Mobile Health Home-Based Cardiac Rehabilitation in Heart Disease: A Systematic Review

Background: Cardiac rehabilitation (CR) is underutilized worldwide. Mobile health (mHealth) technologies enable home-based cardiac rehabilitation (HBCR). This updated meta-analysis evaluates the effectiveness of mHealth HBCR compared with usual care and center-based CR (CBCR). Methods: We searched for randomized controlled trials (RCTs) of phase II mHealth HBCR in patients with heart disease (coronary artery disease [CAD], heart failure [HF] and post revascularization). The primary outcomes were the 6-minute walk test (6MWT) and peak oxygen uptake (VO 2 peak). Secondary outcomes included blood pressure, resting heart rate, body mass index, lipid profile, depression, and anxiety. Random-effects meta-analyses were performed using RevMan 5.4.1. Subgroup analysis by cardiac diagnosis, sensitivity analysis, and publication bias assessment were conducted. Results: Seventeen trials (2,381 participants) were included. Compared with usual care, mHealth HBCR significantly improved 6MWT (mean difference [MD] 16.00 m, 95% CI 11.14-20.86; p < 0.0001) and VO 2 peak (MD 1.55 mL/kg/min, 95% CI 0.96-2.15; p < 0.0001). Significant reductions were observed in systolic blood pressure (MD -7.98 mmHg, 95% CI -9.89 to -6.07), diastolic blood pressure (MD -2.14 mmHg, 95% CI -3.72 to -0.57), and resting heart rate (MD -2.14 bpm, 95% CI -3.76 to -0.53). Depressive symptoms improved significantly (SMD -0.24, 95% CI -0.39 to -0.10), while anxiety did not (SMD -0.14, 95% CI -0.29 to 0.01). No significant effects were observed for lipids or BMI. Subgroup analysis showed no difference in treatment effect between HF and CAD (p-value 0.84). mHealth HBCR demonstrated comparable effectiveness to CBCR. Conclusions: mHealth home-based cardiac rehabilitation improves functional capacity, cardiorespiratory fitness, blood pressure, and depressive symptoms compared with usual care, while achieving outcomes comparable to center-based CR. These findings support mHealth HBCR as an effective, accessible alternative to traditional CR.