Yang X; Department of Cardiology, Hebei Province, 056002, China.
Liang J; Li Y; Miao J; Xu Y; Li W

BMC Cardiovascular Disorders. 26(1), 2026 May 23.

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.