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This randomized controlled trial aims to determine if a 12-week home-based telerehabilitation (HBTCR) program is as effective as traditional center-based cardiac rehabilitation (CBCR) in improving psychological well-being (anxiety and depression) and quality of life in patients who have undergone coronary artery bypass grafting (CABG). A third group receiving usual care served as a control.
Psychological distress, such as anxiety and depression, is common after coronary artery bypass grafting (CABG) and negatively affects recovery and quality of life. While center-based cardiac rehabilitation (CBCR) effectively addresses these issues, participation is often limited by barriers like travel, cost, and scheduling. Home-based telerehabilitation (HBTCR) offers a potential solution. This single-center, prospective, three-arm randomized controlled trial was designed to compare the effectiveness of HBTCR versus CBCR and usual care. A total of 110 clinically stable patients, 4-8 weeks post-CABG, were randomly assigned in a 1:1:1 ratio to an HBTCR group, a CBCR group, or a control group. The intervention period was 12 weeks. The study hypothesized that the HBTCR program, which includes a personalized exercise plan, remote monitoring via a wearable device and mobile app, and weekly psychosocial support from a nurse, would be as effective as the traditional supervised in-person CBCR program in reducing symptoms of anxiety and depression and improving health-related quality of life.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Home-Based Telerehabilitation (HBTCR) Group | Experimental | Participants received a personalized 12-week exercise program to perform at home. They were provided with a wearable heart rate monitor and a mobile application to log their activities. A dedicated cardiac rehabilitation nurse contacted each patient weekly via phone or video call to review progress, adjust the exercise plan, and provide structured psychosocial support and counseling. |
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| Center-Based Cardiac Rehabilitation (CBCR) Group | Active Comparator | Participants attended 36 supervised sessions at the hospital's cardiac rehabilitation center over 12 weeks (3 sessions/week). Each session included aerobic and resistance exercises. In addition, patients attended weekly group sessions for health education and psychosocial support, covering topics like stress management and coping strategies. |
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| Control Group | Sham Comparator | Participants received usual care, which included standard postoperative medical advice and health education pamphlets detailing general recommendations for diet, medication, and physical activity. They did not receive any structured exercise prescription or formal psychological support from the study team. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Home-Based Telerehabilitation Cardiac Rehabilitation | Behavioral | A 12-week structured and remotely monitored cardiac rehabilitation program including a personalized exercise prescription (aerobic and resistance training), remote monitoring with a wearable heart rate sensor and mobile app, and weekly one-on-one psychosocial support and counseling via phone or video call from a rehabilitation nurse. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Anxiety Symptoms | The change from baseline in the Hamilton Anxiety Scale (HAMA) score. The HAMA scale is a clinician-rated scale where higher scores indicate greater symptom severity. | Baseline, 12 Weeks |
| Change in Depression Symptoms | The change from baseline in the 17-item Hamilton Depression Scale (HAMD) score. The HAMD is a clinician-rated scale where higher scores indicate greater symptom severity. | Baseline, 12 Weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Health-Related Quality of Life | The change from baseline in scores on the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The SF-36 assesses eight domains: Physical Functioning (PF), Role-Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning (SF), Role-Emotional (RE), and Mental Health (MH). Scores for each domain range from 0 to 100, with higher scores indicating better quality of life. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Peak Oxygen Consumption (VOâ‚‚ peak) | The change from baseline in VOâ‚‚ peak, a measure of cardiopulmonary fitness, assessed via an exercise test. Unit: mL/kg/min. | Baseline, 12 Weeks |
| Change in 6-Minute Walk Distance (6MWD) |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Hospital of Hebei Medical University | Shijiazhuang | Hebei | 050000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42035003 | Derived | Liu Y, Wang X, Li H, Wang C, Kong M, Zhang M, Ma J, Liu H. The impact of home-based telerehabilitation versus center-based cardiac rehabilitation on anxiety, depression, and quality of life after coronary artery bypass grafting: a randomized controlled trial. BMC Cardiovasc Disord. 2026 Apr 25;26(1):499. doi: 10.1186/s12872-026-05703-1. |
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|
| Home-Based Telerehabilitation Cardiac Rehabilitation | Behavioral | A 12-week structured and remotely monitored cardiac rehabilitation program including a personalized exercise prescription (aerobic and resistance training), remote monitoring with a wearable heart rate sensor and mobile app, and weekly one-on-one psychosocial support and counseling via phone or video call from a rehabilitation nurse. |
|
| Usual Care | Behavioral | Standard postoperative care including prescribed medications and routine follow-up, supplemented with health education pamphlets on lifestyle modification. No structured or supervised rehabilitation was provided. |
|
| Baseline, 12 Weeks |
The change from baseline in the distance a patient can walk in six minutes, measuring functional exercise capacity. Unit: Meters.
| Baseline, 12 Weeks |
| Change in Left Ventricular Ejection Fraction (LVEF) | The change from baseline in LVEF, assessed by echocardiography. Unit: Percentage (%). | Baseline, 12 Weeks |
| Adherence Rate | The percentage of completed cardiac rehabilitation sessions out of the total prescribed sessions for the HBTCR and CBCR groups. | Through study completion, 12 weeks |
| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| D003863 | Depression |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
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