# Home-Based Exercise Cardiac Telerehabilitation on Adherence and Functional Capacity for Patients After Percutaneous Coronary Intervention in Indonesia: Protocol for a Quasi-Experimental Study

## TL;DR

This study tests a home-based cardiac telerehabilitation program in Indonesia to improve patient adherence and physical function after heart procedures.

## Contribution

The study introduces a telerehabilitation model using a smartwatch and app to monitor home-based cardiac rehabilitation in post-PCI patients.

## Key findings

- HBECTR is expected to improve adherence to cardiac rehabilitation in low- and middle-income countries.
- The program integrates remote monitoring to ensure safety and track patient progress during home exercises.
- Preliminary data analysis will assess the feasibility and functional outcomes of the intervention.

## Abstract

Home-based cardiac rehabilitation is a promising approach to improve access and adherence to cardiac rehabilitation (CR), which remains underutilized. However, monitoring patient adherence and safety during home-based exercise is challenging. Therefore, we develop and implement a home-based exercise cardiac telerehabilitation (HBECTR) program, integrating structured exercise guidance with remote monitoring.

This trial is designed as a pilot feasibility study to evaluate the practicality, safety, and preliminary effects of HBECTR in patients who have undergone percutaneous coronary intervention (PCI). The primary objective is to analyze the effect of HBECTR on patients’ adherence to CR, while the secondary objective is to measure the effect of HBECTR on the functional capacity of patients after PCI.

This study is a quasi-experimental nonequivalent control group pretest-posttest. The eligible participants are adults (≥18 y), patients with coronary artery disease after successful PCI, and patients having active health insurance. Patients will be consecutively recruited from Dr. Sardjito General Hospital, Yogyakarta, Indonesia, with a minimum of 60 patients after PCI as samples, divided into 2 groups: an intervention group and a comparison or control group. The intervention group will receive hybrid cardiac rehabilitation. Patients will be scheduled to do exercise twice a week at the hospital and 3 times a week at their home. When patients exercise at home, they will have to wear the smartwatch “CovWatch,” which will be connected to the web-based app (App Rehab Cardio) to monitor their vital signs and the distance of walking. The control group will get usual care (center-based cardiac rehabilitation). The data will be analyzed using the Student t test to see if the data comply with the normality assumption. This protocol received approval from the institutional review board of the Faculty of Medicine, Public Health, and Nursing UGM (approval number: KE/FK/0850/EC/2024).

The recruitment of the patients started in August 2024. This study is being funded since February 2025. During the submission, we have recruited 63 patients in both intervention and control groups. The intervention for both groups was finished in June 2025, and the data are being analyzed.

It is expected that the HBECTR program will be feasible and safely implemented in low- and middle-income countries, particularly in Indonesia. By integrating a telerehabilitation model, it is expected that HBECTR will improve patients’ adherence to CR and also increase the functional capacity of patients after PCI.