Journal of Cardiac and Pulmonary Rehabilitation
Open Access

Tele-rehabilitation; Cardiac rehabilitation; Post-cardiac surgery; Functional recovery; Remote monitoring; Exercise adherence; Patient satisfaction; Quality of life; Randomized controlled trial; Healthcare accessibility

Introduction

Cardiac surgery, including coronary artery bypass grafting (CABG) and valve repair or replacement, significantly improves survival and symptoms in patients with advanced cardiovascular disease. However, optimal recovery requires structured cardiac rehabilitation, traditionally delivered through center-based programs [1-5]. Despite their proven efficacy, these programs face low participation rates due to logistical barriers, travel difficulties, and limited availability, especially in rural or underserved areas. As healthcare systems increasingly adopt digital solutions, tele-rehabilitation has emerged as a promising alternative to in-person rehabilitation. Tele-rehabilitation utilizes remote communication technologies to deliver exercise guidance, patient education, and monitoring, thereby overcoming many accessibility challenges. This study aimed to evaluate the efficacy of tele-rehabilitation in improving functional outcomes, quality of life, and adherence among post-cardiac surgery patients, compared to conventional center-based cardiac rehabilitation [6-10].

Discussion

The findings of this randomized controlled trial highlight the comparable effectiveness of tele-rehabilitation to traditional in-person cardiac rehabilitation in enhancing physical recovery and patient-reported outcomes after cardiac surgery. Participants in the tele-rehabilitation group demonstrated significant improvements in six-minute walk distance (6MWD), reduced fatigue scores, and enhanced health-related quality of life (HRQoL), similar to those in the center-based group. One notable advantage of tele-rehabilitation was a higher rate of program completion and exercise adherence, likely attributable to its flexibility and convenience. Participants reported fewer logistical barriers and expressed satisfaction with the accessibility and personalized nature of the virtual sessions. The integration of wearable monitoring devices and video consultations allowed clinicians to adjust exercise intensity and provide real-time feedback, ensuring both safety and individualized care. However, some limitations were observed. Internet literacy and technical issues occasionally interfered with participation, especially among older adults. Furthermore, psychological and social support components, more organically present in group settings, were less prominent in the remote model. Future models of tele-rehabilitation may benefit from hybrid approaches, integrating occasional in-person interactions or group video sessions to foster community support. From a health systems perspective, tele-rehabilitation presents an opportunity for cost-effective, scalable, and equitable rehabilitation delivery. As telehealth platforms continue to evolve, further research should explore their long-term impact on hospital readmissions, cardiovascular risk factor modification, and survival outcomes in post-cardiac surgery populations.

Conclusion

Tele-rehabilitation offers a viable and effective alternative to traditional cardiac rehabilitation for patients recovering from cardiac surgery. This study confirms that virtual rehabilitation programs can achieve comparable improvements in physical function, quality of life, and program adherence, while also addressing longstanding barriers to access. These findings support the integration of tele-rehabilitation into routine post-operative care, particularly in geographically dispersed or mobility-limited populations. Nonetheless, implementation should consider patient preferences, digital literacy, and infrastructure to maximize its impact. As healthcare delivery continues to shift toward digital models, tele-rehabilitation stands as a critical component in the continuum of cardiac care, aligning with modern demands for accessibility, personalization, and value-based outcomes.