The Accessibility and Effect of Cardiac Rehabilitation in COVID-19 Pandemic Era

Objective: To prospectively compare the efficacy of conventional center-based cardiac rehabilitation (CBCR) and home-based cardiac rehabilitation (HBCR) during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Ninety Patients were divided into HBCR and CBCR groups based on cardiovascular risk stratification and individual preference. The CBCR group performed supervised in-hospital exercise training 2-3 times/week and subsequent self-exercise at home. The HBCR group performed self-exercise at home after one or two sessions of exercise education. The cardiopulmonary exercise test results at baseline and those at the 3-, 6-, and 12-month follow-ups were analyzed as primary outcome.

Results: The peak oxygen consumption (peak VO2, mL/kg/min) in the CBCR group was 20.1 and 24.0 at baseline and 12 months, respectively, showing significant improvement (p=0.006). In the HBCR group, it only increased from 24.4 to 25.5, showing suboptimal improvement. A significant increase in the Korean activity scale/index was confirmed only in the CBCR group (p=0.04). The cardiovascular outcome did not differ between the two groups, nor did the dropout rate or demographic factors.

Conclusion: During the COVID-19 pandemic, only CBCR was associated with a significant improvement in peak VO2 and physical activity levels, a finding that differs from those of other studies and seems to be affected by COVID-19. Therefore, in situations where the importance of HBCR is emphasized, it is essential to introduce measures to monitor and enhance exercise adherence among participants.