Effects of Different Telerehabilitation Methods In Patients With Hypertension (TELE-HT) (TELE-HT)

The Role of Supervision: Effects of Different Telerehabilitation Methods In Patients With Hypertension

This study aims to compare two different ways of providing exercise therapy to people with high blood pressure (hypertension) through digital technology. Participants are divided into two groups: one group performs exercises at home while being watched and guided by a physiotherapist in real-time through video calls (synchronous). The other group performs the same exercises by watching pre-recorded videos on their own (asynchronous). The study measures how these two methods affect the patients' exercise capacity, daily blood pressure levels, heart functions, and their ability to manage their own health over an 8-week period.

Study Overview

• Status: Completed
• Conditions: Hypertension; Arterial Hypertension; Systemic Hypertension
• Intervention / Treatment: Behavioral: Synchronous Cardiac Telerehabilitation; Behavioral: Asynchronous Cardiac Telerehabilitation

Detailed Description

In this randomized, controlled, single-blinded study, 35 hypertensive individuals are assigned to either a synchronous telerehabilitation (STR) or an asynchronous telerehabilitation (ATR) group. Both groups perform an 8-week aerobic-based calisthenics program consisting of 24 sessions (3 sessions per week, 45 minutes each). The STR group exercises under the live supervision of a physiotherapist via videoconferencing. The ATR group uses pre-recorded video content and maintains an exercise diary. During all sessions, heart rate is monitored in real-time using wearable smartbands to maintain a submaximal intensity (70-85% of age-predicted maximum heart rate). Assessments performed at baseline and at the 8th week include ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TTE), maximal stress tests, self-care inventories, physical activity and body composition.

• Study Type: Interventional
• Enrollment (Actual): 31
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye)
    • Hacettepe University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Diagnosis of systemic hypertension.
• Age between 18 and 65 years.
• Access to the internet.
• Ownership of a mobile device suitable for telerehabilitation participation.

Exclusion Criteria:

• Presence of comorbid cardiovascular and/or pulmonary diseases.
• Unstable metabolic conditions.
• History of cerebrovascular and/or cardiovascular disease events within the past three months.
• Mental disorders that interfere with exercise cooperation.
• Balance or fall-related problems.
• Orthopedic or neurological conditions that compromise the safety of exercise.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Synchronous Telerehabilitation (STR); 8-week aerobic-based calisthenics (3 sessions/week, 45 min/session) under real-time physiotherapist supervision via videoconferencing.	Behavioral: Synchronous Cardiac Telerehabilitation; An 8-week aerobic-based calisthenics program consisting of 24 sessions (3 sessions/week, 45 minutes each). Exercises are performed in real-time under the live supervision of a physiotherapist via videoconferencing (WhatsApp). Intensity is maintained at 70-85% of age-predicted maximum heart rate, monitored in real-time using a wearable smartband. Exercises include high knees, knee-to-elbow, side jacks, and other calisthenics.; Other Names: aerobic exercise training; Home-based Exercise Training
Active Comparator: Asynchronous Telerehabilitation (ATR); 8-week aerobic-based calisthenics (3 sessions/week, 45 min/session) delivered via pre-recorded videos and exercise diaries.	Behavioral: Asynchronous Cardiac Telerehabilitation; The same 8-week aerobic-based calisthenics program (24 sessions, 3 sessions/week) as the STR group. Exercises are performed independently by participants using pre-recorded video content. Participants maintain an exercise diary to record heart rate and blood pressure levels, which are reviewed weekly by a physiotherapist. Exercise intensity is adjusted weekly based on data from the participant's wearable smartband.; Other Names: aerobic exercise training; Home-based Exercise Training

