Comparison of mHealth-supported and centre-based cardiac rehabilitation in patients with stable coronary heart disease: a randomized controlled trial

BACKGROUND: High-intensity interval training (HIIT) is an effective exercise modality in cardiac rehabilitation; however, participation in conventional centre-based programs remains suboptimal due to barriers such as limited accessibility and adherence. Mobile health (mHealth) technologies may improve accessibility and supervision of exercise training. While previous studies have primarily focused on training modality, evidence comparing different delivery models of HIIT-based cardiac rehabilitation remains limited. This study aimed to compare the effectiveness and safety of mHealth-supported versus centre-based delivery of a standardized HIIT cardiac rehabilitation program in patients with stable coronary heart disease (CHD). METHODS: Between December 2024 and April 2025, 98 adults with stable CHD eligible for Phase II cardiac rehabilitation were enrolled and randomly assigned to either the control group (n = 49) or the intervention group (n = 49). Both groups performed the same standardized HIIT protocol; the control group received supervised centre-based rehabilitation, whereas the intervention group performed mHealth-supported home-based training with real-time monitoring and individualized feedback via the Xin'ankang mHealth platform. Primary outcomes included the six-minute walk distance (6MWD), cardiopulmonary exercise testing (CPET) parameters, and SF-36 quality of life scores. Secondary outcomes included anxiety, depression, and sleep quality. RESULTS: Baseline characteristics were generally comparable between groups, although minor differences were observed in certain SF-36 domains. After adjustment for baseline values, the intervention group demonstrated significant improvements compared to the control group in sleep quality scores (3.17 ± 2.09 vs. 4.83 ± 2.09), peak METs (5.83 ± 0.09 vs. 4.94 ± 0.09), anaerobic threshold METs (4.29 ± 0.07 vs. 3.53 ± 0.07), peak VO₂ (20.12 ± 0.30 vs. 16.70 ± 0.30 ml/kg/min), and 6MWD (563.83 ± 3.21 vs. 531.49 ± 3.21 m) (all P < 0.05). Improvements in SF-36 scores were observed in several domains, although no significant difference was found in vitality or mental health. Subgroup analyses revealed consistent improvements across age groups, while a sex-specific difference was observed for changes in VO₂ peak. CONCLUSION: Compared with centre-based delivery of the same HIIT program, mHealth-supported HIIT was associated with greater improvements in cardiopulmonary function, exercise capacity, and quality of life in patients with CHD. These findings suggest that delivery modality may influence the effectiveness of HIIT-based cardiac rehabilitation. TRIAL REGISTRATION: Clinical Trial Registration Number: ChiCTR2500104462, June 17, 2025.