week Home-Based Telerehabilitation (HBTCR) program including personalized aerobic and body-weight resistance exercise, wearable heart rate monitor, smartphone app logging, and weekly one-on-one remote nurse support and counseling.

Comparator

Center-Based Cardiac Rehabilitation (CBCR) consisting of 36 supervised sessions over 12 weeks (3 sessions/week) with group psychosocial support, OR usual care (health education pamphlets only). All groups received standard postoperative care including guideline-directed medical therapy.

Outcome

Change from baseline in psychological distress, measured by the Hamilton Anxiety Scale (HAMA) and the 17-item Hamilton Depression Scale (HAMD-17) at 12 weeks.patient reported

Home-based telerehabilitation is as effective as traditional center-based cardiac rehabilitation in reducing anxiety and depression and improving quality of life after CABG, offering a viable alternative to overcome participation barriers.

Main Result

Effect estimate: Mean difference -0.4 (95% CI -1.8 to 1.0)

Absolute Event Rate: -8.3% vs -7.9%

p-value: p=0.58

Limitations

Single-center design may limit generalizability
Short 12-week follow-up period
Participant group was relatively tech-savvy and willing to use smartphones, which may not be representative of all older patients
Lack of formal cost-effectiveness analysis
Lack of preoperative baseline psychological data to distinguish pre-existing conditions from new-onset symptoms

Abstract

Anxiety, depression, and reduced quality of life are common after coronary artery bypass grafting (CABG), yet participation in traditional center-based cardiac rehabilitation (CBCR) is limited by access barriers. This study aims to compare the effectiveness of a home-based telerehabilitation (HBTCR) program with CBCR in improving psychological and quality-of-life outcomes for post-CABG patients. In this prospective randomized controlled trial, 110 clinically stable patients 4–8 weeks post-CABG were allocated to a 12-week HBTCR program (wearable monitoring, mobile app, weekly nurse support), CBCR (supervised center sessions), or usual care. Primary outcomes were changes in Hamilton Anxiety (HAMA) and Depression (HAMD-17) scores. The secondary outcome was change in health-related quality of life (SF-36). Both HBTCR and CBCR groups demonstrated significant and comparable improvements compared to usual care (mean HAMA change: -8.3 vs. -7.9 vs. -1.1, P < 0.001; HAMD-17: -9.5 vs. -9.1 vs. -1.5, P < 0.001). No significant difference was found between HBTCR and CBCR. Quality of life improved significantly across all SF-36 domains in both intervention groups versus control (P < 0.01). A structured home-based telerehabilitation program is as effective as traditional center-based rehabilitation in alleviating psychological distress and enhancing quality of life after CABG. HBTCR represents a vital, accessible alternative to deliver comprehensive cardiac rehabilitation and overcome participation barriers. This trial was retrospectively registered at ClinicalTrials.gov (identifier: NCT07232693, Registration date: 2025-11-14).

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