Telehealth-guided home exercise within cardiac rehabilitation matches centre-based cardiac rehabilitation for training dose and adherence in lymphoma survivorship: randomized trial results

Abstract Background Access to cardiac rehabilitation (CR) for cancer survivors can be limited by travel and scheduling barriers. Remotely guided, home-based CR programmes may offer a practical alternative, but concerns persist about achieving the prescribed training dose outside supervised settings. Purpose To compare training duration, relative intensity and adherence between a telehealth-guided, home-based CR aerobic programme and supervised, centre-based CR in lymphoma survivors, and to document safety over 12 weeks. Methods In a single-centre randomised trial, adult lymphoma survivors in remission were allocated 1:1 to home-based or centre-based aerobic training for 12 weeks. Both arms were prescribed three sessions per week at 60–85% of maximal heart rate. Exercise was delivered within a service and overseen by a multidisciplinary CR team. Heart-rate wearables and digital logs captured session duration, intensity and completion; outcomes were analysed with non-parametric tests at α=0.05. Results Forty-four participants completed the intervention. Baseline characteristics were comparable between groups. Mean session duration was significantly longer with home-based CR (49.6 ± 7.9 min) than with centre-based CR (41.0 ± 4.3 min). Relative intensity was similar (77.7% vs 78.6% maximal heart rate). Adherence did not differ (80.9% vs 78.0%). Across 1,245 sessions, no adverse events or medical complications occurred during or within six hours after exercise. Conclusions A telehealth-guided home-based CR programme delivered training doses (duration and intensity) and adherence comparable to supervised centre-based CR, with an excellent safety profile. Remote CR may be a feasible and scalable model for delivering rehabilitation to lymphoma survivors within cardio-oncology care pathways.