BACKGROUND: The impact of real-time remote cardiac rehabilitation (CR) on health and disability-related outcomes and its correlation with physical function are unknown. We compared the effectiveness of real-time remote CR with that of hospital-based CR on physical function improvement and physical functions of improvement (DELTA) to clarify the relationship between health and disability at baseline. METHODS: Patients with cardiovascular diseases (CVDs) were enrolled (n = 38) in this quasi-randomised controlled trial and underwent 4 weeks of hospital-based CR, followed by 12 weeks of remote or hospital-based CR based on quasi-randomised allocation. Patients were assessed at baseline and after 12 weeks of remote or hospital-based CR using the shortened version of the World Health Organization (WHO) Quality of Life scale (WHOQOL-BREF) for subjective satisfaction, WHO Disability Assessment Schedule (WHODAS2.0-J) for objective performance, and cardiopulmonary exercise test for physical function and peak oxygen uptake (peak VO2). The trends in measured variables from baseline to the post-CR stage were analysed. RESULTS: Sixteen patients (mean age 72.2 +/- 10.4 years) completed remote CR, and 15 patients (mean age 77.3 +/- 4.8 years) completed hospital-based CR. The post-CR physical function differed significantly between the groups (Deltapeak VO2, 2.8 +/- 3.0 versus 0.84 +/- 1.8 mL/min-1/kg-1; p < 0.05). The differences in post-CR changes in the WHOQOL-BREF scores between the groups were insignificant. The post-CR changes in the WHODAS2.0-J scores were significantly lower in the remote CR group than in the hospital-based CR group (DeltaWHODAS2.0-J score, -8.56 +/- 14.2 versus 2.14 +/- 7.6; p < 0.01). Forward multiple stepwise regression analysis using overall data showed that the intervention method (beta = 0.339, p < 0.05), baseline cognition (beta = -0.424, p < 0.05), and social interaction level (beta = 0.658, p < 0.01; WHODAS2.0-J) were significant independent contributors to DELTApeak VO2 (r2 = 0.48, F = 8.13, p < 0.01). CONCLUSIONS: Remote CR considerably improved physical function and objective performance in patients with CVDs. Remote CR can be used to effectively treat stable patients who cannot visit hospitals. TRIAL REGISTRATION: This interventional trial was registered at the UMIN-CTR registry (trial title Development of remote programme for cardiac rehabilitation using wearable electrocardiograph; trial ID UMIN000041746; trial URL https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046564; registration date 2020/09/09).

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