Implementation of home-based HIIT in adults with cardiac disease: a systematic review using the RE-AIM framework

High-intensity interval training (HIIT) is safe and more effective than moderate-intensity continuous training (MICT) for improving cardiorespiratory fitness in adults with cardiac disease. Healthcare settings are gradually adopting home-based delivery models of cardiac rehabilitation to improve uptake and participation of programs. The aim of this systematic review was to explore the implementation of home-based HIIT programs in adults with cardiac disease. A systematic search was conducted in three electronic databases. Studies were included if they compared home-based HIIT to other centre-based or home-based exercise interventions. Implementation was explored using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Data from 164 participants were included in the analysis. There were no differences in exercise capacity or quality of life (QoL) between home-based HIIT and other centre-based or home-based exercise interventions (<i>p</i> &gt; 0.05). Adherence to the home-based HIIT protocol varied between 36% and 100%. The rate of adverse events was 3%. Key components of the RE-AIM framework such as implementation costs, long term outcomes, and intervention satisfaction were inadequately reported. Home-based HIIT appears to be safe and equally effective as other cardiac rehabilitation exercise programs. A home-based HIIT program may be provisionally recommended for adults with stable cardiac disease.