Abstract
Adapted physical activity (PA) programs benefit patients with non‑communicable diseases, but access barriers limit reach. Hybrid programs mixing in‑person and telehealth sessions may overcome these constraints. The purpose of this study was to evaluate the acceptability and effectiveness of a 3‑month hybrid APA program compared with usual face‑to‑face care and to examine whether benefits persist up to 36 months. Twenty patients with chronic diseases completed an APA program that began onsite and transitioned to videoconference plus home exercises. A historical cohort of 100 patients who received the standard onsite program and matched baseline characteristics served as controls. Changes in self-reported PA, physical capacities, and body composition of patients from both programs were measured at baseline and 3, 6, 12, 4, 36 months and analyzed using random-effect models. Adherence and satisfaction were also evaluated. Participants in the hybrid program showed high adherence and acceptability to the program, significant improvements in cardiorespiratory capacity, and reported increased PA levels. Overall effect sizes between the two groups were small. Importantly, the effects of both programs on these variables persisted 3 months after the end of the program with meaningful effect sizes and up to 33 months after the end of the program for 6 MWT. However, dropout rates during follow-up were high. Despite high acceptability and adherence for most patients of the hybrid group, some patients demonstrated lower participation. In conclusion, a hybrid program including telehealth was feasible, well‑accepted, and produced durable, clinically meaningful gains in cardiorespiratory fitness, and physical activity that matched conventional rehabilitation. Larger randomized trials are warranted to confirm these findings.