Sports Medicine - Open · Aug 3, 2026

Effect of Combined Aerobic and Resistance Training on Exercise Capacity, Muscle Strength, Quality of Life, and Mortality in Patients with Coronary Heart Disease: A Systematic Review with Meta-analysis

By Gois CO, Guimarães ALA, Conceição LSR et al.

BACKGROUND: CART (combined aerobic and resistance training) has shown important results in exercise-based cardiovascular rehabilitation. However, there are little data concerning the effects of CART on the exercise capacity, muscle strength, health-related quality of life (HRQoL), and mortality of coronary heart disease (CHD) patients. Therefore, the aim of this study was to analyze the published randomized controlled trials (RCTs) that investigated the effects of CART on exercise capacity [peak oxygen consumption (peak VO₂) and 6-min walking distance (6MWD)], muscle strength [1-repetition maximum (1-RM), peak torque and handgrip strength], HRQoL, and mortality in patients with CHD. METHODS: We search for references in MEDLINE/PubMed, Scopus, Cochrane Central Register of Controlled Trials, and EMBASE databases to find RCTs that evaluated the effects of CART for CHD. Mean difference (MD), standardized mean difference (SMD), risk ratio (RR), and 95% confidence intervals (CIs) were calculated. RESULTS: CART improved relative peak VO₂ of 2.20 ml/kg/min (P < 0.0001), peak torque of 16.69 N.m (P < 0.0001), handgrip strength of 4.68 kgf (P < 0.0001), and HRQoL of 1.00 (P < 0.00001) and reduced mortality (RR = 0.40; P = 0.002) compared to non-exercising usual care. CART improved (relative and absolute) peak VO₂ by 0.28 (P < 0.002), 6MWD by 21.98 m (P = 0.004), 1-RM by 0.61 kg (P < 0.0001), peak torque by 4.03 N.m (P = 0.002), and HRQoL by 0.50 (P < 0.0004) compared to aerobic training. CART improved relative peak VO₂ by 1.91 ml/kg/min (P < 0.00001) compared to resistance training. CONCLUSION: CART was efficient in improving peak VO₂, peak torque, handgrip strength, HRQoL, and lower mortality events compared to non-exercising usual care in patients with CHD. CART appears superior to aerobic training in improving peak VO₂, 6MWD, 1-RM, peak torque, and HRQoL in patients with CHD. Furthermore, CART was more effective than resistance training for peak VO₂ in patients with CHD. CART should be considered as a method in the rehabilitation of patients with CHD.

doi.org/10.1186/s40798-026-01080-3Open accessPubMed 42543470Interventions