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Exercise Capacity	Change in Functional Exercise Capacity (6-Minute Stepper Test); The number of steps completed within six minutes using a stepper device. Higher step counts indicate better functional capacity.	Before and after the training (0 and 8th Week)
Exercise Capacity	Predicted maximal oxygen uptake; Calculated from the duration of the maximal stress test (Bruce protocol) using validated formulas for men and women. It represents maximal aerobic capacity in mL/kg/min.	Before and after the training (0 and 8th weeks)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Blood Pressure Levels	Ambulatory Blood Pressure Monitoring (ABPM) Parameters; Mean 24-hour, daytime, and nighttime systolic (SBP) and diastolic blood pressure (DBP) levels measured in mmHg.	Before and after the training (0 and 8th weeks)
Cardiac Functions	Systolic functions assessed with echocardiography expressed by ejection fraction (EF, %) and diastolic functions E and A waves measured via transthoracic echocardiography (TTE). E wave represents early diastolic velocity, and A wave represents late diastolic velocity.	Before and after the training (0 and 8th weeks)
Self-Care Levels	Self-Care of Hypertension Inventory (SC-HI V3.0) Score; A 23-item Likert-type scale with maintenance, monitoring, and management subscales. Each subscale is scored from 0 to 100, where higher scores indicate better self-care.	Before and after the training (0 and 8th weeks)
Postural Stability and Upper Extremity Function	Plank test duration (in seconds)	Before and after the training (0 and 8th weeks)
Lower Extremity Muscle Function	Numbers of Squat	Before and after the trainining (0 and 8th weeks)
Objective Physical Activity Level	Average daily and weekly total step counts and weekly exercise duration were recorded using a wearable smart wristband	Before and after the training (0 and 8th weeks)
Subjective Physical Activity Levels	Self-reported PA levels according to the International Physical Activity Questionnaire (IPAQ) score. IPAQ includes vigorous, moderate and walking activities during the last seven days and higher scores reflect higher physical activity levels.	Before and after the training (0 and 8th weeks)
Body Mass Index	Body weight/ (height*height) (kg/m2)	Before and after the training (0 and 8th weeks)
Body Composition-Anthropometric Measure	Weight to height ratio (kg/cm)	Before and after the training (0 and 8th weeks)
Body Fat Percantage	body fat percentage (%) assessed by bioelectrical impedance analysis	Before and after the training (0 and 8th weeks)
Fat Free Mass	Fat Free Mass assessed by bioelectrical impedance analysis	Before and after the training (0 and 8th weeks)
Lipid Profile	Measured via blood samples including low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels in mg/dL.	Before and after the training (0 and 8th weeks)
Cardiovascular Disease (CVD) Risk Profile	Cardiovascular Disease (CVD) Risk Profile; Estimated using the SCORE-TR risk chart, which calculates the 10-year risk of fatal cardiovascular disease based on age, gender, smoking status, systolic blood pressure, and total cholesterol.	Before and after the training (0 and 8the weeks)
Waist Circumference	Waist Circumference in cm	Before and after the training (0 and 8th weeks)

Collaborators and Investigators

• Sponsor: Hacettepe University
• Collaborators: Bozok University

Publications and helpful links

General Publications

• Brouwers RWM, Scherrenberg M, Kemps HMC, Dendale P, Snoek JA. Cardiac telerehabilitation: current status and future perspectives. Neth Heart J. 2024 Jan;32(1):31-37. doi: 10.1007/s12471-023-01833-9. Epub 2023 Dec 12.

Study record dates

Study Major Dates

• Study Start (Actual): February 28, 2024
• Primary Completion (Actual): July 30, 2024
• Study Completion (Actual): November 30, 2024

Study Registration Dates

• First Submitted: January 3, 2026
• First Submitted That Met QC Criteria: January 14, 2026
• First Posted (Actual): January 23, 2026

Study Record Updates

• Last Update Posted (Actual): January 23, 2026
• Last Update Submitted That Met QC Criteria: January 14, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Aerobic exercise; telerehabilitation; cardiac rehabilitation; synchronous; asynchronous
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Hypertension
• Other Study ID Numbers: 2017-KAEK-189_2024.02.23_01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The individual participant data will not be shared due to ethical restrictions, institutional policies, and national legal regulations (such as KVKK) regarding the protection of sensitive personal health data in Turkey. The informed consent obtained from participants does not include permission for the public sharing of their raw clinical and diagnostic data.

Drug and device information, study documents

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