Key result
Telemedicine cardiac rehab modestly improves exercise capacity and physical activity versus usual care in CHD.
Why the study?
Traditional exercise-based cardiac rehabilitation suffers from low participation rates despite proven effectiveness, whereas telemedicine-based rehabilitation can overcome access barriers while providing personalized, structured exercise training and remote monitoring.
Does personalized structured telemedicine-based exercise cardiac rehabilitation improve health outcomes in patients with coronary heart disease compared to centre-based exCR or usual care?
Does personalized structured telemedicine-based exercise cardiac rehabilitation improve health outcomes in patients with coronary heart disease compared to centre-based exCR or usual care?
Telemedicine-based exercise cardiac rehabilitation is an effective alternative to center-based programs, offering superior improvements in exercise capacity and cardiovascular risk factors compared to usual care for patients with coronary heart disease.
Supports telemedicine exCR as accessible alternative to center-based programs; reinforces RCT evidence of benefit over usual care in CHD.
Aims Despite its proven effectiveness, traditional exercise-based cardiac rehabilitation (exCR) suffers from low participation rates. However, telemedicine-based exCR can overcome access barriers to traditional rehabilitation while providing personalized, structured exercise training and remote monitoring. The aim of this review is to ascertain the efficacy of personalized, structured, telemedicine-based exCR in improving health outcomes in patients with coronary heart disease (CHD). Methods and results A systematic search was conducted in databases including Cochrane Library, PubMed, Web of Science, Embase, CINAHL, Scopus, Medline, China National Knowledge Infrastructure, Wanfang, VIP, and SINOMED from inception to March 2024 to identify randomized controlled trials (RCTs). The final analysis included 19 RCTs comprising 2219 participants. Among patients with CHD, telemedicine-based exCR demonstrated comparable effects to centre-based exCR across multiple outcomes, including exercise capacity, physical activity levels, cardiovascular risk factors, and quality of life (all P > 0.05). Notably, when compared with usual care, telemedicine-based exCR showed significant improvements in exercise capacity [standardized mean difference (SMD) = 0.23, 95% CI: (0.12, 0.35), I2 = 34%, P < 0.0001], physical activity level [SMD = 0.32, 95% CI: (0.09, 0.54), I2 = 53%, P = 0.006], diastolic blood pressure [mean difference (MD) = −1.54, 95% CI: (−2.89, −0.20), I2 =8%, P = 0.02], body mass index [MD = −0.54, 95% CI: (−1.94, −0.14), I2 = 4%, P = 0.008], and depression [SMD = −0.27, 95% CI: (−0.42, −0.13), I2 = 33%, P = 0.0002]. Conclusion Telemedicine-based exCR is equally effective as centre-based exCR in improving key health outcomes for patients with CHD, including exercise capacity, physical activity levels, cardiovascular risk factors, and quality of life. Furthermore, telemedicine-based exCR shows superior effectiveness to usual care, with statistically significant improvements in exercise capacity, physical activity, diastolic blood pressure, and depressive symptoms. Registration PROSPERO: CRD42024521465
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Liu et al. (2025) studied this question. Telemedicine-based exercise cardiac rehabilitation improved exercise capacity by 0.23 SMD and physical activity levels by 0.32 SMD compared to usual care in patients with CHD.
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