What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Coronary heart disease (n=2717). Intervention: Cardiac telerehabilitation vs. Center-based cardiac rehabilitation or usual care. Primary outcome: Cardiorespiratory fitness (peak VO2) compared with center-based cardiac rehabilitation at short-term (3 months) (MD 1.55, 95% CI -1.60 to 4.70, p=0.168).

What does this research mean for the field?

Phase II cardiac telerehabilitation improves cardiorespiratory fitness and functional capacity in patients with coronary heart disease to a similar extent as center-based cardiac rehabilitation, and significantly more than usual care. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 30, 2026

Impact of phase II cardiac telerehabilitation on physical capacity in coronary heart disease: a systematic review and meta-analysis

Key Result

Cardiac telerehabilitation yielded similar improvements in peak VO2 compared with center-based rehabilitation (MD 1.55; 95% CI -1.60 to 4.70) and significantly greater improvements than usual care.

Key Points

To evaluate the clinical benefits of cardiac telerehabilitation on physical capacity in patients with coronary heart disease.
Systematic review and meta-analysis according to PRISMA guidelines.
Included randomized controlled trials enrolling adults with coronary heart disease in phase II telerehabilitation with exercise training.
Outcomes measured included cardiorespiratory fitness and functional capacity, analyzed using random-effects meta-analysis.
No significant difference in improvements in VO2peak versus center-based cardiac rehabilitation at 3 months (MD: 1.55, 95% CI: −1.60 to 4.70; p = 0.168).
Significant improvement in VO2peak compared to usual care at 3 months (MD: 3.86, 95% CI: 3.03 to 4.69; p < 0.0001).
Significant improvement in 6MWT compared to usual care at 3 months (MD: 37.83, 95% CI: 22.12 to 53.53; p = 0.001).

Study Design

Type

Meta-Analysis (n=2,717)

Structured PICO

Does phase II cardiac telerehabilitation improve cardiorespiratory fitness and functional capacity compared to center-based cardiac rehabilitation or usual care in adults with coronary heart disease?

Population

25 RCTs pooling 2,717 adults with coronary heart disease (CHD)

Intervention

Phase II cardiac telerehabilitation (CTR) with exercise training as a mandatory core component

Comparator

Center-based cardiac rehabilitation (CBCR) or usual care

Outcome

Cardiorespiratory fitness (peak VO2) and functional capacity (6MWT, ISWT) at short-term (3 months) and long-term (6-12 months)surrogate

Cardiac telerehabilitation is an effective alternative to center-based cardiac rehabilitation for improving physical capacity in patients with coronary heart disease, offering superior benefits to usual care.

Main Result

Effect estimate: MD 1.55 (95% CI -1.60 to 4.70)

p-value: p=0.168

Abstract

Text abstract Aims Coronary heart disease (CHD) is the leading cause of death globally. Cardiac rehabilitation (CR) reduces cardiovascular mortality, hospital readmissions, and improves quality of life, yet participation in center-based programs remains low. Therefore, the aim of this systematic review and meta-analysis was to evaluate the clinical benefits of cardiac telerehabilitation (CTR), using exercise as the primary intervention, on physical capacity compared with center-based cardiac rehabilitation (CBCR) or usual care in patients with CHD. Methods This review followed PRISMA guidelines and was registered in PROSPERO (CRD420251160310). Five databases (PubMed, Embase, Scopus, CINAHL, CENTRAL) were searched from January 2000 to 15 October 2025. Eligible studies were randomized controlled trials (RCTs) enrolling adults with CHD in phase II CTR, with exercise training as a mandatory core component, optionally supplemented by other CR elements. Outcomes were cardiorespiratory fitness (CRF) (peak VO2) and functional capacity (6MWT, ISWT) between CTR and CBCR or usual care. For outcomes with substantial heterogeneity (I2 50%), random-effects meta-analyses were conducted using inverse-variance weighting, restricted maximum likelihood estimation, and Knapp–Hartung adjustment. Results Twenty-five studies (n=2717) were included. Compared with CBCR, no statistically significant difference was observed between CTR and CBCR in improvements VO2peak (mean difference (MD): 1.55, 95% CI: −1.60 to 4.70; I2 = 83.7%; p = 0.168) and 6MWT (MD: 15.01, 95% CI: −7.30 to 37.33; I2 = 0.0%; p = 0.187) at short-term (ST; 3 months). These comparable improvements persisted long-term (LT; 6-12 months). By contrast, CTR led to a significantly greater improvement compared with usual care in VO2peak (MD: 3.86, 95% CI: 3.03 to 4.69; I2 = 0.0%; p 0.0001) and 6MWT (MD: 37.83, 95% CI: 22.12 to 53.53; I2 = 62.3%; p = 0.001) at short-term. Conclusion CTR provides improvementsin CRF and functional capacity with no statistically significant difference compared with CBCR, and significantly greater improvements compared with usual care.

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