JMIR Publications

ABSTRACT

Background:

With the accelerating aging of China's population, the incidence and mortality of coronary heart disease (CHD) continue to rise, making it one of the major diseases threatening the health of Chinese residents. Percutaneous coronary intervention (PCI) is one of the effective treatments for CHD. Implementing effective cardiac rehabilitation (CR) after surgery can improve patients' cardiac function and quality of life, while also effectively reducing readmission and mortality rates1. The safety and efficacy of traditional center-based CR have been confirmed. However, due to constraints such as time, distance, and medical costs, patient participation and completion rates in center-based CR remain low2. Home-based cardiac rehabilitation (HBCR) primarily provides long-term or even lifelong rehabilitation guidance in a home setting3. Its benefits are comparable to those of hospital-based CR, and it offers advantages such as flexibility and convenience4. Nevertheless, due to the lack of safety monitoring and professional guidance, patient compliance has not significantly improved.CR resources in China are highly limited, and HBCR is still in its early stages, making it difficult to promote effectively at the grassroots level5. Therefore, exploring new CR models is particularly important. Home-based cardiac telerehabilitation (HBCTR) utilizes mobile communication technology to provide real-time guidance to patients through voice and video communication, while also monitoring their conditions via portable devices to ensure the completion of home-based rehabilitation plans6,7. However, its clinical application remains in the early stages, and related reports are still limited. This study compares the effects of HBCTR, center-based CR, and refusal of guidance on the safety, health-related quality of life (HRQoL), health behaviors, psychological status, and exercise capacity of patients with unstable angina after PCI.

Objective:

To investigate the efficacy of home-based cardiac rehabilitation under remote guidance (HBCTR) in patients with unstable angina after percutaneous coronary intervention (PCI).

Methods:

A total of 117 patients with unstable angina who underwent PCI at the Department of Cardiology, Zigong Fourth People’s Hospital, from June 2024 to June 2025 were selected and divided into three groups based on their rehabilitation preferences: the home-based telerehabilitation group (n=64), the center-based cardiac rehabilitation group (n=36), and the refusal of guidance group (n=17). The home-based telerehabilitation group received home-based rehabilitation guidance through remote monitoring devices and regular follow-ups, the center-based cardiac rehabilitation group participated in clinic-based rehabilitation training three times per week, and the refusal of guidance group received no professional guidance. After 12 and 36 weeks of intervention, indicators such as safety, health-related quality of life (HRQoL), exercise capacity, mental health, and health behaviors were compared among the three groups.

Results:

The home-based telerehabilitation group showed significantly greater improvements in the Physical Component Summary (PCS) score, 6-minute walk test (6MWT), and tobacco dependence compared to the center-based cardiac rehabilitation group and the refusal of guidance group (all P<0.05). Additionally, the home-based telerehabilitation group had lower anxiety scores (GAD-7) at 36 weeks (P<0.001). There was no significant difference in the incidence of adverse events among the three groups (P>0.05).

Conclusions:

HBCTR effectively improves physical function, exercise capacity, and mental health in patients after PCI, with a favorable safety profile. It is a feasible home-based rehabilitation model, particularly suitable for patients with limited access to medical resources or those who prefer a home-based environment