Effects of telerehabilitation and mobile app-based cardiac rehabilitation on muscle strength and quality of life in coronary artery disease patients: a 3-month follow-up

Abstract Background Coronary artery disease (CAD) often leads to reduced peripheral muscle strength and impaired quality of life. Although traditional cardiac rehabilitation (CR) is effective, limited access and poor long-term adherence remain major challenges. Technology-assisted interventions, such as telerehabilitation and mobile application–based programmes, may improve accessibility and support sustainable lifestyle changes. However, evidence regarding their long-term effectiveness remains limited. Purpose This study aimed to evaluate the effectiveness of telerehabilitation and mobile application–based CR programmes in improving and maintaining quality of life and peripheral muscle strength in patients with CAD during a 12-week follow-up following a 12-week exercise programme. Methods A randomised controlled trial was conducted with 52 patients with CAD who met the inclusion criteria. Participants were allocated to a telerehabilitation group (TRG), a mobile application group (MAG), or a control group (CG). The TRG received remotely supervised exercise sessions, the MAG followed an app-guided programme, and the CG performed a home-based exercise programme. Assessments were performed at baseline, immediately post-intervention, and 12 weeks post-programme. Outcome measures included disease-specific quality of life (MIDAS), health-related quality of life (SF-36), and peripheral muscle strength. Muscle strength was evaluated using a standardised handheld dynamometry protocol. Results Significant time effects were observed for physical activity, insecurity, and medication-related concerns on the MIDAS, indicating improvements across all groups (p0.05). On the SF-36, physical functioning, vitality, mental health, and social functioning demonstrated significant time effects, while role-physical, role-emotional, and general health showed significant time-group interactions (p0.05), reflecting differential improvements between groups. Knee extensor strength and handgrip strength exhibited significant time-group interactions, with greater gains in TRG and MAG compared with CG (p0.05). These findings suggest enhanced muscular adaptations in technology-assisted groups. Conclusions Telerehabilitation and mobile application–based CR programmes were effective in improving and sustaining peripheral muscle strength and quality of life for up to 12 weeks after the intervention in patients with CAD. These benefits may be related to improved adherence, increased engagement, and structured progression enabled by remote supervision and digital support. Incorporating technology-assisted interventions into CR protocols may enhance accessibility and promote long-term health outcomes in the management of CAD.