Effect of combined aerobic and resistance training versus aerobic training alone in individuals with coronary artery disease: a meta-analysis
Abstract
BACKGROUND: Resistance training (RT) has only a permissive role as an adjunct to aerobic training (AT) in cardiac rehabilitation. DESIGN AND METHODS: To compare the effect of AT with combined RT and AT (CT) we searched MEDLINE, Cochrane Controlled Trials Register, EMBASE, PreMedline, SPORT DISCUS, CINAHL (from the earliest date available to October 2009) for randomized controlled trials (RCTs), examining effects of CT versus AT on body composition, cardiovascular fitness (VO(2peak)), strength, and quality-of-life (QOL) in coronary artery disease (CAD) (excluding heart failure). Two reviewers selected studies independently. RESULTS: Twelve studies met the study criteria (229 AT patients, 275 CT patients). Compared with AT, CT decreased percent body fat by -2.3% (WMD (weighted mean difference); 95% CI: -3.59 to -1.02), decreased trunk fat (SMD (standardized mean difference): -0.56; 95% CI: -0.96 to -0.15) and increased fat-free mass by 0.9 kg (WMD; 95% CI: 0.39 to 1.36) in three studies (n = 106). Similarly CT was associated with larger increases in lower body strength (seven studies, n = 225, SMD: 0.77; 95% CI: 0.49 to 1.04) and upper body strength (eight studies, n = 262, SMD: 1.07; 95% CI: 0.76 to 1.38). Compared to AT, CT improved peak work capacity (three studies, n = 92, SMD: 0.88; 95% CI: 0.45 to 1.31) and there was a trend for CT to increase VO(2peak) by 0.41 ml/kg/min (nine studies, n = 399, WMD; 95% CI: -0.05 to 0.88). Qualitative analysis of QOL data favors CT. Study withdrawals were similar for AT (14.2% ± 13.2) and CT (11.5% ± 15.5). No serious adverse events were reported. CONCLUSIONS: CT is more effective than AT in improving body composition, strength, and some indicators of cardiovascular fitness, and does not compromise study completion or safety when compared to AT.
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The combination of aerobic exercises and resistance training is the most effective option compared with aerobic or resistance exercise alone for improving cardiorespiratory fitness, body composition, and muscle strength.
“the combination of aerobic exercises and RT appears as the most effective option--compared with aerobic or RT exercise alone--for improving CRF, body composition, and muscle strength.80,81”
From Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation (2023) · cites this paper as [80]
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- Authors
- Marzolini, S., Oh, P. I., & Brooks, D.
- Affiliations
- University of Toronto (CA)
- Toronto Rehabilitation Institute (CA)
- Corresponding author
- Marzolini, Susan
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-02-21
- Volume
- 19
- Issue
- 1
- Pages
- 81-94
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W2081661328
- Cited by
- 199
- References
- 40
- Citations by year
- 2026: 15 · 2025: 17 · 2024: 12 · 2023: 13 · 2022: 20 · 2021: 17 · 2020: 9 · 2019: 14 · 2018: 10 · 2017: 16 · 2016: 17 · 2015: 8 · 2014: 12 · 2013: 9 · 2012: 9
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Toronto Rehabilitation Institute
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- resistance training, aerobic exercise, concurrent training, coronary artery disease, cardiac rehabilitation, body composition, fat-free mass, fat mass, peak oxygen uptake, cardiorespiratory fitness, muscle strength, quality of life, dropout rates, adverse events, exercise adherence, exercise duration, exercise frequency, exercise dose-response
- MeSH terms
- Aged, Body Composition, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Physical Fitness, Quality of Life, Exercise, Randomized Controlled Trials as Topic, Treatment Outcome, Evidence-Based Medicine, Muscle Strength, Resistance Training
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