Noninferiority of Randomly Assigned Telehealth and Center-Based Regional Exercise-Based Cardiac Rehabilitation Programs When Delivered With High Fidelity.

In 30 seconds

This randomised noninferiority trial compared telehealth with center-based exercise-based cardiac rehabilitation in adults with coronary heart disease. Both programs prescribed aerobic exercise three days weekly for six weeks, with behavioral support. Telehealth was noninferior for change in cardiorespiratory fitness: the between-group 95% confidence interval was -1.6 to 1.3 mL·kg⁻¹·min⁻¹, within the prespecified noninferiority margin of 3.5 mL·kg⁻¹·min⁻¹. Exercise-session adherence and intensity were equivalent, while telehealth participants exercised longer than prescribed. Quality of life and vascular augmentation index showed time effects; sleep and heart-rate variability did not differ significantly.

Key findings

• Telehealth was noninferior to center-based rehabilitation for cardiorespiratory fitness (95% confidence interval, -1.6 to 1.3 mL·kg⁻¹·min⁻¹).
• Exercise sessions and intensity were equivalent between groups; telehealth participants exercised 40 ± 9 vs 30 ± 0 minute.
• Quality of life and vascular augmentation index showed time effects, while heart-rate variability and actigraphy-based sleep assessment did not.

Why it matters

The findings support telehealth as a potential way to deliver exercise-based cardiac rehabilitation to regional populations without compromising the measured fitness outcome, when exercise delivery and adherence are comparable. The study also highlights the role of activity monitoring and behavioral support in maintaining program fidelity. Its results concern a structured, six-week program and should be interpreted within that context.

What to keep in mind

The comparison covered a six-week program, so the abstract does not establish longer-term outcomes. The reported noninferiority applies to cardiorespiratory fitness under comparable program fidelity.