Does a 12-week technology-assisted hybrid cardiac rehabilitation program improve physical, physiological, and psychological outcomes in adults with coronary heart disease?
A 12-week technology-assisted hybrid cardiac rehabilitation program significantly improves exercise self-efficacy, health-promoting behaviors, and anxiety in patients with coronary heart disease.
BACKGROUND: Technology-assisted interventions offer a promising alternative to conventional cardiac rehabilitation. However, there is limited evidence on their effectiveness, particularly in non-Western settings with emphasis on exercise self-efficacy. AIMS: To evaluate the effects of a 12-week, technology-assisted hybrid cardiac rehabilitation (TecHCR) program on physical, physiological, and psychological outcomes of patients with coronary heart disease. METHODS: A two-arm parallel randomized controlled trial including 160 participants was randomly assigned to either TecHCR or usual care. TecHCR was underpinned by the Health Belief Model, consisting of three supervised exercise training and occupational therapy sessions, a fitness watch for exercise self-monitoring, six audio-visual educational videos, and a weekly video call follow-up. Data were collected at baseline, immediately post-intervention, and at 24 weeks post-intervention. RESULTS: Participants in TecHCR demonstrated significantly greater improvement in exercise self-efficacy (β = 5.909, 95% CI 3.146, 8.672; p < 0.001), health-promoting behaviors (β = 9.058, 95% CI 5.524, 12.591; p < 0.001), and perceived anxiety levels (β = -1.255, 95% CI -1.893, -0.616; p < 0.001) at immediate post-intervention and (β = 8.506, 95% CI 4.951, 12.061; p < 0.001, β = 14.563, 95% CI 8.809, 20.317; p < 0.001, β = -1.145, 95% CI -1.975, -0.315; p = 0.007, respectively) 24 weeks post-intervention when compared with the control group. No statistically significant improvements were observed in perceived depression and cardiovascular risk factors. LINKING EVIDENCE TO ACTION: The TecHCR program, combining supervised sessions with technology-assisted components, is an effective approach for significantly improving exercise self-efficacy, health-promoting behaviors, and anxiety in patients with coronary heart disease. Healthcare institutions should consider implementing hybrid programs to overcome barriers to traditional cardiac rehabilitation, leveraging technology to extend support and maintain patient engagement beyond supervised sessions. TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT04862351.
Chong et al. (Mon,) studied this question.
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