{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:34:05Z","timestamp":1787960045869,"version":"build-2784847793"},"reference-count":60,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,8,20]]},"abstract":"\n Background<\/jats:title>\n \n Center\u2010based cardiac rehabilitation (\n CBCR<\/jats:styled-content>\n ) has been shown to improve outcomes in patients with heart failure (\n HF<\/jats:styled-content>\n ). Home\u2010based cardiac rehabilitation (\n HBCR<\/jats:styled-content>\n ) can be an alternative to increase access for patients who cannot participate in\n CBCR<\/jats:styled-content>\n . Hybrid cardiac rehabilitation (\n CR<\/jats:styled-content>\n ) combines short\u2010term\n CBCR<\/jats:styled-content>\n with\n HBCR,<\/jats:styled-content>\n potentially allowing both flexibility and rigor. However, recent data comparing these initiatives have not been synthesized.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We performed a meta\u2010analysis to compare functional capacity and health\u2010related quality of life (hr\u2010\n QOL<\/jats:styled-content>\n ) outcomes in HF for (1)\n HBCR<\/jats:styled-content>\n and usual care, (2) hybrid\n CR<\/jats:styled-content>\n and usual care, and (3)\n HBCR<\/jats:styled-content>\n and\n CBCR<\/jats:styled-content>\n . A systematic search in 5 standard databases for randomized controlled trials was performed through January 31, 2019. Summary estimates were pooled using fixed\u2010 or random\u2010effects (when I\n 2<\/jats:sup>\n >50%) meta\u2010analyses. Standardized mean differences (95%\n CI<\/jats:styled-content>\n ) were used for distinct hr\u2010\n QOL<\/jats:styled-content>\n tools. We identified 31 randomized controlled trials with a total of 1791\n HF<\/jats:styled-content>\n participants. Among 18 studies that compared\n HBCR<\/jats:styled-content>\n and usual care, participants in\n HBCR<\/jats:styled-content>\n had improvement of peak oxygen uptake (2.39\u00a0mL\/kg per minute; 95%\n CI<\/jats:styled-content>\n , 0.28\u20134.49) and hr\u2010\n QOL<\/jats:styled-content>\n (16 studies; standardized mean difference: 0.38; 95%\n CI<\/jats:styled-content>\n , 0.19\u20130.57). Nine\n RCT<\/jats:styled-content>\n s that compared hybrid\n CR<\/jats:styled-content>\n with usual care showed that hybrid\n CR<\/jats:styled-content>\n had greater improvements in peak oxygen uptake (9.72\u00a0mL\/kg per minute; 95%\n CI<\/jats:styled-content>\n , 5.12\u201314.33) but not in hr\u2010\n QOL<\/jats:styled-content>\n (2 studies; standardized mean difference: 0.67; 95%\n CI<\/jats:styled-content>\n , \u22120.20 to 1.54). Five studies comparing\n HBCR<\/jats:styled-content>\n with\n CBCR<\/jats:styled-content>\n showed similar improvements in functional capacity (0.0\u00a0mL\/kg per minute; 95%\n CI,<\/jats:styled-content>\n \u22121.93 to 1.92) and hr\u2010\n QOL<\/jats:styled-content>\n (4 studies; standardized mean difference: 0.11; 95%\n CI<\/jats:styled-content>\n , \u22120.12 to 0.34).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n HBCR<\/jats:styled-content>\n and hybrid\n CR<\/jats:styled-content>\n significantly improved functional capacity, but only\n HBCR<\/jats:styled-content>\n improved hr\u2010\n QOL<\/jats:styled-content>\n over usual care. However, both are potential alternatives for patients who are not suitable for\n CBCR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.119.012779","type":"journal-article","created":{"date-parts":[[2019,8,17]],"date-time":"2019-08-17T09:08:06Z","timestamp":1566032886000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":112,"title":["Home\u2010Based Cardiac Rehabilitation Alone and Hybrid With Center\u2010Based Cardiac Rehabilitation in Heart Failure: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"8","author":[{"given":"Hafiz M.","family":"Imran","sequence":"first","affiliation":[{"name":"Providence Veterans Affairs Medical Center Providence RI"},{"name":"Center for Cardiac Fitness The Miriam Hospital Providence RI"},{"name":"Alpert Medical School Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Baig","sequence":"additional","affiliation":[{"name":"The Miriam Hospital Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebhat","family":"Erqou","sequence":"additional","affiliation":[{"name":"Providence Veterans Affairs Medical Center Providence RI"},{"name":"Alpert Medical School Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey H.","family":"Taveira","sequence":"additional","affiliation":[{"name":"Providence Veterans Affairs Medical Center Providence RI"},{"name":"University of Rhode Island College of Pharmacy Kingston RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishant R.","family":"Shah","sequence":"additional","affiliation":[{"name":"Providence Veterans Affairs Medical Center Providence RI"},{"name":"Alpert Medical School Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Morrison","sequence":"additional","affiliation":[{"name":"Providence Veterans Affairs Medical Center Providence RI"},{"name":"Alpert Medical School Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Providence Veterans Affairs Medical Center Providence RI"},{"name":"Alpert Medical School Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Chih","family":"Wu","sequence":"additional","affiliation":[{"name":"Providence Veterans Affairs Medical Center Providence RI"},{"name":"Center for Cardiac Fitness The Miriam Hospital Providence RI"},{"name":"Alpert Medical School Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7441.711-b"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2003.11.033"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.05.070"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.04.203"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.4081\/monaldi.2015.732"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcnurse.2006.02.002"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmm021"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.03.008"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0004-9514(08)70041-2"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.06.207"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJR.0b013e32832e097f"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-10-31"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.94.07112016"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)90582-W"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00531-3"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02602348"},{"key":"e_1_3_3_19_2","first-page":"273","article-title":"Quality of life in patients with advanced heart failure","volume":"11","author":"Dracup K","year":"1992","unstructured":"Dracup K, Walden JA, Stevenson LW, Brecht ML. 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