The impact of home-based telerehabilitation versus center-based cardiac rehabilitation on anxiety, depression, and quality of life after coronary artery bypass grafting: a randomized controlled trial

Anxiety, depression, and reduced quality of life are common after coronary artery bypass grafting (CABG), yet participation in traditional center-based cardiac rehabilitation (CBCR) is limited by access barriers. This study aims to compare the effectiveness of a home-based telerehabilitation (HBTCR) program with CBCR in improving psychological and quality-of-life outcomes for post-CABG patients. In this prospective randomized controlled trial, 110 clinically stable patients 4–8 weeks post-CABG were allocated to a 12-week HBTCR program (wearable monitoring, mobile app, weekly nurse support), CBCR (supervised center sessions), or usual care. Primary outcomes were changes in Hamilton Anxiety (HAMA) and Depression (HAMD-17) scores. The secondary outcome was change in health-related quality of life (SF-36). Both HBTCR and CBCR groups demonstrated significant and comparable improvements compared to usual care (mean HAMA change: -8.3 vs. -7.9 vs. -1.1, P < 0.001; HAMD-17: -9.5 vs. -9.1 vs. -1.5, P < 0.001). No significant difference was found between HBTCR and CBCR. Quality of life improved significantly across all SF-36 domains in both intervention groups versus control (P < 0.01). A structured home-based telerehabilitation program is as effective as traditional center-based rehabilitation in alleviating psychological distress and enhancing quality of life after CABG. HBTCR represents a vital, accessible alternative to deliver comprehensive cardiac rehabilitation and overcome participation barriers. This trial was retrospectively registered at ClinicalTrials.gov (identifier: NCT07232693, Registration date: 2025-11-14).