Effectiveness of a hybrid cardiac rehabilitation program: a comparative study with standard supervised exercise training

Introduction Cardiac rehabilitation (CR) is globally recognized as an effective secondary prevention strategy for heart patients. However, low referral and participation rates persist due to accessibility challenges. This study investigates the effectiveness of a novel Hybrid CR (HCR) program, combining facility-based exercise sessions and home-based exercise sessions facilitated by a smartphone application. Purpose The study aims to evaluate the HCR program's effectiveness for a selected population of heart patients. A comparison is made between the HCR program and the standard of care involving solely supervised centre-based cardiac rehabilitation (CBCR). The research focuses on exercise capacity and body composition. Methods Participants were allocated to receive either conventional care or the HCR program. The intervention comprised a blend of supervised and home-based exercise sessions, while the control group exclusively received supervised CBCR. VO2 peak, peak load and fat percentage were measured through Cardiopulmonary Exercise Testing (CPET) and multi-frequency bioelectrical impedance analysis. Assessments were conducted at baseline, after a 12-week rehabilitation period, and, for a subset of patients, at one-year follow-up (1YFU). Results Eighty-four cardiac patients met the inclusion criteria to be enrolled in the study. Both the HCR group as the CBCR group showed statistically significant (p<0.05) improvements in VO2 peak (mean +3.9 mlO2/kg/min vs +3.2 mlO2/kg/min respectively), peak load (mean +37.7W vs +24.9W respectively) and fat percentage (mean -2.14% vs -1.17% respectively) over the 12-week rehabilitation period. At 1YFU no statistically significant changes have been found. The HCR group exhibited no statistically significant differences compared to CBCR group, indicating comparable effectiveness. Conclusion This research supports the integration of hybrid rehabilitation models tailored to individual patient needs, emphasizing their potential to overcome accessibility challenges and enhance the impact of cardiac rehabilitation. Further studies should explore optimal populations and protocols for HCR, acknowledging their equal effectiveness alongside centre-based programs.