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A Comparison of Exercise Intensity in Hybrid Versus Standard Phase Two Cardiac Rehabilitation

To improve enrollment and participation in cardiac rehabilitation (CR), alternate models such as hybrid-CR (combined clinic- and telehealth home-based) need to be implemented. This study showed that the telehealth-CR sessions used for hybrid-CR result in exercise training intensities that were not significantly different from standard facilitybased CR. Purpose: To compare exercise training intensity during standard cardiac rehabilitation (S-CR) versus hybrid-CR (combined clinic- and remote home-/community-based). Methods: The iATTEND (improving ATTENDance to cardiac rehabilitation) trial is currently enrolling subjects and randomizing patients to S-CR versus hybrid-CR. This substudy involves the first 47 subjects who completed ≥18 CR sessions. Patients in S-CR completed all visits in a typical phase II clinic-based setting and patients in hybrid-CR completed up to 17 of their sessions remotely using telehealth (TH). Exercise training intensity in both CR settings is based on heart rate (HR) data from each CR session, expressed as percent HR reserve. Results: Among patients in both study groups, there were no serious adverse events or falls that required hospitalization during or within 3 hr after completing a CR session. Expressed as a percentage of HR reserve, the overall mean exercise training intensities during both the S-CR sessions and the TH-CR sessions from hybrid-CR were not significantly different at 63 ± 12% and 65 ± 10%, respectively (P = .29). Conclusion: This study showed that hybrid-CR delivered using remote TH results in exercise training intensities that are not significantly different from S-CR.