Abstract
Relevance. Myocardial infarction is accompanied by long-term functional, clinical, and psycho-emotional consequences, whereas insufficient accessibility of traditional centre-based cardiac rehabilitation programmes determines the need for evidence-based home-based, hybrid, and telerehabilitation models capable of supporting safe physical activity, self-management, and secondary prevention in the long-term rehabilitation period.
Aim. To summarise the current evidence base on home-based cardiac rehabilitation after myocardial infarction and determine its effectiveness, safety, and prospects for use in the long-term rehabilitation period.
Materials and methods. The study was prepared as an analytical narrative review with elements of a systematised search. Systematic reviews, meta-analyses, randomised controlled trials, cohort studies, scientific statements of professional societies, and clinical guidelines on exercise-based cardiac rehabilitation, home-based cardiac rehabilitation, cardiac telerehabilitation, mobile health technologies (mHealth), the maintenance phase, adherence to home-based physical exercises, kinesiophobia, psychological distress, and long-term self-management in patients after myocardial infarction were analysed.
Results. Current evidences indicate that home-based cardiac rehabilitation can achieve outcomes comparable to those of centre-based cardiac rehabilitation programmes in clinically stable patients at low or moderate risk following myocardial infarction. The safety of the home-based model depends on appropriate patient selection, risk stratification, individualised exercise prescription, self-management training, regular professional feedback, and symptom-response algorithms – that is, structured rules for stopping or modifying physical exercise, contacting a specialist, or seeking emergency care when clinical signs of exercise intolerance appear. Telerehabilitation and mobile digital health technologies can improve accessibility, support self-management, and facilitate the monitoring of symptoms and physical activity. However, they should complement rather than replace a clinically structured cardiac rehabilitation programme. The greatest gap remains the long-term rehabilitation period, in which the maintenance of movement behaviour, adherence, psychological adaptation, overcoming kinesiophobia, self-efficacy, and social support become decisive.
Conclusions. Home-based cardiac rehabilitation after myocardial infarction is a promising secondary prevention model for selected clinically stable patients, but its long-term effectiveness requires structured professional supervision, risk stratification, psychological-behavioural support, telerehabilitation or analogue self-management tools, and standardised assessment of functional, clinical, and behavioural outcomes.