Home-Based Versus Center-Based Cardiac Rehabilitation After CABG Surgery

Efficacy of Home-Based Telerehabilitation Versus Center-Based Cardiac Rehabilitation on Cardiopulmonary Function and Exercise Capacity in Patients After Coronary Artery Bypass Grafting: A Randomized Controlled Trial

This randomized controlled trial was designed to compare the efficacy of a 12-week home-based telerehabilitation (HBTCR) program against traditional center-based cardiac rehabilitation (CBCR) and usual care in patients who have undergone coronary artery bypass grafting (CABG). The primary goal was to assess changes in cardiopulmonary function, measured by peak oxygen consumption (VO₂ peak), and exercise capacity, measured by the 6-minute walk test (6MWT), to determine if HBTCR is a viable alternative to CBCR.

Study Overview

• Status: Completed
• Conditions: Coronary Artery Disease
• Intervention / Treatment: Behavioral: Structured Exercise Program; Behavioral: Standard Health Education

Detailed Description

While cardiac rehabilitation (CR) is a Class IA recommendation for patients after coronary artery bypass grafting (CABG) to improve long-term outcomes, participation in traditional center-based programs (CBCR) is low due to barriers like travel, cost, and scheduling. Home-based telerehabilitation (HBTCR) emerges as a potential solution. This study was a three-arm, prospective, single-center randomized controlled trial to rigorously evaluate if a structured HBTCR program is as effective as CBCR. A total of 110 patients, 4-8 weeks post-CABG, were randomized into three groups: HBTCR, CBCR, or a control group receiving usual care with educational pamphlets. The HBTCR group performed prescribed exercises at home, using wearable monitors and a mobile app, with weekly remote monitoring by a rehabilitation team. The CBCR group attended supervised sessions at the hospital three times a week. The control group received standard follow-up and educational materials. The interventions lasted 12 weeks, with assessments of cardiopulmonary function, exercise capacity, cardiac function, psychological status, and quality of life conducted at baseline and at 12 weeks. The study aimed to provide robust evidence for HBTCR as an effective alternative model of care for post-CABG rehabilitation.

• Study Type: Interventional
• Enrollment (Actual): 110
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Hebei
    • Shijiazhuang, Hebei, China, 050000
      • The First Hospital of Hebei Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients aged 30 to 75 years.
• Had undergone Coronary Artery Bypass Grafting (CABG) 4 to 8 weeks prior.
• In a stable clinical condition.
• Able to provide written informed consent.
• No cognitive impairments.

Exclusion Criteria:

• Acute decompensated heart failure.
• Severe physical comorbidities (e.g., fractures, severe hearing impairment) that would preclude participation in an exercise program.
• Recent stroke or pulmonary embolism.
• Significant hepatic or renal dysfunction.
• Unstable angina.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Home-Based Telerehabilitation (HBTCR) Group; Participants received a personalized 12-week cardiac rehabilitation program to perform at home. They were provided with a wearable heart rate monitor and used a mobile application to log their exercise sessions and vital signs. A rehabilitation team remotely monitored their progress and communicated weekly via phone or video call.	Behavioral: Structured Exercise Program; A 12-week comprehensive cardiac rehabilitation program. The exercise prescription (frequency, intensity, duration, type) was based on a baseline cardiopulmonary exercise test, typically starting at 40-60% of heart rate reserve and increasing progressively. The program included aerobic and resistance training components. This intervention was delivered either remotely (HBTCR group) or in-person (CBCR group), three times per week.
Active Comparator: Center-Based Cardiac Rehabilitation (CBCR) Group; Participants attended supervised cardiac rehabilitation sessions at the hospital's rehabilitation center three times per week for 12 weeks. Each session included warm-up, aerobic exercise, resistance training, and cool-down under the direct supervision of a healthcare team.	Behavioral: Structured Exercise Program; A 12-week comprehensive cardiac rehabilitation program. The exercise prescription (frequency, intensity, duration, type) was based on a baseline cardiopulmonary exercise test, typically starting at 40-60% of heart rate reserve and increasing progressively. The program included aerobic and resistance training components. This intervention was delivered either remotely (HBTCR group) or in-person (CBCR group), three times per week.
Sham Comparator: Control Group; Participants received usual care, which included routine follow-up appointments and standard health education delivered through verbal instructions and printed pamphlets. They did not participate in a structured or monitored exercise program.	Behavioral: Standard Health Education; Participants received routine follow-up and standard health education pamphlets covering topics such as medication adherence, diet, and general advice on physical activity, without a structured or monitored exercise plan.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Peak Oxygen Consumption (VO₂ peak)	Measured in mL/kg/min by cardiopulmonary exercise testing (CPET) on a treadmill using a symptom-limited protocol. The change from baseline to 12 weeks was assessed.	Baseline, 12 weeks
Change in 6-Minute Walk Distance (6MWD)	Measured in meters, assessing the maximum distance a patient can walk in 6 minutes on a flat, hard surface. The change from baseline to 12 weeks was assessed.	Baseline, 12 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Left Ventricular Ejection Fraction (LVEF)	Assessed as a percentage (%) by transthoracic echocardiography.	Baseline, 12 weeks
Change in Forced Expiratory Volume in 1 second to Forced Vital Capacity Ratio (FEV1/FVC)	Measured by spirometry to assess pulmonary function.	Baseline, 12 weeks
Change in Psychological Status (Anxiety)	Assessed using the Hamilton Anxiety Scale (HAMA). A lower score indicates less anxiety.	Baseline, 12 weeks
Change in Psychological Status (Depression)	Assessed using the Hamilton Depression Scale (HAMD). A lower score indicates less depression.	Baseline, 12 weeks
Change in Quality of Life	Measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), which assesses eight domains of health.	Baseline, 12 weeks
Change in Cardiac Index (CI)	Assessed non-invasively to measure cardiac output relative to body surface area.	Baseline, 12 weeks
Adherence to Rehabilitation Program	Calculated as the percentage of completed sessions out of the 36 total prescribed sessions for the HBTCR and CBCR groups.	Up to 12 weeks
Incidence of Major Adverse Events	Number of participants experiencing major adverse cardiovascular events (e.g., death, myocardial infarction, urgent revascularization).	Up to 12 weeks
Change in Stroke Volume Index (SVI)	Assessed non-invasively to measure the volume of blood pumped from the ventricle per beat relative to body surface area.	Baseline, 12 weeks
Change in Systemic Vascular Resistance Index (SVRI)	Assessed non-invasively to measure the resistance to blood flow offered by all systemic vasculature, indexed to body surface area.	Baseline, 12 weeks

Collaborators and Investigators

• Sponsor: The First Hospital of Hebei Medical University

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2024
• Primary Completion (Actual): September 1, 2025
• Study Completion (Actual): September 1, 2025

Study Registration Dates

• First Submitted: November 14, 2025
• First Submitted That Met QC Criteria: November 19, 2025
• First Posted (Actual): November 21, 2025

Study Record Updates

• Last Update Posted (Actual): November 21, 2025
• Last Update Submitted That Met QC Criteria: November 19, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Heart Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Coronary Disease; Myocardial Ischemia; Coronary Artery Disease
• Other Study ID Numbers: S00775-1

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No