Table 1.
Information on included studies, risk of bias, and PEDro score
| Study | Sample (n) | Drop-outs | Population | Setting | Intervention design | Follow-up duration | Control | Main outcomes | PEDro scorea |
|---|---|---|---|---|---|---|---|---|---|
| Jolly et al15 | 525 | Home programme: 6-month data, n= 246 (11 DNA, three died, three withdrew). At 12 months, n= 239 (14 DNA, four withdrew). Hospital programme: 6-month data, n= 239 (18 DNA, two died, three withdrew). At 12 months, n= 236 (20 DNA, one died) |
After acute MI, coronary revascularisation or CABG | UK | HM for patients covering risk factor management. Telephone follow-up |
12 months | Hospital-based CR | Home-based CR comparable to hospital-based CR in CVD risk factor improvements at 12 months of follow-up. Similar costs in running each programme |
9 |
| Dalal et al16 | 230: 104 into randomised arm, and 126 to preference arm | 9-month follow-up data were available for 84/104 (81%) randomised, and 100/126 (79%) preference patients | Hospitalised for acute MI | UK | HM for 6 weeks. Cardiac rehab nurse made one home visit in first week after discharge, followed up by telephone calls over 6 weeks (typically one call in weeks 2, 3, 4, and 6) | 9 months | Hospital-based CR | Home-based CR (HM) as effective as hospital-based CR in improving modifiable CVD risk factors | 8 |
| Zutz et al19 | 15: seven for usual care, and eight for home-based intervention | Two drop-outs by the end of the study for the usual care group | On a waiting list for cardiac rehabilitation, living within 60 km of site | Canada | Internet-based intervention with education modules, email communication with case manager and, dietician optional online discussion group, and entry of health behaviour data to monitor self-progress | 12 weeks | No active treatment | The home-based CR programme group significantly improved modifiable CV risk factors compared to controls | 8 |
| Sinclair et al23 | 324: 163 in intervention and 161 in control groups | 134/163 (82%) in intervention group. 133/161 (82.6%) in the control group | Discharged from hospital with acute MI, and ≥65 years old | UK | At least two home visits from trained support staff nurse to encourage patients around compliance, risk factor reduction, advice on stress, exercise, smoking cessation, and diet. Visits supplemented by telephone support and manual | 100 days | Hospital-based cardiac rehabilitation | Significant improvement in confidence and self-esteem in the home-based group, although comparable improvements in CVD risk factors between home-based and centre-based CR | 8 |
| Lie et al24 | 203 | 93/101 (92%) in intervention group. 92/102 (90%) in control group |
Patients with ischaemic heart disease (post-CABG patients) | Norway | A psychoeducative intervention, consisting of structured information and psychological support. All patients in the intervention group received two 1 hour home visits at 2 and 4 weeks after surgery | 6 months | Standard discharge care that involved a non-standardised talk with the nurse/doctor | Home-based CR comparable to control group in terms of improving quality of life and activities of daily living | 8 |
| Wang et al14 | 160 | Intervention group: at 6 months, n= 68/80 (85%). Control group: at 6 months, n= 65/80 (81%) |
Patients who are post-MI | China | A home-based cardiac rehabilitation programme using a self-help manual, the HM, developed by the researchers. Patients had a 1-hour introduction to the manual, and telephone follow-up at 3 weeks | 6 months | Usual care, hospital- based cardiac rehabilitation | Home-based CR (HM) improves quality of life and reduces anxiety compared to usual care for patients who are post-MI | 8 |
| Lee et al17 | 81 | No data on drop-outs | Patients who are post-MI or with coronary revascularisation | UK | The home-based programme is nurse facilitated (with home visits and telephone contact), using the HM | 3 months | Hospital supervised exercise sessions twice weekly for 12 weeks | Home-and hospital-based CR showed comparable improvements in haemostatic indices and CVD risk factors | 9 |
| Piotrowicz et al20 | 152 | 75/77 (97%) for home-based intervention. 56/75 (75%) for the control |
Patients with heart failure | Poland | Home-based telemonitored rehabilitation based on continuous walking training on level ground. Patients wore an ECHO3 device which allowed remote ECG recording of the participant by the researchers | 8 weeks | Control group: standard interval training on a cycle ergometer. Both groups: trained three times a week. All patients and their partners participated in an education programme |
Home-based CR equally as effective centre-based CR for patients with heart failure, although better adherence in home-based group | 8 |
| Oerkild et al21 | 75 patients | 30/36 (83%) for home-based intervention. 34/39 87%) for the control |
Patients ≥65 years old with ischaemic heart disease | Denmark | For home-based, programme a physio visited twice within a 6-week interval to develop a training programme that could be performed at home and in the surrounding outdoor area. All patients received counselling and medical adjustment from a cardiologist at baseline and after 3, 6, and 12 months | 12 months | The centre-based CR consisted of a 6 week group-based supervised exercise training for 60 minutes, twice a week, and patients were also encouraged to exercise at home | Home-based CR as effective as centre-based CR in improving exercise capacity, CVD risk factors, and health-related quality of life | 8 |
| Varnfield et al18 | 120 patients | For intervention, n= 46/60 (77%). For control, n= 26/60 (43%) |
Patients who are post-MI | Australia | CR delivered at home: health and exercise monitoring, motivational and educational materials. Weekly mentoring consultations for 6 weeks, via telephone (approx. 15 mins each) |
6 months | Traditional hospital-based CR (TCR)-two supervised exercise and 1hour educational sessions weekly for 6 weeks at one of four community centres | Home-based CR had better uptake, adherence and completion rates than centre-based CR. Comparable improvements in CVD risk factors in both groups |
8 |
| Oerkild et al22 | 40 patients | 19/19 (100%) for the home-based intervention. 17/21 (81%) for the control |
≥65 years with coronary heart disease | Denmark | Physiotherapist in home visits developed individualised exercise programme for home and surrounding outdoor area. Risk factor intervention, medical, physical, and psychological adjustments at baseline, 3, 6, and 12 months | 12 months of follow-up, and mortality data after 5.5 years | Usual care with no rehabilitation for those who declined participation in centre-based CR | Home-based CR programme group significantly improved 6MWT performance at 3 months compared to controls | 8 |
a
PEDrO score maximum = 11. CABG = coronary artery bypass graft. CVD = cardiovascular disease. CR = cardiac rehabilitation. DNA = did not attend. ECG = electrocardiogram. HM = Heart Manual. MI = myocardial infarction. PEDro = Physiotherapy Evidence Database. 6MWT = 6-minute walk test.