Hybrid versus traditional cardiac rehabilitation models: A systematic review and meta-analysis.

BACKGROUND: The common drawbacks of standard cardiac rehabilitation (CR) models include low participation rate, high cost, and dependence on the on-site exercise sessions. Therefore, hybrid CR protocols have been developed.

AIM: In this study, we aimed to test whether hybrid CR models are superior or equivalent to the traditional CR models in patients after myocardial infarction, heart failure, and cardiac surgery using a meta-analysis framework.

METHODS: We searched Medline, Scopus, Cochrane Central, and Web of Science for relevant original studies. Data were extracted from these studies and analyzed using the RevMan software (version 5.3 for windows). The standardized mean difference (SMD) was used as a summary effect estimate, along with 95% confidence interval (CI).

RESULTS: Based on data from 1195 patients, the summary effect size showed similar functional capacity improvement in hybrid and standard CR programs (SMD=-0.04, 95% CI [-0.18, 0.09], p=0.51). No significant difference was detected between the two models in terms of exercise duration (SMD=-0.14, 95% CI [-0.51, 0.24], p=0.47), systolic (SMD=-0.01, 95% CI [-0.14, 0.12], p=0.91) and diastolic (SMD=-0.03, 95% CI [-0.16, 0.11], p=0.7) blood pressure changes, and health-related quality of life (SMD=-0.08, CI [-0.23, 0.07], p=0.27). In terms of blood lipids, no significant difference was noted between hybrid and traditional CR models in all assessed lipid profile parameters, except for triglycerides (favoring the traditional CR model).

CONCLUSION: Hybrid CR protocols showed comparable efficacy to the traditional model. Further well-designed studies are required to establish these findings, especially on the long-term outcomes.