Effectiveness, safety and adherence of home-based exercise rehabilitation in patients with coronary heart disease patients: A systematic review

Exercise rehabilitation is important in the home-based rehabilitation of coronary heart disease. However, a comprehensive model to assess the effectiveness, safety, and adherence of home exercise rehabilitation has not yet been established. This study aimed to synthesize and evaluate the evidence on the effectiveness, safety, and adherence of home-based exercise rehabilitation for patients with coronary heart disease. English and Chinese databases were retrieved from the inception of the database to March 1 in 2024 for HBCR and exercise. A total of 26 studies met the inclusion criteria. The main indicators to assess the effectiveness of exercise rehabilitation include: peak oxygen uptake, metabolic equivalents, 6-min walk test distance, and quality of life. The main indicators to assess the safety of exercise rehabilitation include: re-hospitalization rate, and mortality. Aerobic exercise can increase peak oxygen uptake with better safety. The main indicators for assessing adherence include the number and duration of adherent training sessions and the percentage of training completed. A comprehensive model to assess the effectiveness, safety, and adherence of home exercise rehabilitation has been established based on these indicators. Furthermore, enhancing the effectiveness necessitates high-intensity aerobic exercise. The key element ensuring the safety is the development of precise and personalized exercise prescriptions. An important trend in enhancing adherence is the integrated application of intelligent wearable technology. In the future, the home-based exercise rehabilitation will evolve towards individual precision, greater safety, and higher effectiveness.