Quality-of-life and functional outcomes in virtual vs traditional cardiac rehabilitation: A retrospective cohort study

Virtual cardiac rehabilitation (VCR) offers a potential strategy to expand access to cardiac rehabilitation and address participation barriers, including transportation, work obligations, and limited program availability. This retrospective cohort study compared quality-of-life, functional capacity, and other clinical outcomes between patients enrolled in VCR and traditional cardiac rehabilitation (TCR) at a single academic center between June 2022 and August 2024. Outcomes of interest included changes in Dartmouth COOP quality-of-life scores, metabolic equivalents (METs), Patient Health Questionnaire-9 (PHQ-9), Rate Your Plate dietary scores, body mass index (BMI), and systolic and diastolic blood pressure. A total of 171 patients (40 VCR, 131 TCR) were included. VCR participants demonstrated greater improvement in Dartmouth COOP scores (-5.13 ± 4.65vs -3.20 ± 4.34; <i>p</i> < 0.05), whereas TCR participants had comparable improvements in METs (1.93 ± 1.19 vs 0.92 ± 0.85; <i>p</i> = 0.11). No significant differences were observed in PHQ-9, Rate Your Plate scores, BMI, or blood pressure. In exploratory subgroup analyses, female participants in VCR had greater quality-of-life improvement (-6.18 ± 4.85 vs -2.86 ± 3.85; <i>p</i> < 0.05), while TCR participants had greater MET improvement among those with ≥5 mmHg diastolic blood pressure reduction. VCR was associated with quality-of-life improvements comparable to TCR and may offer potential benefits for women, while TCR produced larger functional capacity gains in subgroup analyses. These findings are hypothesis-generating, reflect a single-center predominantly homogenous population, and require confirmation in prospective, randomized studies.