Traditional versus hybrid outpatient cardiac rehabilitation: A comparison of patient outcomes

Purpose: Due to the sub-optimal uptake of cardiac rehabilitation (CR), alternative models have been proposed. This study compared the effectiveness of a traditional supervised program in a medical setting versus a hybrid CR model, where patients transition to unsupervised programming. Methods: This was a prospective, two-arm, non-randomized study. Health related quality of life (HRQoL), functional capacity, physical activity, diet, smoking, blood pressure, lipids, blood glucose, anthropometrics and depressive symptoms, were assessed before and after the eight week program models. Program adherence and completion was also recorded. Both models offered outpatient supervised exercise sessions, group health education classes and a resource manual. The hybrid model involved a blend of supervised and unsupervised, independent homebased exercise, and follow-up phone calls. Results: 125 cardiac patients consented to the study, of whom 72 (57.6%) and 52 chose the traditional and hybrid program, respectively. 110 (Traditional n=62, 86.1%; Hybrid n=48, 92.3%; p>.05) participants completed their program. Significant improvements were observed for both models over time in HRQoL (p<.001), physical activity (p<.001), and diet (p<.001). Significant reductions in smoking (p=.043), systolic blood pressure (p<.001), total cholesterol (p<.001), low-density lipoprotein (p<.001), waist circumference (p<.001) and depressive symptoms (p<.001) were also observed. There were no significant differences pre and post between models for any outcome. Conclusions: Hybrid CR was not significantly different compared to the traditional model in terms of HRQoL, functional capacity, heart-health behaviours and risk factors, with no differences in completion rates.