Comparing the effectiveness of home-based and center-based cardiac rehabilitation: a randomized clinical trial

Abstract

Purpose Center-based cardiac rehabilitation (CR) is the standard of care for patients with cardiovascular disease. However, access limitations have led to increased interest in home-based alternatives. This study aimed to compare the effects of home-based and center-based CR in an Iranian population. Methods In this randomized controlled trial, 236 patients with cardiovascular disease were randomized to receive either home-based (n = 107) or center-based (n = 129) CR. Interventions lasted 8 weeks, with outcomes assessed at baseline and 6 months. The primary outcome was the change in exercise capacity. Secondary outcomes included exercise capacity, maximum heart rate, blood pressure (BP), lipid profile, fasting blood sugar, body mass index, and waist circumference. Results Between-group analysis using ANCOVA, adjusting for baseline values, showed that center-based CR was significantly more effective in improving exercise capacity (11.49 +/- 0.22 vs 13.65 +/- 0.19, p < 0.001), systolic BP (122.08 +/- 1.33 vs 116.58 +/- 1.17, P = 0.005), and diastolic BP (79.83 +/- 0.84 vs 74.35 +/- 0.74, p < 0.001). No significant between-group differences were observed in other variables. Conclusion Both home-based and center-based CR improved exercise capacity; however, center-based CR achieved superior gains and better blood pressure control. Home-based CR may be a practical alternative when access to supervised programs is limited.