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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

Home-based telerehabilitation after CABG: higher objectively verified adherence and 12-week functional outcomes in a single-center observational cohort

  • Yan Liu1
  • Xugang Wang1
  • Cuihua Wang2
  • Minjuan Zhang3
  • Manman Kong1
  • Meng Wang4
  • Jingjing Ma1
  • Huili Liu1
4 affiliations
  1. 1Department of Cardiovascular Surgery, The First Hospital of Hebei Medical University
  2. 2Department of Cardiac Function Rehabilitation, The First Hospital of Hebei Medical University
  3. 3Department of Otorhinolaryngology Head and Neck Surgery, Shijiazhuang People’s Hospital
  4. 4Department of Thoracic Surgery, The First Hospital of Hebei Medical University
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Abstract

Background: Home-based telerehabilitation (HBTCR) may address access barriers to center-based cardiac rehabilitation (CBCR) after coronary artery bypass grafting (CABG). However, real-world comparative evidence on objectively verified adherence and functional recovery, with careful confounding control, remains sparse. This observational cohort study compared session completion and 12-week functional outcomes between HBTCR and CBCR in post-CABG patients using routine clinical data.

Methods: This single-center observational cohort screened 288 patients and identified 195 potentially eligible post-CABG patients (February 2024–February 2025). After excluding 28 patients with unresolved rehabilitation exposure, 167 patients (56 HBTCR, 54 CBCR, 57 usual care) formed the propensity-score estimation cohort, adjusted for 25 baseline covariates with generalized propensity scores and overlap weighting. The primary complete-case analysis included 105 patients (35 per group) with complete 12-week follow-up. The primary outcome was objectively verified session completion (% of 36 prescribed sessions). The key clinical outcome was 12-week VO ₂ peak, analyzed via weighted ANCOVA. Results are reported as adjusted differences with 95% CIs.

Results: After weighting, covariates were well balanced (all SMDs <0.10). HBTCR showed significantly higher objectively verified session completion than CBCR (87.7% vs. 78.5%; overlap-weighted difference 9.1 percentage points, 95% CI: 4.4 to 13.7; P < 0.001). The adjusted HBTCR–CBCR difference in 12-week VO ₂ peak was small and not statistically significant (0.17 mL/kg/min, 95% CI: −0.50 to 0.84; P = 0.616). Both active rehabilitation groups showed substantially larger 12-week VO ₂ peak gains than usual care (adjusted differences >4.0 mL/kg/min).

Conclusion: Among post-CABG patients who chose HBTCR or CBCR in routine practice, those choosing HBTCR had higher objectively verified session completion and comparable observed 12-week improvement in VO ₂ peak. These findings support HBTCR as a feasible option for patients who prefer or require home-based rehabilitation because of work, travel, or scheduling constraints. Formal equivalence was not tested, and the clinical meaningfulness and cost-effectiveness of this delivery model warrant further evaluation.

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Cite

BibTeXRIS
BibTeX
@article{liu2026homebased,
  title = {{Home-based telerehabilitation after CABG: higher objectively verified adherence and 12-week functional outcomes in a single-center observational cohort}},
  author = {Yan Liu and Xugang Wang and Cuihua Wang and Minjuan Zhang and Manman Kong and Meng Wang and Jingjing Ma and Huili Liu},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1947232},
  url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1947232/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Home-based telerehabilitation after CABG: higher objectively verified adherence and 12-week functional outcomes in a single-center observational cohort
AU  - Yan Liu
AU  - Xugang Wang
AU  - Cuihua Wang
AU  - Minjuan Zhang
AU  - Manman Kong
AU  - Meng Wang
AU  - Jingjing Ma
AU  - Huili Liu
PY  - 2026
DA  - 2026/10/15
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1947232
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1947232/full
AB  - Background: Home-based telerehabilitation (HBTCR) may address access barriers to center-based cardiac rehabilitation (CBCR) after coronary artery bypass grafting (CABG). However, real-world comparative evidence on objectively verified adherence and functional recovery, with careful confounding control, remains sparse. This observational cohort study compared session completion and 12-week functional outcomes between HBTCR and CBCR in post-CABG patients using routine clinical data.  Methods: This single-center observational cohort screened 288 patients and identified 195 potentially eligible post-CABG patients (February 2024–February 2025). After excluding 28 patients with unresolved rehabilitation exposure, 167 patients (56 HBTCR, 54 CBCR, 57 usual care) formed the propensity-score estimation cohort, adjusted for 25 baseline covariates with generalized propensity scores and overlap weighting. The primary complete-case analysis included 105 patients (35 per group) with complete 12-week follow-up. The primary outcome was objectively verified session completion (% of 36 prescribed sessions). The key clinical outcome was 12-week VO ₂ peak, analyzed via weighted ANCOVA. Results are reported as adjusted differences with 95% CIs.  Results: After weighting, covariates were well balanced (all SMDs <0.10). HBTCR showed significantly higher objectively verified session completion than CBCR (87.7% vs. 78.5%; overlap-weighted difference 9.1 percentage points, 95% CI: 4.4 to 13.7; P < 0.001). The adjusted HBTCR–CBCR difference in 12-week VO ₂ peak was small and not statistically significant (0.17 mL/kg/min, 95% CI: −0.50 to 0.84; P = 0.616). Both active rehabilitation groups showed substantially larger 12-week VO ₂ peak gains than usual care (adjusted differences >4.0 mL/kg/min).  Conclusion: Among post-CABG patients who chose HBTCR or CBCR in routine practice, those choosing HBTCR had higher objectively verified session completion and comparable observed 12-week improvement in VO ₂ peak. These findings support HBTCR as a feasible option for patients who prefer or require home-based rehabilitation because of work, travel, or scheduling constraints. Formal equivalence was not tested, and the clinical meaningfulness and cost-effectiveness of this delivery model warrant further evaluation.
SN  - 2297-055X
ER  -