Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 4;6(3):508-518.
doi: 10.1093/ehjdh/ztaf014. eCollection 2025 May.

Feasibility, safety and patient perceptions of exercise-based cardiac telerehabilitation in a multicentre real-world setting after myocardial infarction-the remote exercise SWEDEHEART study

Maria Bäck  1   2   3 , Margret Leosdottir  4   5 , Mattias Ekström  6 , Kristina Hambraeus  7 , Annica Ravn-Fischer  2 , Sabina Borg  3 , Madeleine Brosved  1 , Marcus Flink  8 , Kajsa Hedin  9 , Charlotta Lans  10   11 , Jessica Olovsson  12   13 , Charlotte Urell  14 , Birgitta Öberg  3 , Stefan James  15   16
Affiliations

Feasibility, safety and patient perceptions of exercise-based cardiac telerehabilitation in a multicentre real-world setting after myocardial infarction-the remote exercise SWEDEHEART study

Maria Bäck et al. Eur Heart J Digit Health. .

Abstract

Aims: Cardiac telerehabilitation addresses common barriers for attendance at exercise-based cardiac rehabilitation (EBCR). Pragmatic real-world studies are however lacking, limiting generalizability of available evidence. We aimed to evaluate feasibility, safety, and patient perceptions of remotely delivered EBCR in a multicentre clinical practice setting after myocardial infarction (MI).

Methods and results: This study included 232 post-MI patients (63.7 years, 77.5% men) from 23 cardiac rehabilitation centres in Sweden (2020-22). Exercise was delivered twice per week for 3 months through a real-time group-based video meeting connecting a physiotherapist to patients exercising at home. Outcomes were assessed before and after remote EBCR completion and comprised assessment of physical fitness, self-reported physical activity and exercise, physical capacity, kinesiophobia, health-related quality of life (HRQoL), self-efficacy for exercise, exercise adherence, patient acceptance. Safety monitoring in terms of adverse events (AE) and serious adverse events (SAE) was recorded. A total of 67.2% of the patients attended ≥ 75% of prescribed exercise sessions. Significant improvements in physical fitness, self-reported exercise, physical capacity, kinesiophobia, and HRQoL were observed. Patients agreed that remote EBCR improved health care access (83%), was easy to use (94%) and found exercise performance and interaction acceptable (95%). Sixteen exercise-related AEs (most commonly dizziness and musculoskeletal symptoms) were registered, all of which were resolved. Two SAEs requiring hospitalization were reported, both unrelated to exercise.

Conclusion: This multicentre study supports remote EBCR post-MI as feasible and safe with a high patient acceptance in a real-world setting. The clinical effectiveness needs to be confirmed in a randomized controlled trial.

Trial registration number: NCT04260958.

Keywords: Cardiac rehabilitation; Coronary artery disease; Exercise; Secondary prevention; Telerehabilitation; eHealth.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: none declared.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
PRISMA flow diagram of the screening process.
Figure 2
Figure 2
Patient perceptions of remote exercise-based cardiac rehabilitation.
See this image and copyright information in PMC

References

    1. Sidney S, Quesenberry CP, Jaffe J, Sorel MG, Nguyen-Huynh M, Kushi MN, et al. Recent trends in cardiovascular mortality in the United States and public health goals. JAMA Cardiol 2016;1:594–599. - PubMed
    1. Fox KAA, Carruthers KF, Dunbar DR, Graham C, Manning JR, De Raedt H, et al. Underestimated and under-recognized: the late consequences of acute coronary syndrome (GRACE UK–Belgian study). Eur Heart J 2010;31:2755–2764. - PubMed
    1. Kotseva K, De Backer G, De Bacquer D, Ryden L, Hoes A, Grobbee D, et al. Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry. Eur J Prev Cardiol 2019;26:824–835. - PubMed
    1. Ambrosetti M, Abreu A, Corra U, Davos CH, Hansen D, Frederix I, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: from knowledge to implementation. 2020 update. A position paper from the secondary prevention and rehabilitation section of the European association of preventive cardiology. Eur J Prev Cardiol 2021;28:460–495. - PubMed
    1. Dibben G, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler AD, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2021;11:CD001800. - PMC - PubMed

Associated data

LinkOut - more resources