X-CircuiT and conventional exercise in home-based cardiac rehabilitation for patients with coronary artery disease and risk factors: a randomized controlled non-inferiority trial

This study evaluated the effectiveness of Xiangya Hospital Circuit Training (X-CircuiT), a multi-component exercise program, as an alternative to conventional exercise (ConEx) in improving cardiorespiratory and muscular fitness within home-based cardiac rehabilitation (HBCR) for patients with coronary artery disease and risk factors (CADRF). This randomized controlled non-inferiority trial consecutively enrolled patients with CADRF at Xiangya Hospital, China, between April and December 2020. Patients were assigned to a smartphone-guided X-CircuiT-HBCR or telephone call-guided ConEx-HBCR group for 12 weeks. Primary outcomes were cardiorespiratory fitness (peak oxygen uptake, V̇O₂peak), and muscular fitness (30-sec arm curl and chair stand tests). The non-inferiority margins were 2.17 mL/kg/min, 2.70 reps, and 1.23 reps, respectively. Secondary outcomes included V̇O₂ pulse, V̇O₂ at ventilatory threshold, balance, flexibility, body mass index, health-related quality of life (HRQoL), self-efficacy, physical activity, safety, and exercise adherence. This trial included 54 participants (median age 53 yr, 37% females), with 27 per group. Both groups showed significant improvements in fitness. There were no significant differences between groups in the improvements in V̇O₂peak (mean difference, −0.13 [95%CI, −1.76 to 1.50] mL/kg/min), arm curl test (0.21 [−1.35 to 1.77] reps), and chair stand test (1.30 [−0.18 to 2.77] reps), with 95% CIs within the non-inferiority range. No significant differences were found in HRQoL, self-efficacy, and exercise adherence (all <i>p</i> &gt; .05). No adverse events occurred. X-CircuiT is non-inferior to ConEx in HBCR for CADRF patients, suggesting it as an effective alternative or supplement in HBCR programs. ChiCTR2000032451 Xiangya Hospital Circuit Training (X-CircuiT), a smartphone-guided multi-component exercise program, is an effective alternative or supplement to conventional exercise programs in home-based cardiac rehabilitation for patients with coronary artery disease and risk factors.Introducing the X-CircuiT program into home-based cardiac rehabilitation represents an innovative approach in personalized cardiac care, potentially enhancing patient outcomes.This research supports the integration of multi-component exercise programs like X-CircuiT, offering practical solutions for the growing population of cardiac patients requiring rehabilitation. Xiangya Hospital Circuit Training (X-CircuiT), a smartphone-guided multi-component exercise program, is an effective alternative or supplement to conventional exercise programs in home-based cardiac rehabilitation for patients with coronary artery disease and risk factors. Introducing the X-CircuiT program into home-based cardiac rehabilitation represents an innovative approach in personalized cardiac care, potentially enhancing patient outcomes. This research supports the integration of multi-component exercise programs like X-CircuiT, offering practical solutions for the growing population of cardiac patients requiring rehabilitation.